Whenever I see a drawing of Tiktaalik like the one above, I always think “Man, that walking fish sure looks snooty.” But Tiktaalik roseae, discovered in 2004 by University of Chicago evolutionary biologist Neil Shubin and his team in the Canadian Arctic, is worthy of its haughty air. For one thing, the “fishapod” had a neck, a feature you don’t typically find on a fish, and the explanation for its stuck-up posture. Tiktaalik’s limbs were even more unusual and exciting, as Shubin found bones that were more like fingers than the tiny bones typically seen in fish fins. These structures meant Tiktaalik held a very important place in the tree of life, one of the elusive transitional species (in this case between fish and amphibians) that evolutionary biologists dream of discovering.

Shubin’s book about Tiktaalik and how it demonstrates the process of evolution, Your Inner Fish: A Journey Into the 3.5-Billion-Year History of the Human Body, was released almost two years ago. Perhaps it takes scientists a while to squeeze in some non-journal reading time, because the book (now in paperback, cough plug cough) was today named as the 2009 book of the year by the National Academy of Sciences. Here’s what they said:

Neil Shubin for his delightful, intellectually challenging view of evolution from primitive fish to humans by a scientist who finds fossils in the most uncomfortable places and chronicles it all in Your Inner Fish: A Journey Into the 3.5-Billion-Year History of the Human Body (Pantheon Books).

Your Inner Fish was also on the shortlist for this year’s Royal Society Prize for Science Books, in the esteemed company of science writers such as Carl Zimmer, Leonard Mlodinow and Ben Goldacre.

UPDATE: You can read an online excerpt from Your Inner Fish, thanks to University of Chicago Magazine!

Shubin is as good a public speaker as he is a writer. As probably the only fish paleontologist who teaches anatomy to medical students (here at the Pritzker School of Medicine), Shubin uses evolutionary theory to explain the stranger features of the human body. I caught an excellent lecture from him at the AAAS Meeting this past February (my favorite quote: “When I look at a human being, what I see is a giant, morphed-up fish.”), and he came off like a seasoned television pro on the Colbert Report. If you’d like to see Shubin live and in person, he is one of several speakers at the star-studded Darwin Conference taking place October 29-31 at the University of Chicago to celebrate the 150th anniversary of The Origin of the Species.

For a little teaser, here’s some video taken by Jeremy Manier earlier this year of Shubin talking about how cartoons and toys mischaracterize the process of evolution.

Convincing people to stop smoking is no easy task, as family members or friends of smokers know all too well. But consider a situation where roughly three-quarters of active smokers find themselves ready to quit, willing to make that all-important first step of deciding to go smoke-free. When is this short window of vulnerability and motivation open? The time is when a smoker is in the hospital, said Dr. Lisa Shah, instructor in the section of hospital medicine at the University of Chicago Medical Center, a time when the patient is also surrounded by the infrastructure needed to nurture a desire to stop smoking into a successful change of behavior.

But Shah, a researcher focused on studying inpatient tobacco cessation, said in her Medicine Grand Rounds presentation Tuesday afternoon that many doctors miss this opportunity to help their patients kick a dangerous habit. In fact, it was right there on a slide titled The Missed Opportunity, which laid out why inpatients find themselves ready to quit: the no-smoking policies in place at hospitals*, the shock of being hospitalized for an illness that may be a direct result of smoking, and the isolation from environmental cues at home or work that may trigger the urge to smoke.

“For the smokers we see here, often one big barrier to quitting smoking is that they have family members and friends who also smoke cigarettes, Shah said. “Social smoking is a huge impetus to smoke, and makes it hard to quit. So hospitalization helps them succeed in quitting smoking without the temptation.”

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Sam Volchenboum has his head shaved by Joshua Crosby, Sept. 24, 2009 (photos by David Christopher)

A researcher will do a lot for grant money, the fuel necessary to power a laboratory’s work. Sam Volchenboum, a pediatric oncologist at the University of Chicago Medical Center, took that adage to its follicular extreme last week, volunteering to go bald for funds from the St. Baldrick’s Foundation.

St. Baldrick’s, a California-based organization which raises funds for pediatric cancer research, asks their volunteers and award recipients to shave their heads in solidarity with cancer-stricken children who have lost their hair to chemotherapy. Thursday evening, Volchenboum went under the razor himself, shedding his dark brown hair with the help of Joshua Crosby, a 13-year-old cancer survivor. A small price to pay, Volchenboum said, for a $330,000 award that will help him design faster and more specific diagnostic tools for neuroblastoma.

“It can often take a while and be a little frustrating to get to the diagnosis,” Volchenboum said. “Despite all we know about this disease, even with aggressive treatment - chemo and radiation and surgery - over half of the kids will still die from their disease.”

Despite what its name implies, neuroblastoma is not brain cancer, but rather a cancer of the sympathetic nervous system that connects the spinal cord to organs of the body. Though it’s rare as far as diseases go - with only about 800 new cases a year in the US - it’s nevertheless the most common solid-tumor cancer seen in children and is responsible for about 15% of childhood cancer deaths. But not all neuroblastomas are fatal; in fact, some tumors in infants even regress spontaneously without treatment. That wide variation in prognosis presents a challenge to oncologists, Volchenboum said, who must decide the best course of treatment for a child with neuroblastoma, doing as much as possible to attack the tumor without over-treating with therapies that can be toxic and harmful in an adult, never mind a growing kid.

“We need to be able to sub-stratify the patients to predict outcome better,” Volchenboum said about the goals of his project. “There are probably some patients that will do poorly despite any conventional treatments, so let’s give this patient emerging therapy, let’s try something new. Likewise, there are some patients with apparent high-risk disease who get lots of therapy and are ultimately cured but may not have needed all that therapy.”

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(photo courtesy hivresearch.org)

Rare Encouraging News in HIV and Parkinson’s Disease

HIV/AIDS and Parkinson’s Disease are two areas of medical research where good news is hard to come by, as researchers encounter countless setbacks in trying to translate promising laboratory findings into clinical practice. Both diseases have seen progress in the past decade in ex post facto treatments - preventing the maturity of HIV into AIDS with antiretroviral treatment or reducing the motor symptoms associated with Parkinson’s. But drugs that seemed to offer a cure for either disease, or in the case of Parkinson’s a mere brake to the progression of symptoms, have consistently disappointed in human trials.

That changed - slightly - this week, as two highly-publicized studies were published offering faint glimmers of hope on both disease fronts. Grabbing the most headlines was the first-ever demonstration of a successful HIV vaccine in a study conducted in Thailand but funded by the U.S. Army and the National Institutes of Health. The caveats are flying hot and heavy - the researchers saw only a 31% decrease in the number of HIV cases after treatment with a vaccine and a booster drug, one of the HIV strains protected against is specific to southeast Asia, and mystery lingers over why this particular combination of drugs was protective where so many others have failed. The two drugs used in the Thai trial - one a “primer” and one a “booster” - had themselves failed in previous large clinical trials. But the first small success in protecting against the deadly virus nevertheless encouraged many HIV/AIDS researchers; Dan Barouch, an immunologist at the Beth Israel Deaconess Medical Center in Boston, Massachusetts, told Nature “It’s the largest step forward that’s ever occurred in the HIV-vaccine field, but there’s a tremendous amount of more work that will need to be done.”

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Dr. Funmi Olopade and Dr. Mary Ann Malloy at the Harold Washington Public Library in Chicago, September 22, 2009 (photo by Rob Mitchum)

On Monday we previewed Dr. Funmi Olopade’s public lecture at the Harold Washington Public Library in Chicago titled “Nature, Nurture and Breast Cancer.” For that post, I talked about some recent work from Olopade’s research group that compared the types of breast tumors found in West African women with the tumors seen most often in black and white American women. That research indicated that there likely is a genetic difference between women of African origin and Caucasian, North American women that leads to fewer breast cancer cases but a  higher rate of aggressive, harder-to-treat tumors in black women here and abroad. But the patients from Senegal and Nigeria which Olopade’s group studied also showed different proportions of tumors when compared to African-American women, suggesting a strong role for environmental factors in causing breast cancer as well.

In her library appearance Tuesday evening with NBC reporter Dr. Mary Ann Malloy, Olopade expanded upon those mysterious “environmental factors” that likely contribute to the higher breast cancer numbers in North America. To a rapt audience, Olopade listed off the most well-known and common risk factors for breast cancer: age, family history and “the most important risk factor,” being a woman.

(Chicago Public Radio’s Chicago Amplified is supposed to post audio from Tuesday night’s event, but it’s not up yet. I’ll add a link when it’s available.)

But even to a crowd that, judging from their questions, was very well informed about breast cancer medicine and science, Olopade inspired gasps of surprise by rattling off some less-publicized environmental factors: breastfeeding, age at childbirth, even height. Many of these factors, in combination with more mundane things like lack of moderation in diet, exercise and alcohol intake, are behaviors more commonly seen in rich countries where women have achieved a more equal status in their work and private lives.

“I think what we’re still struggling with is, as we get more affluent and as people live the good life, then you see the rising incidence of breast cancer,” Olopade said. “We want people to have the good life, but what is it about the good life that is predisposing us to breast cancer?”

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A three-dimensional image of a "BK" cellular ion channel (Yale University/Futurity)

I apologize for the lack of a Linkage post last Friday - instead of blogging, your editors were learning about Chicago’s downtown architecture as we floated along the green if not Green Chicago River on one of summer’s final days. But like the reversed flow of that waterway, the science never stops, and last week saw the official launch of a new source for science news: Futurity.

Disclosure alert: the University of Chicago is one of the contributors to Futurity’s content, and our esteemed paleontologist Paul Sereno’s new “punk-size” T-Rex spent much of last week as the site’s featured story. But as both producers and consumers of science writing, we’re genuinely excited about the site, which will aggregate articles from an initial pool of 39 universities in an attempt to the gap left by shrinking science and medicine staffs at newspapers and television stations. With reduced space and time for science stories in the mainstream media, the news offices of these universities have taken it upon themselves to bring their science to the public directly, sometimes by employing refugees from those very same shrinking science staffs.

Yes, that largely means publishing press releases, though it must be said that many press releases are now themselves written and laid out like a news article, with an eye-catching lead, quotes from researchers and outside sources, historical perspective and photo or graphic art. Sites like ScienceDaily and Eurekalert are well-known depositories for these releases, but can be sensory overload for the casual reader with hundreds of new releases posted to the site each day. Futurity looks like it will filter out some of the noise and present the most exciting research in an aesthetically pleasing manner, with the hope that general audience readers, not just other science journalists and news office personnel, will find it entertaining and informative.

The site had a soft launch in the spring and went full-on live last Tuesday, so there’s already been a bit of attention paid to it by sites such as Inside Higher Ed, the San Jose Mercury News, and the Columbia Journalism Review. Skeptics note, appropriately, that there is a certain preaching-to-the-niche quality, where only people actively seeking out science news will be exposed to science news. But through deals with wider-audience news aggregators like Google and Yahoo!, the hope is that a casual reader will be distracted by interesting science news on their way to sports scores or celebrity gossip, just like they used to do in a newspaper.

Here are a few of the Futurity stories that caught our eye in the website’s opening week:

• Scientists cure color blindness in monkeys with a human gene (University of Washington)
• Using Legos to model nanobiology (Johns Hopkins)
• Thin, overeating friends can inspire unhealthy eating behavior (Duke; with a slick YouTube video that makes us very envious)
• Using trees to generate electricity (University of Washington)
• An “open-source” camera with a brilliant name: Frankencamera (Stanford)

Dr. Funmi Olopade

A fact often lost in the charity walks and commercials that have dramatically raised awareness of breast cancer over the past two decades is that beneath the diagnostic umbrella of  “breast cancer” are numerous types of tumors. Other than the fact that all of these tumors are found in breast tissue, different forms of breast cancer grow at different rates, will express different types of hormone receptors or genes that can act as drug targets, and are more or less likely to become “invasive,” spreading throughout the body. To complicate matters further, not every population experiences these different types of breast cancer in equal proportions - black women in the United States have a poorer survival rate for breast cancer than white women, and women in Africa  have an equal breast cancer mortality rate to North American women despite four times as many diagnoses of the disease in the U.S., Canada and Mexico.

University of Chicago Medical Center researcher Olufunmilayo Olopade (Funmi, for short) has dedicated her career to the study of these discrepancies since moving to Chicago from her home country of Nigeria in the 1980’s. Olopade, a professor of medicine and human genetics, has received several accolades for her work, including the prestigious MacArthur fellowship (known sometimes as the “genius grant”) in 2005. On Tuesday evening, she’ll give a lecture at the Harold Washington Library Center in Chicago titled “Nature, Nurture and Breast Cancer” that will explain what we know about the genetic and environmental factors that cause the disease in more than 200,000 American women each year.

In a recent Journal of Clinical Oncology paper, Olopade and colleagues from Chicago, Senegal and Nigeria looked for physiological reasons to explain the differences in breast cancer rates and outcomes between American and African populations. Learning more about these differences could help direct women into the most effective treatments for their particular type of breast cancer, Olopade said, as well as offer clues as to how genes versus the environment cause breast tumors to arise.

“Breast cancer doesn’t affect all individuals the same way,” Olopade said this past weekend, as she prepared for Tuesday’s lecture. “What we found is that the types of cancer that people get in different populations differ, that’s why when we talk about personalized medicine at an individual level we also have to talk about it on a population level.”

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Whether you call it pop, soda, a soft drink or lower-case coke, sugary, carbonated beverages have become a staple of the American diet. And as we all know, the American diet is not exactly the healthiest. So with obesity racking up an estimated $150 billion a year in health care costs - which, as you may have heard, is in the news lately - some researchers have considered whether Coke, Pepsi and their sucrose-packed brethren should be subject so the same type of “sin tax” that has been applied in the past to alcohol and tobacco by some governments.

Here in ScienceLife’s home state of Illinois, carbonated soft drinks (as well as most candy) were recently reclassified from being considered as food to “general merchandise” - a seemingly innocuous change that actually means a sales tax increase from 2.25 percent to 10.25 percent in Chicago. In Illinois, the switch was justified as a way to generate much-needed revenue for state services, but could it also have a direct public health benefit by discouraging people, particularly children and teenagers, from drinking hundreds of calories in soda pop each day?

In this week’s New England Journal of Medicine, seven public health experts assess the best methods of improving public health through taxation of soft drinks. Soda is already taxed in 33 states, according to the article, at an average of 5.2%. But research indicates that those taxes have only marginal effects on soda consumption and obesity. One recent study out of UIC found only “weakly significant” effects of tax rate on the body mass index of children “at risk” of being overweight. In NEJM, the authors immediately state that the current tax rates are too small to have an effect on consumption - after all, a 5% tax on a 75-cent can of Coke is less than 4 cents, hardly enough to get someone to switch to water.

But the authors go on to suggest different methods of taxation that could be more effective in motivating people to change their beverage behavior. Rather than imposing an increased sales tax on all soda purchases, the authors suggest a tax of 1 cent per ounce on beverages with “added caloric sweetener” - your standard sugary Coke or Pepsi, but not your Nutrasweet-infused Diet versions. So a 12 oz. can of soda would set you back 12 cents, and a convenience-store fountain drink behemoth would cost almost a dollar extra, but if you opt for the diet version, no tax. Thus, the authors hope the tax will encourage (or financially push) consumers to make healthier decisions rather than merely opting for cheaper sugary drinks.

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A relatively simple food web, believe it or not. (from Allesina & Pascual, 2009)

Ecologists drifted long ago from the simplistic model of the food chain to food webs, intricate, multi-tendril interactions between species that paint a more accurate picture of an ecosystem’s network. But, as with most sciences, as the models become more complex, so too does the analysis required to answer questions about the role each animal plays in an ecosystem. In a chain, if you remove one piece, the whole network falls apart. But how do you rank the importance of organisms in a system that looks like the tangle of wires behind an entertainment center?

Stefano Allesina, a brand new assistant professor in the University of Chicago Department of Ecology & Evolution (like, really brand new, as in moved into town last week) found the answer to this question in a brand name rapidly taking over our lives: Google. Specifically, he got a hunch that the algorithm Google uses to operate its search engine could be turned into a tool for detecting what species are most integral to an ecosystem’s health.

“One of the main problems in conservation is to forecast what’s going to happen if the species we are looking at is going down or going toward extinction,” Allesina said. “This single extinction can cascade in the loss of other species that are apparently unrelated, because all things are interdependent and it’s a very complex machinery. Or you could take away one piece and maybe the whole thing will reshape itself.”

So Allesina, and his collaborator Mercedes Pascual from the University of Michigan, constructed a computer model, published earlier this month in PLoS Computational Biology, to find vulnerabilities in an ecosystem. As Allesina describes it, they tried to help the cause of conservation by looking for the best way to destroy an ecosystem.

“How can we damage the network in the fastest possible way? How can we take away the most important species first so we can make the whole system collapse? It’s the best solution, but it’s actually not very good for the environment,” Allesina laughed.

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As you’ve no doubt heard by now, actor Patrick Swayze died yesterday at age 57 after a battle with pancreatic cancer. In March, blog founder Jeremy Manier interviewed University of Chicago Medical Center physician Dr. Irving Waxman about pancreatic cancer, one of the deadliest and hardest to treat cancers. The challenge, as Waxman explains, is twofold - the symptoms of pancreatic cancer typically do not present until the disease is in advanced stages, and the organ’s location deep behind the abdomen makes makes surgical treatment more difficult. The statistics are sobering: even with treatment, only about 5% of those diagnosed with pancreatic cancer survive 5 years.

But doctors are hopeful that the momentum could be shifting in the battle against pancreatic cancer. “Smart chemotherapy” with less severe side effects, new imaging techniques to detect pancreatic cancer in its early stages, and new drug treatments - a study released just yesterday found that an already-existing diabetes medication may be effective in combination with chemotherapy for selectively killing tumor cells.

Here again is the interview with Dr. Waxman where he discusses the clinical challenges of pancreatic cancer and some of the promising frontiers of research to reduce those challenges.

The shortened "Philadelphia chromosome" seen in certain leukemias (picture from nature.com)

The big science news of the day was the announcement of the Lasker Awards, informally thought of as the American version of the Nobel Prize for physiology and medicine. This year’s clinical medical research award went to a trio of researchers from Oregon Health & Science University, Sloan-Kettering Cancer Center and drug company Novartis, but you could just as easily say it was awarded to a drug: the cancer treatment Gleevec. And Gleevec’s roots stretch back to the campus of the University of Chicago and a very familiar face on this blog: Janet Rowley.

This year, Rowley has already received the Presidential Medal of Freedom, the Gruber Genetics Prize and stood at President Obama’s shoulder as he repealed federal limitations on stem cell research. Oh, and she’s already won the Lasker Award herself, in 1998. So it’s okay that she’s not mentioned among today’s winners.

As with most stories of scientific discovery moving from the laboratory bench to the pharmacy, it’s simplistic to pin the achievement on one, three, or even ten people. The path to Gleevec’s discovery go back beyond Rowley to the 1950’s when Peter Nowell and David Hungerford - working at the University of Pennsylvania in Philadelphia - found an odd, shortened chromosome in patients with a form of cancer called chronic myelogenous leukemia (CML). They called that stubby piece of DNA, appropriately enough, the Philadelphia chromosome.

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Our weekly roundup of science news from around the world that doesn’t easily fit anywhere else.

A cuscus. Crazy. (photo from Wikimedia Commons)

Wild Kingdom Gets Weirder

If you’re a fan of weird animal stories, this was a week for you. First, there was the discovery of a never-before-seen giant rat and about 40 other unidentified species by a group of British and American scientists in a volcano crater on the island of Papua New Guinea (they also stumbled upon Doria’s tree kangaroos and cuscuses while they were at it; adorable photo gallery here). Christened the Bosavi woolly rat, it’s 32 inches long and 3.5 pounds, and was completely friendly to humans, having never really seen them before.

Then a report came out in Biology Letters about a group of birds called tits in Hungary that were forced to add an unusual menu item when food became scarce: bats. These cute little birds apparently get on a real mean streak when they’re hungry, attacking hibernating bats (small ones - only 4cm) and dragging them out of their caves for dinner. The paper’s authors found that the tits (okay, stop giggling) would only go for bat meals when other food wasn’t available, which they proved by satiating the carnivorous birds with…bacon. I’d provide some more links on this story, but it’s not exactly the kind of topic you want to be caught Googling at work.

Finally, in a study that will probably end up on some politician’s pork-barrel list, NASA revealed this week they can now make mice float with magnets. The superconducting magnet is powerful enough to use a mouse’s natural water content to cause its entire body to float, an unusual sensation that the mice apparently get used to fairly quickly (3-4 hours). Why levitate mice? To study the effects of microgravity on astronauts, of course, though Switched points out rightly that NASA has already been bringing rodents for ride-alongs into space for decades. Alas, there is nary a video of levitating mice to be found, and the article is accompanied only by terrible overhead pictures. C’mon, NASA. read more

The question was a welcome one, given the heated, exhausting health care debate that has raged through the summer: On the day after health care reform (whatever form it takes), what are the potential stumbling blocks and opportunities?

That’s how moderator Michele Norris (of NPR’s All Things Considered) thoughtfully began the panel at the University of Chicago-curated “Chicago Contributes” health care forum, held Thursday in Washington, DC less than a day after President Barack Obama’s speech to Congress. Reform supporters might consider that question to be a jinx as Obama and the Democrats struggle to find a consensus plan, but it allowed the forum’s panelists to clear the political fog and put the focus back where it should be - on the challenging questions of access and cost reduction that face modern American medicine.

After a keynote address by Kathleen Sebelius, Obama’s Secretary of Health and Human Services, echoed many of the points the President made himself the night before, the stage was turned over to a national group of university experts that were grappling with these issues long before health care became the season’s political hot potato. The importance of access to health care, not just insurance, was summarized nicely (and immediately) by Gerard Clancy, Dean of the University of Oklahoma-Tulsa College of Medicine: “If we have 40-50 million people now with health care coverage, who’s going to take care of them?”

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Last night, President Barack Obama addressed Congress about the need for health care reform, and today the University of Chicago is presenting a timely forum in Washington, DC, on the subject of access to health care. With a keynote address from Secretary of Health and Human Services Kathleen Sebelius and a panel that includes several health care policy experts, the event promises to be a interesting discussion of how universities are participating in the current national health care conversation. In cooperation with the UofC News Office, we’ll be running a live-stream of the event from 12 noon Chicago time, along with live, updating commentary from blog editor Jeremy Manier and Medical Center communications director John Easton at the forum, and Rob Mitchum, who will be watching the stream with you. Below the video feed and live blog you can find the agenda and the participants in the health care forum, or you can read more about the Chicago Contributes event (which will also feature an education forum following the health care discussion) here:

Keynote: Kathleen Sebelius, U.S. Department of Health and Human Services Secretary
Panel: “Access After Health Care Reform”
Moderator: Michele Norris, Host of NPR’s All Things Considered

Panelists:

• Eric Whitaker
  • Executive VP, Strategic Affiliations, and Associate Dean of Community-based Research at the University of Chicago Medical Center
• Pedro Jose Greer
  • Assistant Dean of Academic Affairs and Chair of the Department of Humanities, Health and Society, Florida International University School of Medicine
• Gerard Clancy
  • President, University of Oklahoma-Tulsa, and Dean, University of Oklahoma-Tulsa College of Medicine
• Kavita Patel
  • Director of Policy of the White House Office of Public Engagement and Intergovernmental Affairs
• Patrick Soon-Shiong, M.D.
  • Executive Chairman & CEO, Abraxis Health, and Executive Director, UCLA Wireless Health Institute, University of California, Los Angeles

A portrait of Joseph Kirsner outside his Grand Rounds lecture

It’s not every day you get to hear a lecture from a physician two weeks shy of his 100th birthday. But for yesterday’s Department of Medicine Grand Rounds at the University of Chicago Medical Center, the honored speaker was 99.96 years old (to be exact) and spent an hour recalling a career spanning an incredible 70+ years in the field.

Joseph B. Kirsner, affectionately known to the medical world as “GI Joe” (the GI stands for gastrointestinal, of course), came to the University of Chicago in 1936, the year Jesse Owens won four gold medals at the Berlin Olympics and Gone With the Wind was first published. 73 years later, he remains a full professor at the University of Chicago, no longer seeing patients but working from his hospital office two days a week.

In May, Kirsner was honored during the Digestive Disease Week meeting held this year in Chicago, an annual gathering of doctors in the gastroenterology field where Kirsner is considered a giant. Tuesday was the University’s chance to pay tribute, and Kirsner received two standing ovations from a crowd wearing buttons reading “JBK 100.”

Titled Gastroenterology: A Look Back 1936-2009, Kirsner’s talk was a first-hand account of how disorders of the digestive system have been studied, diagnosed and treated over the last seven decades. For example, Kirsner talked about how the endoscope revolutionized his field…then talked about how Rudolph Schindler, co-inventor of the endoscope, came to Chicago and taught him how to use the device. The first endoscope was a rigid, steel tube that had to be threaded down a person’s mouth, down the esophagus and into the stomach. “This was not an easy task,” Kirsner said. I’ll say.

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