Of Vocal Cords And Adversities

 I got to view the vocal cords of a human being today. Not in a text book, but for real. And now, I cant get them out of my head.

 Today in the OT, as a medical student, I got to observe an anesthetist as she intubated a patient. Intubation requires for a tube to be fitted down the throat into the trachea (windpipe) after sedation is achieved. And as the anesthetist slid the laryngoscope in for visualization, I got to stand right beside her and view the inside of the throat. The tube moved in effortlessly, coming to a stop as they reached the windpipe. From my angle, I could view the vocal cords. And with the light of the laryngoscope, these small white cords appeared almost to glisten.

Here is the reality. Right in the middle of red, wet, bloody tissue that is in our throats these glistening white cords stand out like pearls. They are tiny, you would hardly think they were created for a purpose. But their Maker knew where to place them exactly so that they could come together to produce sound, the very essence of communication, of how we get to know each other. And these tiny, lovely pearl-like cords are there in the throats of every human being, delivering the purpose according to the way they are used. They are there in the neck of a tyrant as he spews out hate, they are there in the victim as he cries for mercy. They are there for the adult who may espouse some wisdom, for the child as he murmurs, cries, screams or shout, for the one who soothes and the one who is soothed, for the oppressor and the oppressed.

These cords were created for a Purpose. Their Maker beautified them even though they are hidden inside our bodies. But how often do we take this for granted and abuse this incredible power that we have been given? And isn’t it even more amazing that no matter how different our skin is from the outside, it looks exactly the same were it to be cut open, for every human being? The patient lying unconsciously before us had come from a far-off village and was of a different ethnicity, but what did that matter?

As the surgery drew to a close, the anesthetist started to inject a drug that would reverse the patient’s sedation. She gestured that I take hold of the ambu bag (that was supplying the oxygen) with her. It took some time for the patient to wake up. I kept squeezing the bag nervously. I did not want her to be deprived of oxygen even for a second. My mind came up with wild possibilities (that are usually typical when you are in med school) of her never waking up (God forbid). The doctor sensed that I was worried and looking at my squeezing fingers, she told me to let go. I looked up as if he was crazy. But then she explained

“If you keep supplying oxygen yourself, she will not be able to breathe independently as her brain will never receive the stimulus…”

At once I understood. It is such a precious moment when random facts that you have been learning for years begin to take shape and you see them being applied. One of these facts, is that for the human body ,the stimulus for breathing is not a lack of oxgen, rather it is an increased concentration of Carbon dioxide (CO2). CO2 is a waste product produced by our body cells. If we hold our breath in for too long, it would start accumulating within our lungs and its concentration would increase. It is this increase that the brain senses. It acknowledges that the body is in distress and throws itself into action mode, sending stimuli for the respiratory muscles to contract. It is this same stimulus that is depressed under anesthesia during surgery and the same one that is needed to kick in when the operation is over so that the patient can breathe independently.

I felt it. I could feel, or rather my fingers could sense, the moment when the patient began breathing on her own, when her lungs defied the mechanical ventilation and demanded to expand on their own. Take it from me, that rate, rhythm of spontaneous, natural breathing is perfect, oh so perfect!

There are times in life when we are brought down, much like when CO2 starts accumulating in our lungs. But if it didn't, how else would the body know it was in distress? How else would it send the stimuli for us to breathe the oxygen in? How else would we ever get up from the state we are in?

My teachers today were not just the kindly anesthesiologists who explained everything step by step. My teachers were also the tiny pearls we have in our throats, it was the gentle rise and fall of the patient’s chest as she drifted back into consciousness. It was the constant need of having to view the monitors to check the vitals that reiterated how vulnerable we are. And it was also the human body regaining its normal, perfect rhythm at the end that taught me the immense beauty and power it possesses.

And they will be my teachers everyday.