Health

Vitals and Bits #3: The Appendix

At the beginning of each new shift, certain members of the hospital staff will receive a pair of freshly laundered scrubs to wear while working. If you’re one of the lucky ones, you’ll be handed a pair of ancient scrubs that have been laundered a billion times. Over time, the unforgiving hospital washing machines pulverize the stiff green scrub material to unbelievably soft oblivion. Old scrubs that are nearing retirement are much more comfortable and better fitting than the awkwardly crisp new scrubs. They’re like a treasured, paper-thin vintage tee shirt. Unfortunately, just like a perfect vintage tee, the ideal pair of worn scrubs is a pretty rare find.

One night while I was working night shift in the newborn nursery, I noticed that one of my favorite pediatric residents had managed to get his hands on a pair of the old soft scrubs. The thing about the soft scrubs, though, is the decades of laundering have also shrunk them to about three quarters of their previous size. My resident, who we shall henceforth refer to as Dr. Abs, kept tugging at the hem of his shrunken scrub top, since it was an inch or so too small for him.

Like many residents, Dr. Abs liked to pass the time during a slow night shift by telling dirty jokes with us at the nurses’ station. That night, around 3:30 a.m., Dr. Abs succumbed to a fit of yawning after delivering the punch line to some filthy joke about Tipper Gore. As he yawned, he raised his arms over his head and the hem of his short scrub top untucked itself and traveled northwards. The five nurses hanging around the desk were held spellbound for the few brief seconds that his bare, toned abdomen revealed itself. I couldn’t help but notice a finger-length scar on his lower right abdomen.

“Is that where Tipper Gore bit you?” I asked him, pointing to the scar.

He glanced casually down at the scar.

“Actually, I had to leave my appendix in Thailand a few years ago,” he replied.

The appendix is an enigmatic segment of bowel-like tissue that juts off of the colon, near the place where the small intestine meets the large intestine. The appendix does not perform any digestive function, and so there are a few theories out there as to just why the heck we have an appendix anyway.

The older argument is that the appendix is vestigial, meaning it used to be an organ that served a purpose in our ancient humanoid ancestors but lost its function as modern humans evolved. Newer theories propose that the appendix, which is a rich reservoir of lymph tissue and healthy intestinal flora, plays a role in immunity and digestive health.

Whatever function the appendix may or may not serve, people who have had theirs removed seem to do just fine without it. In fact, the appendix is a relatively high-risk accessory to be sporting on one’s colon. The appendix has a nasty habit of becoming inflamed or infected, which is the case when someone gets appendicitis. Appendicitis is life-threatening, since an inflamed appendix can rupture. A ruptured appendix spills a slew of bacteria into an abdominal cavity that’s supposed to remain sterile. This means people can become septic and die if their appendix decides to go all supernova on them.

As it turns out, my pediatric resident’s appendix had ruptured while he was vacationing in Thailand. Although he was a medical student at the time, he didn’t put two and two together and waited until he was on the brink of death before dragging himself to a medical clinic in the small Thai village where he was staying. The staff at the clinic recognized what was happening right away, despite a pretty significant barrier language. They started antibiotics and transported him to the main hospital for surgery with lightening speed. He was in surgery that same day, and remained in the Thai hospital for almost two weeks while he recovered from his surgery.

After telling us his story, Dr. Abs stood up and stretched one more time.

“These scrubs are so comfortable,” he said mid-yawn. “They feel like pajamas. I’m going to have to take them off if I’m going to be able to stay awake.”

Five grinning nurses nodded in agreement.