Friday, October 30, 2009

It's Alimentary

Praise to our Intestines

My recent work has taken me to weaving my way in and around people’s bowels, something that is a common task for any general surgeon. However, I’ve had more than my usual share over the last few weeks. While making my way around a particularly difficult colon today those of us in the operating room discussed the relative merits of what has been named the alimentary tract, our intestines, the gastrointestinal tract, bowel , guts or “chitlins”.
If one considers all our various organs one would have to agree that our GI tract is, by far, the most intelligent. Think about it; our brain stands isolated within its protective cage, so snobby and aloof, only allowing certain special materials to enter its domain, always giving orders, but out of touch with its co-organs. The heart is a tireless worker, but mindlessly does the same thing over and over, day in and day out, blood comes in, blood goes out. Ditto for the lungs, a monotonous pastime of breath in, breath out, inhale, exhale, occasionally fending off noxious fumes and fighting invaders.
Kidneys are efficient cleaners and bones are glorified coat racks. Muscle is a little smarter, only working when called upon, but always the same thing, relax, then contract, hold this up, push that down. No wonder they get stiff and sore.
But our bowels do remarkable things. When not needed they rest, blood flow is shut down and our guts essentially go to sleep. Yet, when called upon, they spring into action, sorting out a variety of nutrients, directing them to the liver through the bloodstream or bypassing the liver sending fats through our lymphatic system.
This long tunnel through the middle of our body is constantly fending off invaders, be they micro-organisms, noxious chemicals or a variety of foreign bodies. The GI tract lives in symbiosis with huge numbers of bacteria, using these microscopic invaders for its (and our) own purpose. Yet if one of these foreigners behaves badly they are expelled, one way or another, causing us a brief period of discomfort, but also keeping us well. No other organ has to deal with such insults on so massive a scale, yet our bowels handle them with aplomb. Perhaps, our skin, the body’s largest organ, comes close, but on a much smaller scale.
So, I say, let us praise our bowels. When they are working properly they keep us happy, healthy and whole. But, when they go bad; when they are blocked or punctured or dying nothing can make us so incredibly ill. I say there should be a take your bowel to lunch day. But, come to think of it, everyday is take your bowel to lunch day.