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OBITUARY

Ronald Ellis 'Ronnie' Kottler

Born in Oudtshoorn on 11 December 1927, Ronnie Kottler matriculated from Oudtshoorn Boys' High School in 1944 and qualified MB ChB at the University of Cape Town in 1950. He gained his DCH (RCP&S, London) in 1954. He returned to Cape Town in 1958 to make up a group of four registrars undertaking the first officially sanctioned radiology qualification under Prof. Jack Jacobson in the Groote Schuur Hospital department, graduating MMed (Rad D) in 1960. After working at GSH and for 3 years in private practice, he was appointed senior specialist at Somerset Hospital, where he also collaborated closely with the new School of Radiography.

In 1974 Ronnie returned to GSH, and in 1981 was appointed Professor and Chairman of Radiology at GSH and the University of Cape Town. From 1982, he was Head of the Division of Radiation Medicine. In 1985 he qualified FRCR (Eng).

Ronnie was keenly interested in the technological aspects of radiology, while his main clinical passions were gastrointestinal radiology and mammography. He witnessed first-hand the transition of radiology from plain X-rays to modern imaging. The introduction of image intensifiers in 1960 eliminated the need for blacked-out rooms and adaptation to the dark (and with them the infamous radiologist's red goggles). Ronnie engaged enthusiastically in a variety of barium studies and other fluoroscopic procedures, and was intrigued by techniques for improving the quality of X-ray films.

He experienced the cross-sectional revolution in imaging, from complex-motion tomography via the first brain computed tomography to multi-slice CT, magnetic resonance imaging and digital tomosynthesis. Recalling Dr Alan Cormack's 1963 work on the complex mathematical formula detailing the algorithm applicable to rotating radiation, Ronnie recollected: 'I knew nothing about these things, but remember well Prof. Grieve (head of the therapeutic X-ray department), knowing my own interest in simple tomography, explaining to me how they were trying to research the principles of circular tomography, moving in a circle around the patient.'

The EMI head scanner that arrived at Groote Schuur Hospital in 1976 took 7 minutes to produce each pair of 80-by-80 matrix pictures.

Ultrasound technology also intrigued Ronnie, especially after the GSH obstetrics and gynaecology department acquired the first ultrasound machine in Cape Town in 1968. He was also fascinated by and supportive of the transition to MRI and the PACS systems in later years, the latter eliminating X-ray films by having digital radiographs online and on multiple screens.

He supported the 1958 call for subspecialisation, and visited the UK, the USA and Europe to further his knowledge of GI and breast imaging. The clinical focus of his use of radiology in managing patients ranged from barium studies for gastric and duodenal ulcers, carcinomas, inflammatory bowel disease and tuberculosis, to the later use of abdominal US and CT. At the same time, developments in endoscopy and ERCP had a dramatic impact on diagnosis and intervention in GI disease and clinical collaboration, as did the discovery of Helicobacter pylori. He published widely on gastrointestinal, pancreatic and liver disease, but also on rarer entities such as gastrocolic fistulas, ileosigmoid knots, hypotonic duodenography and intramural rupture of the oesophagus.

In 1992 Ronnie was the South African College of Medicine Travelling Lecturer in Radiology. He convened and examined for many College and MMed exams.

Ronnie was deeply involved in planning the relocation to the New GSH, and in the detailed internal planning of the radiology department, which paid dividends over the following decades. He credited Prof. Philip Palmer, who was appointed Head of Diagnostic Radiology in 1964, with completely modernising the department. He was keenly interested in the department's history. When GSH first opened its doors in 1937, the diagnostic and therapeutic X-ray departments shared the same space. Diagnostic radiology started with four X-ray and fluoroscopy rooms. By 1991, 56 rooms required conformance to radiation protection regulations.

Ronnie strongly encouraged professional growth in his many trainees. His weekly lunchtime GI radiology teaching sessions were cleverly annotated, and many of his teaching points are still regularly put into practice. Always generous with his advice and time, he gratefully noted the contributions by many consultants and registrars over the years, while also making a point of paying tribute to key workers in the department such as radiographers, nurses, porters, and support and clerical staff. From humble beginnings when he qualified in 1960, 25 years later there were 18 specialists and 18 registrars, the latter rotating through the Red Cross War Memorial Children's and Somerset hospitals.

In 1983, our group of six new registrars appreciated the warm welcome we received from Berry Neumann and Prof. Kottler in the Old GSH building. Prof. Kottler was known countrywide as a kind, inquisitive and knowledgeable man with a knack for memorable teaching and common sense. He was a tremendous role model, being very supportive and encouraging in his advice and engagements, both during training and subsequently.

After he retired at the age of 65 years on 31 December 1992, Ronnie was appointed as Emeritus Professor at UCT. He continued sessions in GI radiology and then mammography, until he retired completely at the end of 2013.

He died on Friday 30 July 2021, leaving a proud legacy of personal respect and the academic and teaching ethos of radiology, and also of his thoughtful departmental planning. He is survived by his beloved wife Pam, daughter Jacqui, son Rob, and their families.

S J Beningfield

University of Cape Town, South Africa steve.beningfield@uct.ac.za