One of the great joys of being on a team of the world’s best gastroenterologists, hepatologists and gastro researchers is watching them constantly challenge the conventional thinking in our field.

Liudmila Cebotaru makes a bold statement in this issue of Inside Tract: “We’re trying to cure cystic fibrosis.” Engineering a gene to replace a faulty gene that causes CF is thinking big.

Amy Kim is challenging the Milan criteria, the measure that determines which patients are the best candidates for a liver transplant. She recounts a conversation with a patient who wonders how liver cancers could recur after a transplant. The question bothered her enough to devote a career to finding an answer.

When Vikesh Singh noticed that, every so often, a patient who had an endoscopic procedure involving the pancreas would develop systemic inflammatory response syndrome, he began studying data on the topic. Looking at 12 years of Johns Hopkins admissions data, Singh found a pattern that leads to both better medicine and cost savings.

In hopes of bringing relief to patients who’ve been told their gastric problems aren’t real, Sameer Dhalla and his colleagues in our Neurogastroenterology Center are using 3-D imaging to unlock the mysteries behind the intestinal nerve system. They believe that nerves could hold the answers to questions around idiopathic gastric conditions, such as gastroparesis.

Johns Hopkins fosters a climate that encourages clinicians and researchers to ask big, bold questions. Often those challenges confirm standard practices. But sometimes they produce results that change the way we approach an issue or a condition.