MOLECULAR BATTLEFIELD

I would like to take you into a different world. I am no J.K. Rowling to create a fictitious world. The one we are going is real. Discovered a few centuries ago, this is an elusive world with impeccably arranged moieties which pose perpetual challenges to the understanding of their functions. There are times and places where these moieties exist in reconciliation; but many a times they are engaged in the battles fiercer than the battle of Kurukshetra or the World Wars I and II. There exist peace-keeping bodies like UNO but these battles are inevitable in the sense that they aren’t fought for greed or jealousy. These battles are fought for survival where there is absolutely no mercy for the timid.

I would not have taken you to this world if it were not for Ganaraj who insisted me to take him there. Though it wasn’t the first time I was visiting, with him I found it more vivid than before. The more I explained him, the more I learnt myself. I remember, my physics teacher (Mr. K. S. Murugesh Sir) used to tell us, “You should write your answers in such a way that even the last fool in the universe should understand physics by reading them.” Well, that’s the way I learnt physics. But now, I was asked to answer a biology question in that way…

Ganaraj asked me, “Why does one get fever?” It was 13^th of February. “Well, it isn’t uncommon for a guy like you to get fever on the eve of Valentine’s!” I chuckled, not knowing that he was running a mild fever since some days. He is a techie who analyses the problems to depth before trying to fix them. And so, I had to explain him Immunology in a way I had never done before.

Just as a kingdom’s territory that has some natural barriers like mountains or river or sea at its boundary, the human body too has some natural barriers – viz. Skin (the largest organ in the body), Hydrochloric acid in the stomach that kills microbes in the contaminated foods, the hair and mucous in our nose that trap microbes in the contaminated air etc..

If the bugs somehow manage to cross these barriers and try to gain access into our body, the war begins. Most tissues have got cells called ‘Macrophages’ (literally meaning, ‘Big Eaters’) which function as scavengers. They keep ‘eating’ dead materials (from turnover of worn-out cells) and when they feel there’s some foreign material, they get alert and ‘blow the conch’ for the battle. The white blood cells (WBCs) are the soldiers that are constantly circulating in the blood stream. So, when the macrophages need help, they release ‘cytokines’ or ‘chemical messengers,’ that signal the circulating ‘soldiers’ (WBCs) to move into the place of battle; just as you dial 911 (or 100 in India) when you are in danger. One such cytokine is Interleukin-1 which alters the “temperature regulator” in the brain. It is like setting the ‘thermostat’ at a higher temperature and the body temperature goes up. That’s how Ganaraj was having fever! (So did we all!)

There are different types of WBCs, each of which is a ‘specialist’ in the use of different ‘weapons.’ First ‘Neutrophil’, a kind of WBC, visits the battlefield, makes a general survey and releases some more ‘chemical messengers’ to wake up the ‘sleeping soldiers’ and attack the enemy.

As I said earlier, this battle is going to be fierce and in battles it’s not just the invaders that die; thousands of soldiers and civilians too. To minimise as much damage as possible, the army works on sharpening the target. Once macrophages ‘gulp’ the invading microbe, they process it and the ‘key features’ (antigens) are documented and conveyed to the ‘soldiers’ so that they can distinguish the enemies from the civilians – the process is termed “Antigen Processing.” This is something like the FBI’s way of taking the photographs of the criminals and circulating them with a “Wanted” stamp. Once the enemy is identified (or the antigen is processed) it is taken to the Helper T-cells or the “Commander-in-chief” of the army. Helper T-cells or CD4+ T-cells are also a kind of WBCs. This is the prime target of the notorious virus HIV; HIV kills the commander-in-chief of the army, soldiers go helter-skelter and the army disintegrates. And so, the open door tempts even a saint!!

The commander-in-chief (Helper T-cell) coordinates between the other specialists of the army. It does so by means of ‘cytokines’ or chemical messengers. There are varieties of cytokines, each one carrying a specific message. It is like a Morse code. One specialist of the army is Cytotoxic T-cell, a kind of WBC, comparable to a ‘bombing expert.’ Once the Helper T-cell sensitises the Cytotoxic T-cell with the ‘photograph’ (antigen) of the enemy, it goes in search of the microbe and kills it. As I said, it does so with ‘bombs’ which claim the lives civilians as well!

The other specialist is a B-Lymphocyte or B-Cell, again a kind of WBC, comparable to a ‘missile expert.’ Again the commander-in-chief, Helper T-cell awakens the B-cell by showing the enemy’s photographs (antigens). B-cell generates antibodies (missiles) against the antigens. The antigen’s structure is assessed by the B-cell and the antibody it generates is complementary in structure to that of the antigen, so that the two fit exactly into each other; something like a lock-and-its-key or a box-and-its-lid or simply a USB-port-and-USB-connector! These missiles or the antibodies are released into the blood stream and wherever they encounter the microbe they fasten themselves to their respective antigens. With antibodies sticking on to them, the microbes become docile and thereupon they can easily be destroyed. Again scavengers (macrophages) come to site of destruction and ‘mop up’ the debris. Later on new cells deftly replace the lacunae.

That’s not the end of it all. Some of the ‘specialist’ cells remain quiescent. Not because they are sloths but because they are used as ‘Immunologic Memory.’ It is like adding a copy of the file to the database for future references. In due course of time, should the same microbe invade the body again, the ‘soldiers’ need not waste time in analysing the antigens. The memory cells form copies instantly and attack the bug more vigorously and efficiently. This amazing property of our immune system is the basis for Immunisation. Immunologists artificially process the bugs and present the antigens in the form of vaccine. The immune system gets acquainted with the bug’s antigens and forms ‘memory’ and whenever the infection with that bug occurs; it will be a cake walk for the ‘soldiers.’ The ‘boosters’ we receive every-once-in-five-years or so are meant to trigger our fading Immunologic ‘memory.’

What an immaculate mechanism! I had wondered. It may have taken millions of years of evolution but every day is worth it, I had felt, during the first year of my medical school. But if it were to be as perfect as I had imagined, I would not have to study the subjects in the later years of my medical school! Oh, yes, I mean it! As I moved on, I understood that despite such a composite organisation, things go wrong. I saw a few cases where the ‘Morse code’ was ‘misread’ and resulted in catastrophes beyond imagination. These are the Disorders of Immune System – autoimmune disorders, hypersensitivity (commonly referred to as ‘Allergies’) and Immunodeficiency disorders etc. I also saw the specimens in the pathology museum; sufferings in almost all the wards of the hospital because of bugs that somehow managed to delude the immune system.

No amount of complexity is sufficient. The bugs take it as a challenge and evolve into ‘stronger’ bugs. Antibiotics are no reason to open champagne. Bugs are amazingly brilliant in developing alternate biochemical pathways to elude the harmful chemicals. If we don’t struggle we lose the battle; and complacency is our greatest enemy. So, the quest for perfection continues… Who’s next?

Key that Unlocks the Opportunities

I would like to share with you a small anecdote. This was told to me by one of my Swamijis during our II PUC send off at Sri Ramakrishna Vidyashala, Mysore, where I did my high school and PUC. His name is Swami Tejomayananda.

“There was a small boy who was very competitive in his studies and sports. He had won many prizes and gifts throughout his career. When he was in the final year of his graduation, his father promised him to present him a sports car if he were to bag a medal at the university level.

“It had always been his craze to drive a sports car and his father’s promise motivated him a lot. He worked hard to achieve his dreams and finally did it too. When he came to convey his success, his father pointed to a new book on his table and said, ‘I knew you would do it, my son. There, I have got a new book for you.’

“‘I wanted a sports car…’ the boy shouted angrily. Before his father could explain him, he slammed the door behind him as he went off. He was so angry with his father that he decided to stay away from him. He went off to a distant place and found a job. He married the girl of his choice and was happy there. He never returned back to see what had happened to his father after he had left.

“A few years later, he got news that his father was on his death bed. He returned to see his father, but it was too late. He saw that book still lying on his father’s table. And as he opened that book, something fell to the ground and drew his attention. It was the key of a sports car kept as a bookmark…!”

With that story, Swamiji concluded,

“It does not really matter how many opportunities came our way when we start counting how many we missed just because they did not come a desired form.”

Even though it’s seven years since I heard it, the story and the moral are still afresh in my mind inspiring me to look for hidden opportunities around and to make the best use of them. Hope it has inspired you too.

Everyone is a Diabetic..!

Though I had to read extensively on Diabetes Mellitus as a part of my undergraduate curriculum, it wasn’t until my internship days that I understood it better. You may find diabetics in almost every ward in a hospital but surgical ward is where you find them perceptible. As I began the surgical dressing of a Diabetic Foot Ulcer, that had awfully occupied the entire heel, I wondered why the patient came to the hospital so late. I mean, such a humungous ulcer doesn’t develop overnight. Why could she not seek a medical attention when it was embryonic? She replied, “I was not aware of that!”

Diabetes, a disorder of the carbohydrate metabolism, is described by some authors as “poverty in excess!” because though the glucose levels are high in the blood, glucose cannot be taken up by the cells and used. Spare the insulin-independent organs like Brain and Red Blood Cells, all other organs are starved! So, you see the muscles getting atrophied, the person becoming too weak to fight a trivial injury and succumb to horrendous infections thereafter. Also the unused glucose undergoes an alternative metabolic pathway (non-enzymatic glycosylation) which yields toxic metabolites. Hence the retina gets damaged, the kidneys are affected and the nerves can no longer do their job (Diabetic Neuropathy).

There are sensory nerves collecting the information from every millimetre of your skin. So, you feel the touch, pressure, vibration, temperature and pain from every square mm area of your body even if you can’t see it with your eyes. The moment something hurts you, you are aware of that and you give your attention to that. That’s not the case with Diabetics. They aren’t aware of an ulcer developing in their foot (unseen area of the body) until it goes on to smell badly.

Awareness! That’s the word that churned my thoughts on this appalling disease process. Take a look at the emblem of Karnatak University. It says – "Arive Guru" - which means “Awareness is teacher.” Such is the importance of Awareness. Well, I pity these Diabetics who are not aware of the parts of their body. But they are far better than people who are not aware of themselves! Just like the sensory nerves that pain you but ultimately protect you from developing dreadful complications, awareness or conscience pricks you time and again, and guards you from getting vice.

“A mind which wanders following the objects of desire deludes the intellect of the person just as a strong wind that rips off a ship in the ocean” (Bhagavad Gita 2.67). They are people who are at the verge of their extermination. If at all one could take a photograph of the mental status of such people, I am sure it would be more outrageous than this Diabetic Foot Ulcer.

But why in the first place one loses his awareness? Well, just as diabetics develop neuropathy as a result of uncontrolled blood glucose levels, one loses his intellect as a result of uncontrolled debts of Karma. The disciplines of action as described in the Karma Yoga are very much similar to the mechanisms of Glucose Homeostasis of our body. And that is why the pathology of Diabetes closely resembles the moral instability as per the Karma Yoga.

The Glucose Homeostasis means maintaining the blood levels of glucose within the normal range. There are many mechanisms by which the body senses the decrease or increases in the levels of glucose in blood and tries to bring it back to the normal range. In other words, the body maintains a perfect balance between the “gain” and “expenditure” of glucose. Similarly, Karma Yoga mentions “accepting” and “giving”. It is our duty to sense the “gain” and try to bring the balance back to normal by “giving.”

This is what the Karma Yoga means by mentioning the "Debts" or "Runas." The five debts according to the Karma Yoga are -

1. Debts towards Inanimate Nature (Deva Runa)

2. Debts towards Other Animals and Plants (Bhoota Runa)

3. Debts towards Parents and Ancestors (Pitru Runa)

4. Debts towards Society (Manushya Runa)

5. Debts towards Teachers (Rishi Runa)


So, the “work” or “Karma” we do should be directed in these directions. The Karma Yoga stresses upon clearing these debts so that one becomes free and attains salvation. That goes on to say that we are already in “debts.” Only Yajna (fulfilling the five debts); Daana (contributing more than consuming) and Tapas (stretching the limits and self-improvisation) purify the men of wisdom. (Bhagavad Gita 18.5)

Just as a physically healthy man maintains his blood glucose levels within normal range irrespective of the type and quantity of food he eats or the stressful situations (infections, starvation etc…) he undergoes, the “Sthita Prajna” or the “Yogi” maintains his mental calmness irrespective of the situation he is into.

“Sufferings don’t perturb his mind, He does not cling on to pleasures, He is free from attachment, fear and anger, and He is called a Sage of Stable Wisdom.” (Bhagavad Gita 2.56)

I don’t think we are the “Sages of Stable Wisdom” but we can always strive to be so. That is why I said in the beginning “Everyone is a Diabetic!” Now, the choice is ours – we can either struggle to get our glucose back to normal or go on to lose the sensation sooner or later and develop Diabetic Foot Ulcers!

Funny bone

The kind of posts I am writing makes one wonder if I am totally a serious guy; which I am actually not. Humor is a part of my life - something that keeps me cheerful all the way. Recently, I laughed out more than usual because of a real life incident. Almost everyone bursted out into laughter as I shared the experience and a few felt I should blog it to reach more people. And that's why this one..

It was just another day and I was chatting with my brother who is in UK. Incidentally, one of our cousins came to see him and I said hello to him. He has a daughter aged 3, who has been to India just a couple of times and I had seldom met her. So, the first time we saw each other was on a WebCam.

Though Bhanavi is her name, she feels good when someone calls her "Naughty-Bhanavi"; and she just keeps on exploring ways to make people call her that way reflexly. It took some time for her to get acquainted to me, after which she fluently unfurled her pranks. She sang a few rhymes, played with crayons, danced a bit and showed me a few pictures of animals in her books. One of them was a Starfish. I asked her, "Where do you find a Star?"

She didn't have to think much. "Sky," she replied.

"Where do you find a Fish?"

"Water." She took much less time for this question.

"So, where do you find a Starfish?"

But for the earlier questions, she would have replied instantly. She took some time and replied confidently, "Water!"

I wanted to pull her legs. "If Star is in the Sky, Fish is in the Water, then, Starfish has to be in between - on the Land, isn't it?"

She didn't seem confused at all. She was confident with the answer she gave, yet, she could not convince me. She tried her best but I stuck to my question expressing my dissatisfaction to her answer.

She turned to her dad. "Papa, the person we are talking to... Does he really exist or is he only in the Computer?"

This time, her daddy and I found it hard to convince her!

Darwinism

It has been a long time since I saw a Kannada movie by name “Gouri Ganesha” but I keep recollecting certain sequences from the movie again and again. Not because it has some unparalleled comic scenes in it but because it gives a moral in the end. Those of you who have missed the moral or have not yet seen the movie, please go watch it, it’s worth it. If you aren’t familiar with Kannada language, I pray someone comes up with English subtitles or a remake of this more than 15 year old movie!

Let me brief up the story for you. The story revolves around an intelligent unemployed bachelor struggling to make his living in a metropolitan city. His cunning wit not only helps him cheat people and earn him that day’s living but also gets him caught time and again for his pranks. Next, he moves around the city in search of a new scapegoat only to get caught again. The story gets good momentum when he finds the diary of a deceased damsel in a mortuary and gets to know the intricate details of incidences in her life and persons behind her sorrows. She would have had escaped the clutches of three men in her life to remain chaste but ultimately would have failed to sum up the money required for the cardiac surgery for her illness which would have claimed her life. But the men are under the delusion that she isn’t chaste. The protagonist uses his resourceful wit to create a fictitious son for her and each of the three men believes themselves to be the biological father of that child and sends money to the protagonist assuming him to be the caretaker! The fixed monthly income solves the basic problem of the unemployed protagonist and things turn out to be favourable until a day when all the three men coincidently visit him to meet their sons. The movie reaches the climax when they all find out the truth and attack him. The protagonist confesses that he lied to them but he justifies it by saying he did it for his living. He then questions them, as to why is it that they believed him and sent him the money. They turn speechless. He ends the drama by saying; they were cheated because they had in them some weakness and their weakness was their lust. Also he urges the audience to correct their weaknesses, for as long as one has a weakness there are always guys like him to exploit it!

How meaningful it is! But the irony is that most people fail to take the moral of the movie and keep getting into troubles. You know how? Surf some Indian news channels at night (local time), and I am sure you will find some “Crime Stories” being aired. People watch them but they don’t learn anything from them. That is why most episodes have similar crime sequences! To illustrate a few, some stranger goes to a village and promises to double any amount of money given to him within just six months. He does so for a couple of months and sets the final trap. One fine day the stranger vanishes with a huge amount of money and people find the truth a hard pill to swallow. Viewers often tend to blame only the cheat and forget that it was the greed of the cheated that got them into the scandal. What’s worst is some people get cheated by the same person again and again. That reminds me of a proverb: “If you are cheated by the same person twice, then probably you deserve it!”

Well, if you observe closely, there are many incidents happening around us (or with us) that work on this “Weakness” principle. The stock market gives a huge return to some investors and that always comes at the cost of many people losing their investment. The gamble here is partly luck and partly intelligence. One who has the right information of the share market invests cautiously where as the ignorant erratically loses the gamble. This can very well illustrate that knowledge is strength and ignorance is weakness and wherever the weakness is exposed, it is exploited!

Now, who doesn’t have weakness? Well, in some way or the other, everyone has! I mean everyone. The rich? Yes. Richness is their weakness. Anytime, anything can happen in business and the equation may all of a sudden reverse, turning people from riches to rags. Same is the case with politicians. One defeat in the elections can push them to dark. Celebrities? Yes. A couple of flops in their endeavours can make the public forget them. That’s why you see those celebrities, politicians and business executives so very generous (?) when they visit Thirupati! The astrologers are intelligent enough to exploit their weakness!

If you read the Hindu Mythology, there are several instances where demons perform penance and get extraordinary boons from Gods and Goddesses and misuse the powers. The Gods then struggle to sketch a death plan to end their tyranny. For a moment, I wondered, why do the Gods grant them those boons? It is because, even God has weakness! Yes, goodness is God’s weakness and the demons exploit it!

Ah… when God himself has weakness, who else is spared? Practically none. Everyone has an element of either Greed or Lust or Anger or Jealousy or Ego or Pride. Sit back and reflect upon yourself. I am sure; you will discover your weaknesses. You need not feel bad about it. In fact, you should be happy that you ‘discovered’ it. Some weaknesses can be overcome. This is where a ‘Guru’ (teacher) or the company of good people can help you. And some weaknesses cannot be overcome. That is where you need to use your intelligence to hide them. Remember, there is a proverb, never show your enemy where you bleed.

As Charles Darwin puts it, there is struggle for existence at all the strata of life. One’s strength is another’s weakness. The lion’s power is the deer’s weakness. The deer’s amazing speed is the lion’s weakness. In the end, Darwinism says, “It is neither the strongest of the species that survives, nor the most intelligent, but the one most responsive to change.” Wow! Look at his prophecy! He just summarises the whole essence of life. The humans struggle against bacteria. The bacteria struggle against the human immune system. Humans through their intelligence found out antibiotics. If ‘intelligence’ alone were to be the criteria for the ‘survival of the fittest’, there should have been no harmful bacteria. But look at the nature. The bacteria are responsive to change! They develop alternative biochemical pathways once their niche changes and that’s what we now call “Antibiotic Resistance.”

So, whether you are mighty or weak, intelligent or dull, rich or poor, human or bacteria, you continue to struggle. As long as you struggle, you live. Therefore, as long as you live, you struggle!