Trevor Cooke was born in Walsall, the son and grandson of doctors. He was educated at Uppingham School and Sidney Sussex College, Cambridge, graduating in the natural sciences tripos in 1932 and obtaining his MB BChir in 1936. After house posts he worked with Paul Dudley White [Munk’s Roll, Vol.VI, p.457] at the Massachusetts General Hospital. Boston, USA, and obtained a research fellowship from Harvard University. Paul White was universally regarded as the outstanding cardiologist of his day and Trevor Cooke always considered this to be an important phase in his life, when his attitudes and approach to research were shaped.
Trevor was rejected for military service on three occasions because of a back injury, and in 1940 he was appointed medical registrar to the Queen Elizabeth Hospital, Birmingham. He became reader in medicine in 1946 and assistant physician to the united Birmingham hospitals in 1947. During this time he developed an interest in steatorrhoea, coeliac disease and gluten sensitivity. It was not long before he began to take a more general interest in disorders of the small intestine; steatorrhoea brought the ‘new’ condition of Crohn’s disease his way and turned his attention to inflammatory bowel disease. There followed a productive period of nosological identification and therapeutic exploration; ulcerative colitis came into focus and was more easily identified, colitis due to Crohn’s disease established for the first time, and right-sided colitis, which the Americans insisted on regarding as a form of ulcerative colitis, was shown to be a manifestation of Crohn’s disease. Treatment with steroids, then new, and the recently introduced sulphasalazine, resulted in rational programmes, and the place and limitations of surgery were explored.
Trevor Cooke was intellectually honest and his scientific work bore testimony to this quality and secured his reputation. He abhorred dishonesty in public life just as he did in medical science, and he would not abandon his stance in his medicopolitical activities. When he felt that the prevailing climate made it impossible for him to pursue his researches, he relinquished his post as reader in the department of medicine at Birmingham, became a part-timer, and entered private practice. Many predicted the end of his academic career, but they were wrong. At the Birmingham General Hospital he soon established a gastroenterological unit of international repute. He established links with the biochemistry department of the new University of Aston and drew the staff into his researches.
He always kept scrupulous casenotes, maintained by a thorough and regular follow up which he conducted personally. He could claim one of the largest series of cases of steatorrhoea and Crohn’s disease which he put to good purpose in what would now be known as a medical audit, checking results against treatment over many years and putting them to good use refining the management and control of treatment. He was a recognized authority on Crohn’s disease, ulcerative colitis and coeliac disease. It was largely due to his efforts that the unit continued to flourish after his retirement, under the guidance of his trainees who have continued to build upon his data and methods.
Trevor Cooke was a sensitive and shy man, who seemed to cultivate anger and impatience to overcome what he thought were the shortsighted or unimaginative views of others. Although he was more than considerate to his patients and surgical colleagues, he was less so to those whom he regarded as being in competition. Yet the personal interest he took in those who worked with him enhanced the group ties of his unit. He was usually right in his opinions, but his anger did not endear him to some of his colleagues and it was not always easy to convert his ideas into practice. He was greatly respected by surgeons who worked closely with him, particularly in the management of inflammatory bowel disease, and he collaborated well with his colleagues in radiology and in the laboratories. Those who knew him well realized that he was an extremely kind man, who always had time and sympathy for people. Yet he received less recognition than was due to a man of his international standing, in particular from his medical school. It was partly the result of envy, but also of a reaction within the medical faculty to his irascibility and stubborn refusal to compromise.
In 1967 Trevor Cooke founded the Midland Gastroenterological Society and was its first president. He was a founder member of the Coeliac Trust in 1968 and served for over ten years as a much valued adviser and friend.
He wrote extensively on the management and prognosis of inflammatory bowel disease, on the neurological and malignant complications of coeliac disease, and a comprehensive monograph on this disorder, Coeliac disease, Edinburgh, Churchill Livingston, 1983.
He married Margaret Anne, née Foxell, and they had two daughters, Ann and Alison. His wife and daughters survived him.
Sir Gordon Wolstenholme
[Brit.med.J., 1987, 294, 517; Lancet, 1987, 1, 285, 397, 639]