A control for an endoscope including a catheter having a flexible distal tip portion, the control coupleable to a proximal end of a catheter and configured to control deflection of the flexible distal tip portion, the control comprising: a housing defining an interior volume; a lever external to the housing and extending through the housing into the interior volume; a gear system positioned in the interior volume and operatively coupled to the lever, the gear system including: a worm gear operatively coupled to the lever, the worm gear having at least one helical thread extending along a length of the worm gear; a gear nut positioned about the worm gear, the gear nut cooperating with the at least one helical thread to move along the length of the worm gear as the worm gear rotates, the gear nut including a first cam and a second cam; a first quadrant having a first surface contacting the first cam such that as the gear nut moves in a first direction along a length of the worm gear the first cam contacts the first surface to urge the first quadrant to pivot about a first quadrant's axis; and a second quadrant having a second surface contacting the second cam such that as the gear nut moves in a second direction opposite the first direction along a length of the worm gear the second cam contacts the second surface to urge the second quadrant to pivot about a second quadrant's axis collinear with the first quadrant's axis, wherein the lever is configured such that movement of the lever in a first direction urges the first quadrant to pivot about the first quadrant's axis and deflect the flexible distal tip portion in a corresponding first direction and the lever is configured such that movement of the lever in a second direction different from the first direction urges the second quadrant to pivot about the second quadrant's axis and deflect the flexible distal tip portion in a corresponding second direction. a housing defining an interior volume; a lever external to the housing and extending through the housing into the interior volume; a gear system positioned in the interior volume and operatively coupled to the lever, the gear system including: a worm gear operatively coupled to the lever, the worm gear having at least one helical thread extending along a length of the worm gear; a gear nut positioned about the worm gear, the gear nut cooperating with the at least one helical thread to move along the length of the worm gear as the worm gear rotates, the gear nut including a first cam and a second cam; a first quadrant having a first surface contacting the first cam such that as the gear nut moves in a first direction along a length of the worm gear the first cam contacts the first surface to urge the first quadrant to pivot about a first quadrant's axis; and a second quadrant having a second surface contacting the second cam such that as the gear nut moves in a second direction opposite the first direction along a length of the worm gear the second cam contacts the second surface to urge the second quadrant to pivot about a second quadrant's axis collinear with the first quadrant's axis, a worm gear operatively coupled to the lever, the worm gear having at least one helical thread extending along a length of the worm gear; a gear nut positioned about the worm gear, the gear nut cooperating with the at least one helical thread to move along the length of the worm gear as the worm gear rotates, the gear nut including a first cam and a second cam; a first quadrant having a first surface contacting the first cam such that as the gear nut moves in a first direction along a length of the worm gear the first cam contacts the first surface to urge the first quadrant to pivot about a first quadrant's axis; and a second quadrant having a second surface contacting the second cam such that as the gear nut moves in a second direction opposite the first direction along a length of the worm gear the second cam contacts the second surface to urge the second quadrant to pivot about a second quadrant's axis collinear with the first quadrant's axis, wherein the lever is configured such that movement of the lever in a first direction urges the first quadrant to pivot about the first quadrant's axis and deflect the flexible distal tip portion in a corresponding first direction and the lever is configured such that movement of the lever in a second direction different from the first direction urges the second quadrant to pivot about the second quadrant's axis and deflect the flexible distal tip portion in a corresponding second direction.