An Ode to the Immune System
Each interaction we have with an antigen -any particulate that comes from outside our bodies-, our immune system generates a response by producing molecules that can linger inside of us forever. Remnants of the attacks against each microbe, every "foreign invader" to be jingoistic, that we've ever encountered circulate through our lymph in case we're exposed again. It's remarkable how our blood can be assayed to tell a story; a positive quanterferon test may mean we grew up in an area where tuberculosis is still endemic. A positive titer for hepatitis may mean we once encountered the pernicious virus and successfully protected ourselves against it (or that our childhood vaccination at our pediatrician's behest was successful). The IgG immunoglobulins floating through us were once components of an urgent, elaborately orchestrated defense, and each type we have tells a different tale about an infection or illness we've endured. Memory of where, when, and how we grew up and went on to live our rich, full lives is encoded in our immune cells. Throughout a lifetime, we interact with countless pathogens that have the potential to permanently knock us down, but we're protected by a microscopic, elegantly convoluted system that acts quickly but remembers forever.
The immune system is perhaps one of our most important examples of balance. Too much immune activity can be awful- overactive Th2 causes inconveniences like allergies, rogue stimulation of signaling receptors leads to hyperthyroidism, and deposition of immune complexes can take a systemic toll on every part of the body in conditions like lupus. Not enough immune activity can be equally devastating; people with rapidly growing cancers that have disarmed the immune system or "bubble boys" who can't develop crucial lymphocytes and are left vulnerable to any exposures illustrate this.
When I flip through sheets of dizzying signaling cascades and slides of monochromic blood smears, I try to think about the people who are affected by these lapses in immunity. The young family starting their toddler on chemotherapy, the teenager losing her hair to lupus, the young man who can no longer work in his construction business because of his inflammatory back pain, the grandmother who can't hold her family's hands because of advanced rheumatoid arthritis. I also marvel at the wonder of manipulating pathways to create true remedies. The rapid pace at which immunotherapy has changed the landscape of cancer research. The pain that existed just two generations ago that no one has to endure anymore because of advances in disease-modifying treatments.
These extremes of hope and suffering draw me to medicine, but sometimes the work of a medical student is more quotidian. Memorizing pathways and particles, inventing ineffective mnemonics, and straining to see obvious patterns in indecipherable pathology images can feel tedious. But I have hope that these concepts I'm learning, the window that I'm gaining into the complexities, creativity, and resilience of our bodies, will help me in ways I can't yet imagine.
And with that, I'm getting back to studying for our immunology exam tomorrow!
xoxo,
Juhi
The immune system is perhaps one of our most important examples of balance. Too much immune activity can be awful- overactive Th2 causes inconveniences like allergies, rogue stimulation of signaling receptors leads to hyperthyroidism, and deposition of immune complexes can take a systemic toll on every part of the body in conditions like lupus. Not enough immune activity can be equally devastating; people with rapidly growing cancers that have disarmed the immune system or "bubble boys" who can't develop crucial lymphocytes and are left vulnerable to any exposures illustrate this.
When I flip through sheets of dizzying signaling cascades and slides of monochromic blood smears, I try to think about the people who are affected by these lapses in immunity. The young family starting their toddler on chemotherapy, the teenager losing her hair to lupus, the young man who can no longer work in his construction business because of his inflammatory back pain, the grandmother who can't hold her family's hands because of advanced rheumatoid arthritis. I also marvel at the wonder of manipulating pathways to create true remedies. The rapid pace at which immunotherapy has changed the landscape of cancer research. The pain that existed just two generations ago that no one has to endure anymore because of advances in disease-modifying treatments.
These extremes of hope and suffering draw me to medicine, but sometimes the work of a medical student is more quotidian. Memorizing pathways and particles, inventing ineffective mnemonics, and straining to see obvious patterns in indecipherable pathology images can feel tedious. But I have hope that these concepts I'm learning, the window that I'm gaining into the complexities, creativity, and resilience of our bodies, will help me in ways I can't yet imagine.
And with that, I'm getting back to studying for our immunology exam tomorrow!
xoxo,
Juhi
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