Tuesday, June 10, 2014

Red Shirts Vs. Klingons OR Calor,Rubor, Dolor & Tumor

Yes, Here I go with the doctor speak again.


It's a buzzword lately, but it's been discussed since the Greeks started thinking scientifically.

One of the very first things they taught us in medical school were the following terms:

These are the cardinal signs of inflammation.
You can also add:

functio laesa--loss of function.

Little did I know that this was my first Latin medical language lesson.
I spent a large amount of time with my medical dictionary at my side during my first year of medical school. Most definitions also had the Greek word, in Greek, next to the word. I was very glad I took ancient Greek in college for a semester. It gave me an instant leg up on medical language-- but I digress.

Inflammation is caused by not only infections, but by foreign bodies; injuries to an area like a cut,  broken bone, or crush injury; by cancer; by allergies; and by autoimmune states (attack of self by mistake); by toxins; and by radiation.

It gets pretty complicated. I want to keep it simple.
We may get more complicated if you want, down the road, but let's lay the foundation.

So let's say you get a cut. First it gets red and warm, and painful, and swells and you stop moving it because it hurts. Why does that happen? 

The cut activates a whole cascade of inflammation.

 First, cells at the site of injury recognize a problem and send out a chemical signal that causes the blood vessels around it to open up and get wider. That increases the size of the surrounding highways (blood vessels) for the blood cells and fluid and special chemicals and proteins to get to the site of the injury to wall off invaders, and close up a bleeding wound.

All of the extra blood flow and leakage of proteins and cells causes the wound to ooze, and to get red and to feel warm, and the area to get puffy.

Foreign Invader or "Klingon"
 Also, all of this extra swelling causes some of the bacteria and fluid to get swept up into the lymph blood vessels (lymphatic vessels) which travel to lymph nodes and make them swell up also.  Hence, swollen "glands" when you have a pharyngitis or sore throat.

In the lymph nodes, other immune responses start up. There are special white cells there that get activated when they recognize a foreign invader. (Let's call the foreign invaders the Klingons, and the white cells the "Red shirts"). I think of the lymph nodes as battle stations for the white cells to gather to help with inflammation. (For non Trekkies-In Star Trek, the good guys in red shirts always die. Klingons are one of the bad guys).

Anyhoo, the white blood cells are directed by chemicals released at the site of the injury to the affected area.

Activated WBC or "Red Shirt"
There they line the blood vessel walls. Then they squooge (a scientific term) through the blood vessel walls into the tissues around the wound. Once there, they kind of help direct the show, releasing more chemicals to attract other white cells to the area.  
They recognize the Klingons, and put up tractor beams to pull them in and suck them into the USS Enterprise where Captain Kirk makes out with a pretty girl, Oh, never mind. 

 Okay, where were we?  Oh yeah.

The white cells eat the bad guys, or release chemicals that cause the Klingon to blow up. 

There are also chemicals that cause fibrin to be released. Fibrin is kind of like a fishing net thrown over the wound, and platelets then get caught in the net and cause the wound to stop bleeding by closing up the wound with a clogged up fishing net. 

Some of the white blood cells, the neutrophils, are the real "red shirts" of the process because they often die at the end of the inflammatory process and form pus. So when you have a pus pocket, or a boil, or abscess, you have the remnants of a colossal battle between the Klingons and Red shirts.

The Red shirts will win if the pus is drained and the inflammation goes away.

Anyway, there's a lot more to it, but I decided to keep it simple today.
Maybe, later on, we'll get more specific about all the different types of white cells, their jobs, the chemicals they release, and the immune and clotting systems.

Live Long and Prosper. 

Doctor Diva


  1. I love your explanations, so easy to understand what's going on. I actually got a splinter yesterday and now I get exactly what my body was doing about it. On a side note, I don't think I'll ever view Klingons the same any more!

    1. Thank you! I have many "canned" talks that I give to patients so I thought I should write them down into easy to understand bites and bits. I have a lot of fun doing it. I don't think anyone else is doing a blog exactly like this. Most of the "funny" doctor blogs I see are often complaining about the system or are snarky, and the others are often too dry. Thanks again! I love YOUR blog too and highly recommend it to all of my readers! In fact, I think I just commented on yours a minute ago!

  2. It is such a great way to end a day, learning something important and relatable for myself AND to hear the word "pus pocket."

    1. Doctor speak is awfully fun. My sister and I taught ourselves the sign language alphabet when we were kids, from the World Book Encyclopedia, so we could talk without our parents understanding. Sometimes I inadvertently use Doctor speak with patients. When I get "the look", I realize my mistake and define my words and teach.

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  4. So much fascinating information here, and so simply explained. I agree with Anon; 'pus pockets' is my phrase of the week ;o)

    1. Thank you! I don't have the facility with language that you have, though, but I try to explain terms and processes simply.