Most of you may have heard of me. I’ve been nicknamed “vermiform appendix” because people say I resemble a worm, but I couldn’t care less. A narrow pouch that projects off the cecum (the first part of the large intestine in the digestive system) I am widely viewed as a vestigial organ “with little known function”. Talk about cheeky! Let me confess, though, that I have a notorious reputation for my tendency to become inflamed (appendicitis), which often leads to panic among surgeons and their need to chop me off without mercy. Further, as a testimony to their skills, they even keep me for years in a formalin jar, like their very own trophy for the “good work” done. I patiently put up with all the slights.
There was a time when no surgeon would remain idle. They had their hands full chopping me off. They would blame me for anything and everything. For discomfort in the right lower quadrant of the abdomen due to “gas” or “colitis” and even for “hysterical” symptoms. Yes, I was always the culprit. Not only qualified surgeons, but even pseudo-surgeons and quacks were busy soiling my name. There was one Dr Roldão (name changed) in the vicinity of Margão. He was my avowed enemy. He had a roaring practice. You could tell a person was a patient of Dr Roldão by his/her “appendectomy” scar. Many times after incising the abdomen, he couldn’t even trace me as I change my position furtively from person to person hiding between organs. Surreptitiously, Roldão would close the incision and dishonestly levy his charges all the same. “Operation successful!”, he would declare. On some occasions, veritable disasters would take place at his hands. Presto he would refer the patient to the Hospicio in an attempt to cover his mistakes.
Once, Dr Roldão did an “appendectomy” on a poor lady. It was obvious that he never reached me. Yet he told the victim that the operation went well and she was cured forever. Years later, this “operated-for-appendix” lady, developed typical signs of “appendicitis” and was referred to the Ribandar Hospital where the famous Portuguese surgeon Dr Batista had me removed, before the patient could lose her life. At the time the patient was being discharged, an exasperated Dr Batista told the lady, “Now go and tell your Dr Roldão that dishonesty and lies don’t pay. You could have been dead!” When the “twice-operated” patient timorously approached Dr Roldão in his clinic and told him all the strictures that Dr Batista had passed, the latter, without losing an inch of his cool, said, “Agô bai voss ani Dotor Batistac sang ki piklolem zadd khatorlear aninc ek pavtti pikta. Oi ki nam?”
Other victims of surgeons ‘rapacity in those days were my distant cousins, “the tonsils”. Any sore throat was enough reason for a “tonsillectomy”. The tonsils (palatine tonsils) are a pair of soft tissue masses located at the rear of the throat (pharynx). Each tonsil is composed of tissue similar to lymph nodes, covered by pink mucosa (like on the adjacent mouth lining). Running through the mucosa of each tonsil are pits called crypts. The tonsils are part of the lymphatic system which helps fight infections. Unnecessary removal of the tonsils may increase susceptibility to infections.
But doctors are never short of resources when it comes to making a living. A case in point is the myriad coronary angioplasties, which are needlessly performed. Thank God things eventually change for the better, whatever the reason. The man with the scalpel is now showing greater respect toward me and the number of “appendectomies” has drastically reduced.
I, Mr Appendix, feel quite relieved. My mucky reputation stands vindicated after research recently conducted by the Midwestern University suggested, “I have an important function to perform”. All of you who discredited my need may no longer consider me a vestigial organ “with little known function”. On the contrary, scientists are already convinced that I serve an important purpose in humans, in particular, as a “reservoir for beneficial gut bacteria”. Several other mammal species that also have an appendix are being studied and the research will shed more light on the mysterious organ that I am.
Heather F. Smith, Ph.D., Associate Professor, Midwestern University, is currently studying my evolution across mammals. Dr Smith's international research team discovered that I have evolved independently in several mammal lineages, over 30 separate times, and almost never disappear from a lineage once I have appeared. This suggests that I serve an adaptive purpose. The conclusion? I, the appendix, play an important role as a secondary immune organ. Lymphatic tissue within me can also stimulate the growth of certain types of beneficial gut bacteria, providing further evidence that I serve as a "safe house" for helpful gut bacteria.
This, in short, is my chequered story, which, pardon me, highlights to a great extent how doctors are often misinformed and bark up the wrong tree, or in my case, the wrong organ.
(Dr. Francisco Colaço is a seniormost consulting physician, pioneer of Echocardiography in Goa.)