by Lorne Taichman
The seed that led to my becoming a scientist rather than remaining a physician was planted in a most unexpected fashion. I was in my third year of medical school and fully enjoying the study of medicine. I was learning everything there was to know about the human body. The information I was absorbing had been tested and proven true by years of practice. My task was to acquire that knowledge and let it guide me in dealing with patients. I was secure and confident, that is until I encountered the clinical pathological conferences or CPCs lead by Dr. Jan Steiner.
Dr. Steiner, a Czech émigré, a combat soldier in the British army, a physician and a scientist, led the CPC sessions. We would be given the history, physical findings and laboratory results for a recently deceased patient. In fact, the patient was so recently deceased that his or her organs were displayed before us on stainless steel trays. Our task was to determine the cause of death. What was so remarkable about these sessions was Dr. Steiner’s irreverent tutelage. In most cases he succeeded in convincing us that had the patient not listened to the physician and had the patient stayed clear of the hospital that poor soul would have been outside that very morning basking in the sunshine on University Avenue. I was shocked. How could Dr. Steiner question so openly and so brazenly medical wisdom and standard medical practice? How could he so easily turn our certainty into doubt? I was intrigued by this enigmatic professor. So when Dr. Steiner agreed to let me work on a summer research project with him I was delighted. I was going to get an opportunity to work alongside this renegade. I would learn his secret.
On my first day at work Dr. Steiner briefly explained what he wanted me to do, and on the second day he disappeared for the summer. In the few moments we had had together I learned that my task was to make casts or molds of the blood vessels of the liver in experimental rats. The idea was to learn if gross changes took place in liver blood vessels when the rats were given a drug known to induce liver tumors. In a way the concept of vascular changes and cancer formation was way ahead of its time, a concept that Judah Folkman in Boston painstakingly and successfully developed into a new cancer therapy some 40 years later. But I am digressing. For an eager medical student set adrift I had two immediate problems – I had to figure out how to make the molds, and second, I had to not disappoint Dr. Steiner.
Making molds of the vascular tree was relatively simple. There was a liquid plastic that when injected into blood vessels would work its way into all the small branches and then harden solid. The trick then was to remove the liver tissue without harming the plastic moud. That also turned out to be relatively simple. Immerse the liver in sulfuric acid and allow the acid to digest away the tissue. The plastic was resistant to the acid. Simple.
Somehow I managed to secure working space in a basement office with a small, casement window opening onto an alleyway on eastern side of the institute. I got all the equipment I needed and ordered rats from a licensed supplier and had them housed in the institute. How excited I was to be working on my own project. Perhaps I would really discover something of importance.
In retrospect a kind angel must have been watching over me because, by all rights, I should have been blown sky high, or failing that, I should have been thrown out for destroying institute property. The explosion would have come from my reckless use of ether in an enclosed room a short distance from a lighted Bunsen burner. The ether was used to anesthetize and euthanize these poor creatures. The proper way would have been to work in a special hood that sucked the explosive fumes from the workspace and blew them to the outside. The lighted flame should have been nowhere near the can of ether. Why I did not blow the room and me apart is still a mystery to me.
My second offense was to ruin an exterior wall of the institute. It happened this way. After injecting the livers and allowing the plastic to harden I would remove the livers from the dead animals and place them in a large beaker filled with sulfuric acid. To avoid having the acid fumes linger in the small office I placed the beaker outside on the window ledge. The next morning I would retrieve the beaker, pour out the acid and gently rinse the plastic cast with water. Voilà! I had a delicate and detailed cast of the vascular tree of the liver. The fine branching structure was lovely to behold.
One morning, towards the end of the summer, coming into work I noticed a sizeable group gathered outside the eastern wall of the institute. I muscled my way to the front and there for all to see was an enormous blackened area. The surface of the building stone had been charred a ferocious black color. In the center of the damaged area was my casement window. I knew instantly what had happened. In the stagnant warm summer air the sulfuric acid fumes had wafted upwards along the face of the building and reacted with whatever happens when acid and stone make contact. I slowly backed away, kept very quiet and made no mention of the incident to anyone. That guiding angel once again saved me — no one ever connected my plastic casts with the remodeling job on the east wall of the institute.
In spite of the self-made hazards and property destruction, work on preparing molds proceeded nicely. One day, having several extra animals and not wanting to “waste them” I injected plastic into the bile ducts rather than the blood vessels. I was going to make casts of the biliary tree of the liver but it was the end of the day and I had no more beakers for liver digestion. Rather than euthanizing the animals I sewed up their abdomens and returned them, a little groggy, to recover in their cages. I promptly forgot about them.
As to my great discovery into the cause of cancer, unfortunately there was no difference that I could see between the cast of normal livers and those taken from livers in the early stages of cancer formation. Well, it wasn’t what I had hoped for but at least I had an answer.
A few days before the end of the summer job Dr. Steiner reappeared. When he asked to see what I had done, I showed him the vascular casts. We both agreed the experiment worked as planned but we could see no differences. I then remembered my forgotten mice, the ones whose bile ducts had been injected with plastic. I found the poor creatures, which by now had a severe case of jaundice and were deep yellow in color. I had no idea what had happened to make them so jaundiced. I brought them with some trepidation to Dr. Steiner. When we autopsied the animals and looked inside their abdomen, Dr. Steiner froze for a second and then shouted in his accented voice, “what have you done?” If I could have disappeared down a deep hole I would have gladly leaped. “Quick, make a slide of this liver and let’s look at it under the microscope.” I ran to obey, fully expecting to be ridiculed for something akin to scientific idiocy. I watched as his large hands focused the microscope on the tissue. “Look at what you have done. You have created a model for biliary cirrhosis. This is tremendous. I have been looking for this for years.”
I departed Dr. Steiner’s lab a few days later to start medical school. I hadn’t learned Dr. Steiner’s secret but I had discovered the sheer joy of discovery. I had, in my own blundering way, worked through a problem, used my own devices, tinkered and explored and come forth with an answer. I had created something that, although not monumental, was nevertheless, of my own making. What stuck with me most was that I had created it. There had been no guidelines to follow, no textbooks and no standards to lead the way. I was on my own.
It’s been 52 years since that summer and for 40 of those years, until my retirement, I was a happy scientist. I have never regretted a moment spent in asking the wrong questions, in looking behind the established wisdom and being the first to learn something new about living cells. Do I regret not practicing medicine? Yes, of course I do. It would have been a fulfilling pursuit, but I was seduced by the opportunity to venture into unknown territory and strike out on paths where it was possible to deface other institutional walls.
Lorne Taichman was an academic medical researcher for several decades at Stony Brook University. He joined the IRP three years ago and has coordinated two courses — Cancer Therapy and A Broken Heart (with Bob Braff).