b.4 June 1923 d.31 July 1998
MRCS LRCP(1947) DCH(1949) MRCP(1967) FRCP(1974) FRCPath(1978)
Margot Shiner was a leading gastroenterologist and paediatrician. She was born to a cultivated Jewish family in Berlin where her father, Leo Last, was a textile merchant. The family fled to Prague in 1936, and thence to London in 1938. She was educated at Parliament Hill School, Hampstead, and achieved her childhood ambition to study medicine. She qualified at Leeds in 1947, and then married Alex Shiner. She returned to London for house officer posts in Poplar and then fulfilled her love of children by a post a Great Ormond Street in 1949. Her first child was born in 1950. From 1951 to 1952 she was assistant medical officer of health in Hendon.
She was dissatisfied with clinical care of patients alone, and sought a research career. In 1953 after the birth of her second son and inspired by the example of Sheila Sherlock she sought and obtained an honorary appointment at the Postgraduate Medical School at Hammersmith Hospital, thus embarking on a 45 year long highly productive career in (paediatric) gastroenterology research. In 1957 she joined Francis Avery Jones’s unit at Central Middlesex Hospital and became a full-time member of its Medical Research Council’s gastroenterological research unit, and an honorary consultant to the hospital from 1971. With the closure of this unit she relocated to the MRC at Northwick Park Hospital, taking early retirement in 1983.
She then emigrated to Israel, where she set up a paediatric gastroenterology department at Assaf Harofe medical centre, becoming visiting professor of paediatrics, and, in 1991, emeritus professor of medicine, Tel Aviv University. She remained active and continued working despite the eventually fatal onset of non-Hodgkin’s lymphoma.
Margot Shiner’s research career, with the hundred or so publications, was devoted almost entirely to the mucosa of the small intestine. This organ had previously been difficult to research because autopsy material was subject to rapid autolysis and biopsy material had to be obtained at surgical operation. She also worked on the histology of the stomach and on antibodies to anaerobic faecal bacteria in the rectal and colonic mucosa of patients with ulcerative colitis.
The problem of obtaining peroral specimens of stomach mucosa had been solved by Ian Wood [Munk’s Roll, Vol.VIII, p.548] in 1947 with his invention of a gastric biopsy tube. Margot Shiner was unaware of Royer’s 1955 paper from Argentina describing a duodenal biopsy-tube when in 1956 she published in the The Lancet her 128 cm biopsy tube (longer than Wood’s) and with a shorter shielded head, which could take biopsies beyond the pylorus. Later that year she lengthened the tube to 162 cm and incorporated a rubber balloon at the distal end which when inflated encouraged the tube to pass by peristalsis into the upper small intestine to biopsy the jejunum. Following this pioneering achievement other intestinal biopsy instruments such as the Crosby capsule were devised.
Shiner and colleagues (especially Israel Doniach) were then able to define by light and electron microscopy the identical histology of adult idiopathic steatorrhoea and childhood coeliac disease. Others soon demonstrated that this villous atrophy could be normalized by a gluten-free diet and would become again abnormal after re-introduction of gluten. Biopsies were also diagnostic of other intestinal diseases such as Whipple’s disease and nodular lymphoid hyperplasia in primary hypogammaglobulinaemia, as well as providing samples for biochemical analysis in many other diseases involving malabsorption, such as disaccharidase deficiency.
Her 1963 capsule provided uncontaminated samples of gastrointestinal fluid, thus opening up the field of small intestinal microbiology. Her work not only enabled the small intestine to be extensively researched but also initiated the development of the clinical and academic specialty of paediatric gastroenterology.
Margot Shiner had a quiet peaceful modest retiring and under-assertive personality. Although keen on skiing, swimming and tennis, her great love was music, opera and piano-playing. She was not only a workaholic who relaxed only on long flights, either by reading The Lancet or history (but never fiction), but also a devoted wife, housewife and mother of three sons, one of whom is a doctor.
J H Baron
[Journal of Pediatric Gastroenterology and Nutrition 27:397, Oct 1998; The Jewish Chronicle 25 Sept 1998]
(Volume XI, page 519)
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