Today, in the Path lab, I was a tad on the distracted side. Needless to say, I have been getting more and more antsy as the week has gone on with some impending vacation and interview time around the corner. Also, despite learning and continuing to learn a great deal about pathology and lab medicine as a whole, I feel as if I could be doing more and that I am not getting everything that I could be out of the rotation. I got what I expected and what I wanted out of the rotation, but it is very touch and go with regards to learning opportunities beyond self-study. Thankfully, one of the pathologists took me under his wing this morning and showed me a ton of stuff. Mainly ears, nose and throat things (given that was what he was told to review). But then, in conversation, he found out that I am interested in oncology, so he cracked out a few more “cool” cases he has been reviewing show me some of the subtleties in pathology. I am grateful. One, because I learned something. Two, because he killed at least 3 hours of my day.
The rest of the day was consistent with yesterday. I sat reading a textbook and taking notes waiting for something to happen. In the process, I have learned a lot. For one, I have at least skimmed the entirety of Robbin’s Pathologic Basis of Disease brought to us by Cotran, Kumar and Collins. This is useful in many ways… I have reviewed almost every body system (handy for the LMCC, my big licensing exam to be written in April). I also took notes on the various tumors that can happen in all of the body systems to prepare questions for a peer-reviewed quiz site for medical students and residents that I moderate (www.quiz.md). Early on in the afternoon, I was starting to get really bored and frustrated, as I was starting to wonder if this is really the best way to be learning. So, I took a break and ate a delightful square from the bake sale upstairs (thank goodness for bake sales) and prayed for patience and perseverance (and checked Facebook, my blog stats and my email for the billionth time today). When I went back, nothing had changed. Except my attitude. I decided to try to find the bright side in all of this sitting and waiting and reading and looking at slides (some of which I already listed).
Cells specially stained to show keratin and DNA. Image via Wikipedia
Somewhere between staring into the microscope and reading about body systems processes, I began to think (well, think beyond pink and purple cells). I was examining a few slides with laryngeal (vocal cord) cancer on them and noticing the inflammatory reaction taking place. The body was trying to fight the cancer growing in itself. It was failing, but it was trying. Here I am looking at these tiny little structures and I realize just how amazing our bodies really are. How complex. Millions of tiny tiny cells that form together to form organs. That synthesize all of the proteins we need to function. That protect us from infection and heal us from injury. And all of these processes are programmed into tiny little DNA molecules.
If you study the body, or almost anything else in God’s creation, you can see how intricately things are formed. We still haven’t figured out how some diseases happen or why the body knows exactly what enzyme to break down what food (well, chemical structures, but not every facet of the process). We can estimate the distance between the Earth and the Sun, but we still don’t truly know how many stars or planets there are. Sometimes we just don’t know, even in our know-it-all science-based society.
I love having answers. I am fascinated by how each body process works. It is amazing and yet terrifying how just one mutated cell with tiny errors in the genome can multiply and cause widespread cancers in so little time. How the flu strain this year will be ever so slightly different from the strains next year. Mutations… Survival tactics… How we and other living organisms get through.
Looking at cells under the microscope… Even normal skin, which in and of itself is the largest organ and a barrier to the outside world… It is amazing how the structures form and work together. How the cells know when to proliferate, how to migrate.
The other day, a physician was teaching me about ovarian cancer and we got talking about how ovarian cancer spreads to this section of fat called the omentum. The omentum is a layer of fat and blood vessels that is in the abdomen. On top of the intestines and such. The omentum is a common site of cancer spread because it has many blood vessels and just sits in the fluid in your belly. It is a simple organ… Fat, blood vessels, a couple ligaments hooking it to the bowel. But, it moves. It wraps itself around sites of infection and inflammation in the bowel. It has been said to plug a perforated ulcer, to surround cancer. Nobody really knows why. It doesn’t have muscle; it doesn’t have a nervous supply. How does it know? Studies suggest that the omentum is incapable of moving on its own (though it looks like it does) and that it moves based on the movements within the gut, diaphragm and position. It is postulated that it sticks due to formation of fibrin on contact (basically a protein type glue) and stays stuck because the contact with inflammation causes more blood flow through the omental vessels, thus bringing along white cells and other cells that make more materials that help it to stick like fibroblasts (Florey, Walker & Carlton, 2005. The Nature of Movements of the Omentum, The Journal of Pathology and Bacteriology 29:1). Still, there is debate as to whether or not another piece of the puzzle is missing and why it functions the way it does.
Omentum. Image via Wikimedia.
I can’t look at the body and how intricately it all works and say there is not a Creator. It is too complicated and there are far too many intelligent people who cannot get it sorted out in full. All of those cells working together. Its craziness.
For you formed my inward parts; you knitted me together in my mother’s womb. Psalm139:13
When you think about it, our body is like our communities, our worlds. Bad things happen when one of the pieces stops doing its job or changes in a negative way (i.e. carcinogenesis). The changes have nothing to do with who made the people or the cells. They are caused by errors in how the cell reproduced or how the people made choices. They are caused by things outside that should not have been allowed in. When defenses are down. And like our bodies, when we see that happening, we need to step up, to help to fix things or protect things. We need to be like an omentum and wrap ourselves around those who are hurting and protect them from the harm. And for that matter, protect others from the harm. We need to home towards the lost, the hurt and the wrong and heal it. Like our physical bodies, we need help from the Creator, we need to follow the instructions laid our for us. Sometimes we need others to help for us, like medicines. Professionals who know how to address certain issues or needs in the world and aid us in healing as a community, as a nation.
Just as a body, though one, has many parts, but all its many parts form one body, so it is with Christ. For we were all baptized byone Spirit so as to form one body—whether Jews or Gentiles, slave or free—and we were all given the one Spirit to drink. Even so the body is not made up of one part but of many. 1 Corinthans 12:12-4
The body is so intricate, so well-designed. That is how we should be as a people. Connecting, supporting, sustaining.
Who knew cells could be so inspiring?