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I am Galen, investigative reporter and a roving T-Cell lymphocyte, also known as White Blood Cell or “Killer” (Galen winks) on-site in the Oesophagus. T-Cells don’t ordinarily visit the oesophagus. I’m usually sent elsewhere on “Seek and Destroy” missions – elimination of the bad guys. But there have been rumours of an anomaly, so I’ve been made a deputy scribe by the esteemed Centre for Immunity (CFI) to interview Sophagus, and report my findings to the CFI. Sophagus is a well-respected and popular speaker for the Digestive System (though I have been warned he can be a bit old-school and long-winded). The role is for life, so Sophagus has a wealth of experience. I’ve been given permission to share my interview with all cells and tissues.

Galen: “Citizen Sophagus, I am here surrounded by your upper regions, just below the Pharynx. Can you introduce yourself to our audience and tell us about your background?

Sophagus: With pleasure Galen. To begin: I am Sophagus, one of the first-born from the original embryonic cells. Some of the audience may not know this:  we came from the Neural Tube, our cells multiplied and diversified until we became a great and tireless Nation of multi-tissued, skilled, industrious workers.             (Meaning of course, you, my esteemed audience of Organ -Systems!) I owe all my knowledge and memory to the ‘Lofty and Supreme Council’ (The ‘Lofties’ or ‘Council’) who travels above me in a fortified cranium sanctuary. I feel very honoured to form such a useful part of The Nation. (Sophagus swells slightly with pride)

Galen: So you come from an ancient evolutionary line?

Sophagus: Yes, indeed Galen. And each and every time a new embryo Nation grows inside an adult nation, far below in Utero, this process repeats like clockwork. Unless some aberration unduly meddles with the template. (Sophagus shudders a little).

Galen: An interesting side story, Sophagus. But first can you tell the audience what you actually do?

Sophagus:  Of course, Galen. As Sophagus, I direct food that enters the Nation through a friendly zone: the Mouth, over the Buccal region –full of impressive powerful cutting and grinding surfaces – past Pharynx, into my inner self, then on to Stomach. My closest friends are Tongue, Teeth and Pharynx. We talk all the time. They let me know what’s coming up so I can enjoy the anticipation of the soon-to-arrive delivery. But I tend to avoid having too much to do with Stomach, who can be cantankerous at times and send up unpredictable showers of caustic fluids.  I don’t like any foreign fluids or cells entering me from the lower regions. They can damage my delicate internal lining.

Galen: That might sound a touch xenophobic to some of our readers, Sophagus.

Sophagus: Not at all, Galen. The entire Nation is a co-operative venture in which every organ system has an important but separate role to play.  Suppose the kidneys were suddenly required to grow embryos, or the spleen took over the function of the eyes! Just imagine the chaos!

Galen: I take your point, Sophagus.

Sophagus: Where were we? Ah, yes...I (mostly) enjoy the daily consignments of interesting textures, pressures and temperatures of the food, and go into an ecstasy of contractions, my three layers of tissue on automatic. Long and circular muscles squeeze the squished food, properly called a bolus, in snakelike fashion, while my inner mucoid self enables a slippery, smooth sliding effect. A very pleasant and sensuous experience. (Sophagus shivers with pleasure, and I cling on, hoping I won’t lose my grip).  I especially enjoy the fizzy cool waterfalls carrying some sort of intoxicant. Tongue told me the names of my favourite beverages: They are Prosecco, Sparkling Rose´, and Gin and Tonic– in moderation of course.  Too much, and Stomach loses self control and regurgitates all over me! Disgusting!

Galen: Guiding the flow of food is a very important job, Sophagus.  No wonder you have such a fantastic reputation. Can you say more about your association with The Lofty and Supreme Council? 

Sophagus: (Sophagus starts to swell around me again, and I fall off a slippery wall, barely able to grab on again with some of my T-Cell micro-villi projections). Ahh, I am proud to be close to the Council. You might say I have a seat at Council’s table. (Not in the flesh, so to speak, but we are in continual correspondence!) For without me, the precious food energy the Nation needs would never reach its destination. In a more humble moment, I may admit that other workers, like my good friends Buccal Cavity, Teeth and Tongue, must precede me in the sensing and masticating departments. I remind myself that this is a co-operative venture, where each worker plays their harmonious part like a well practiced choir. The Gonads claim they have more fun than I do.  But they don’t get to savour Prosecco, and their entrances sometimes get invaded by nasty tiny creatures. (Sophagus huffs with distain)

Galen: Mmm. Tell us more about The Lofty and Supreme Council. They sound uber important.

Sophagus:  From their superior position, Council navigates and manages the daily excursions, refuelling, sanitation, reproduction and rest periods for the whole organism, The Nation, which we workers are proud to be a part of. None of the organ systems could survive alone in the outside world. Try to picture Stomach going to a movie theatre or a cafe alone! Laughable! Does that make us totally dependent on Council?  Well yes, but it is a two-way street. Council would die without us too.  I’ve never heard of a brain enjoying a daily stroll along a promenade, though Council sometimes writes fanciful stories about such things! Preposterous!

When not writing silly stories, Council devotes its time to learning, sharing among council members who may be involved in sensing, responding, making decisions then prompting action, along with synthesizing, resting and dreaming. All knowledge transformations are shared with the rest of us workers, even to the level of the mysterious molecular codes in each cell – the DNA and RNA. I apologise to the audience if I am sounding too technical, but sometimes it is necessary to get my meaning across. (I can take questions at the end if we have time, Galen)

Galen: Sophagus, my next question is about Governance.  Is there a union or is there some other structure in place to keep the Nation ticking over?

Sophagus: What keeps us adept, whistling while we work? I’ve given this some thought. (Sophagus sighs gently) We are not a Democracy (the Nation would die of hunger, awaiting decisions) or a Socialist Republic (Council doesn’t eliminate dissenting workers unscrupulously for fear of undermining the health of the Nation). Text book Capitalism or even, oh horrors, a Failing State like the USA? No. This could to lead dangerous disharmony.  I prefer “Benevolent Dictatorship”. I am happy to report that this works quite well in a young and healthy Nation, though things have been known to go badly wrong. The Union role is occupied by the CFI, who watch over cellular health and send out good fellows like you, Galen, to kill any marauders or unwelcome squatters.

Galen:  When I entered your lower canal just above Stomach I spotted some migrant Goblet cells that have squatted in your columnar epithelium, causing ‘unnatural tissue’, and some inflammation.  I also ran into some eosinophil colleagues of mine, not normally your neighbours, who were also taking stock of the situation. Errol, their spokesperson, told me that situation has been given the codename ‘Barrett’s’ Oesophagus’.  It could become serious. What have you decided to do about it?

Sophagus: When I started to feel pain I informed Council and in consultation with another specialist Nation, I was told that the inflamed region was caused by constant invasions of acid from Stomach. Council was quite honest with me and said it was due to too many heavy meals and intoxicating beverages over the years. So, despite being a loyal worker I’ve had to suffer the indignities of pain caused by an irresponsible Council overindulging in cahoots with Buccal Cavity!

Galen:  Have you looked more deeply into the causes of this caustic flood?  Perhaps the problem has its origin lower down in Colonicus and Council hasn’t told you.

Sophagus: (his smooth muscle frowning into a cascade of wavelets) Council has said nothing. I only hear reports from Colonicus if The Lofties see fit to pass them on. Lately, they have been distracted by too many Bacchanalian feasts with Buccal Cavity. Or should I say, Buccalanian! (Sophagus titters, enjoying his own wit). I will confer with Council right now just before lunch.  I need to hurry, so I’ll use the Vagal telegraph to the Lofties before I am required to do my persitalting. Can you wait here, young Galen, until I return with news? You might find the odd microorganism in the food that you can hunt and ingest.  I can’t say what’s on the menu today, but I understand the Nation is “going out”.

*

Sophagus looks for something embedded in the muscular wall – the Vagus Nerve.  The Vagus is part of the powerful Enteric Nervous System or ENS, also known as The Second Brain. It is a two way communications system, allowing the Gutticus Union, including all member organs from Sophagus above to Rectum below, to share states of being, actions and emotions with The Council. The ENS can even function independently of the Council so that Gutticus can continue to do its job in emergencies. Some of the Organ Systems refer to it as The First Brain, because it evolved even farther back in time than The Council and Sophagus himself, which Sophagus finds a little deflating.

To use the Vagus, Sophagus first relaxes his longitudinal muscles and projects his consciousness into the Barrett’s region, collecting information about the uninvited Goblet cells and the surrounding inflammation. Then, reaching deep into the surrounding epithelial layers, he connects with zaps and sparks via some convenient synapses to the Vagus Highway... A powerful flow of electricity carries his data upwards, ever upwards, towards to the Medulla Oblongata-the brain stem.) 

Down below, Galen digs some hooks into Sophagus’ epithelium, and waits, feeling peckish.  Minutes pass and Galen thinks a nice little snack of plump bacterium would be just the thing.  So far, there are no lost bacteria or viruses to be felt nearby.  Galen sighs and continues to wait.

The Vagal stimulation carries Sophagus’ consciousness up through the Medulla stem into the Holy of Holies – the Hall of The Lofty and Supreme Council.

*

Puffing, Sophagus calls out: “I don’t have much time, your Loftinesses.  Lunchtime is coming. I want to know about the latest report from Colonicus. (Puff, puff). I have invaders in my lower regions and Galen the Scribe believes it might have something to do with the situation down there.”

There is a jelly-like wobbling coming from the glistening walls surrounding him, and a resonant Council chimes in unison. “Welcome Sophagus!” A smooth, persuasive voice then takes over: “Sophagus, I am Amygdalana, the Council librarian.” (Amygdalana gives her creamy neurons a flick). “We have learned that the usual food Council has chosen in the past has upset many of our friendly colonies of bacteria. Some belligerent, toxic bacteria and fungi who actually thrive on this diet are trying to push The Friendlies out of Colonicus’ territory. Skirmishes have recently developed into fierce fighting, accompanied by toxic winds and shutdowns in Colonic peristalsis. This is very unpleasant for all of us – painful, even depressing. We have been lacking in energy and taken to indulgence to improve Our collective mood.

The latest messages we have received from the Friendly Colonies have been distressing, and we are deeply concerned. (Amygdalana tentatively reaches an elegant dendrite towards Sophagus to convey this) It’s possible that your Goblet Cell Invasion has something to do with the unbalance of power in Colonicus. The Friendly Colonies are starving.  They are complaining that we feed them too much rich red meat and pastries and not enough vegetables, whole grains and pulses, like we used to feed them before the Big Wars......How times have changed!

Sophagus: (twitching with displeasure) “Council, how could you not consult me about this! I put my trust in you. We do our jobs selflessly, but you have let me down. The ENS telegraph is there for you to listen and respond to concerns from member organ systems, especially the Gutticus Union, of which Colonicus and I are loyal workers. If the Colonic bacteria are starving while you and Buccal Cavity are eating cake, then you could have a revolution on your hands. The Nation could fall! (If Sophagus had a face it would be red and distorted with anger. Instead, he tightens and clenches his circular muscles until poor Galen fears he will fall off and be swept away towards the Barrett’s’ region. Galen imbeds his hooks more deeply into Sophagus’ epithelium with a loud wail.

Sophgagus: “Your Benevolent Dictatorship is losing control!”

Amygdalana (in a motherly tone): Calm yourself Sophagus.  The Council has been seeking advice from another Nation about switching to a Mediterranean diet.  This ought to make the Friendlies happier and encourage rapid recovery of their colonies.  In the meantime, we will arrange for a special procedure to examine the Barrett’s’ region with a tiny camera on the end of a long tube and update you on treatment at a later time. (Amygdalana withdraws her delicate dendrite from Sophagus’ consciousness stream.) But now we are about to enjoy lunch!

(Sophagus zooms back down the Vagus pathway to home and is just in time to see Galen laughing and spluttering tipsily as a cascade of Prosecco threatens to wash him downstream, and away from the family of Salmonella bacteria lurching towards him on the surface of some two day old prawns.

Feature image by Bruce Wetzel and Harry Schaefer