We must unravel myriad complaints and decipher which organ system or systems have problems in the ED. Sometimes the complaint aligns easily with the ultimate diagnosis. You have a sore throat? The tests showed you have strep pharyngitis. Simple. Other times, the complaint and diagnosis may be much more difficult. You feel mushy in your tummy? Aha! It turns out your sodium was 118.
I feel the organs are sometimes arguing which is the most important. I decided they could best discuss it among themselves to determine which system would be deemed the most important in the body, or more specifically, my body.
Brain: Salutations, fellow Brandt organ systems. I think that with a simple deliberation we can all concur that I am obviously the most important organ.
Kidneys: You? You!? You spent the past 30 minutes staring at a tiny screen.
Brain: Such an egregious accusation! I've been conducting research!
Kidneys: You watched nine cat videos. Before that, you took a test to determine which Pokémon you'd be.
Lungs: You should talk, Kidneys. I've been rootin' and tootin', so could you work a little doggone harder please? I'm getting more filled up with water than a horny toad.
Kidney: Lungs, you never do any work yourself! The diaphragm moves you, and you do nothing to keep yourself clear.
Lungs: I reckon I might need some of that Lasix! I want Lasix!
Kidneys: What? How many beatings do I have to take for you? I've got enzymes, I've got ion channels, I'm working my tail off here, and you want Lasix? What do you do to help yourself? You call passive diffusion work?
Pancreas: At least I regulate a wide variety of enzymes.
Brain: Pancreas, it takes about 50 years for someone to notice your imperfections.
Pancreas: Yep, I'm playing the long game.
Lungs: I reckon just because surgeons are terrified of the pancreas doesn't mean the rest of us are!
Liver: I want to get a word in here. This place would be a mess without me.
Arteries: We're already a disgusting mess!
Heart: It's not my fault he can't stop eating pizza. Now I need to get back to getting pumped. Who wants to get pumped!? I want to PUUUUUMP!
Kidneys: Liver, you're just garbage cleanup. And even if you break down, a little paracentesis here, a blood transfusion there, people can live a long time with yellow eyes. Who doesn't like looking spooky?
Liver: You talk a big game, but you're weak, Kidneys! They cut me in two, give half away, and I just come back for more. None of you guys do that.
Kidneys: Blah blah blah, big deal, so you can regenerate. You cry every time Brandt takes a Tylenol. I get 20 percent of all the blood! High blood pressure, boom, I fix it. Fluid overload, boom, I make it better. Filtering Superstar Extraordinaire would be a better name.
Lungs: I reckon, but you aren't priority one. Six minutes, y'all. Six! That's how long we last without me. Also, Kidneys, if doctors think there's even a chance of me having a blood clot, they'll sell you down the river without giving it a second thought.
Brain (fist bumps Lungs): I concur. A possible thrombus near me? Get ready for annihilation, Kidneys. You're just an afterthought at that point. I don't understand why they even bother elucidating the creatinine. They are going to ignore it anyway!
Kidneys: Well, that's just because I'm so tough I can take it.
Lungs: I reckon it's because you can be replaced by a machine.
Kidneys: That's a pretty low blow, Lungs.
Lungs: Not my fault if you die; a trip every Monday, Wednesday, and Friday will replace you.
Taste Buds: Tra-la-la! We're pretty important!
Kidneys: You just taste things. You're just the happiness organ.Reproductive Organs: Whaaaaatzuuuuuuuuup?
Brain: Correction: one of the organs that provides pleasure.
Kidneys: Maybe I can be replaced, but the rest of you would be miserable without me.
Brain: Listen. If I ever power down, they'd round up the rest of you and dispatch you to new owners.
Kidneys: Big talk from the organ that submitted an article to a professional EM magazine all about withholding a giant fart. (EMN. 2016;38:8; http://bit.ly/2kg9J9z.)
Well, I guess I never got my answer, but I guess I'm happy that they all usually get along.
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Dr. Brandtis an emergency physician with the Grand River Emergency Medical Group in Grand Rapids, MI. He was the winner of the 2008 Writer's Digest Short Short Story Writing Competition (http://bit.ly/1kIBaOf). Read his blog and other articles athttp://brandtwriting.com, follow him on Twitter @brandtwriting, and read his past columns athttp://bit.ly/EMN-BrandtsRants.Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.