First, lean back and let me expand, so that I can take in more air. The more air I take in, the easier your brain works and the better you’ll understand what I’m telling you. Irrelevant? Not at all Peter! Every organ in your body has relevance to everything, to the entire cosmos. Your brain needs sugar to work, and you need oxygen in order to burn this sugar and provide your neurons with energy. As I happen to be the organ that takes oxygen from the air and helps it to be transferred into your blood, I will tell you about myself. As a matter of fact, talking about oneself is usually a sign of being self-conceited, but my case is rather different; I actually wish to make you reflect on how perfectly I’ve been created.
I am placed inside your chest cavity as two air sacks-or bellows-surrounded by your muscles. I took my first breath right after birth and I still keep working non-stop. Even while you are sleeping, I fulfill my function with the automatic command I receive from the respiratory center at the back of your brain. My close friend Heart started working even before me while you were in the womb. I was resting then; actually I hadn’t even formed fully. As all your needs like food and oxygen were met in the body of your mother-whose heart you occasionally break-I didn’t have to make extra effort to get air, being filled and emptied. Even if I had attempted to do so, I would have had no chance of succeeding; since you were contained in the amniotic fluid, an attempt to breathe could have caused you to drown.
The first breath I take after birth is critical and rather difficult, since the windpipe is still much narrower than normal. On the other hand, the number of my alveoli where oxygen exchange with the capillaries is realized is so high in relation to body size that it balances the situation. When I make my first move and fill with air, I put pressure on the arteries and veins. Then the vessel directly connecting my artery to my mother’s aorta is dismissed, the curtain between the valves is closed and the blood circulations are separated. If this curtain is not properly closed and a gap remains in between, the oxygen-rich blood and the used-up blood mix and result in the disease known as cyanosis-or “blue baby” syndrome. As these two kinds of blood mix, the tissues are not supplied with sufficient oxygen and the white parts of the skin and eyes assume a bluish appearance.
Turning blue-purple due to lack of oxygen in the tissues is the same for smokers. Cigarettes-my archenemy-contain hundreds of toxic substances, such as carbon monoxide, which combine with the hemoglobin in blood and prevent oxygen transfer. Therefore, the lips of smokers turn slightly purple. You need to be careful with the air you inhale. The windpipe which brings air into me is covered with a ciliated epithelial tissue which catches the dust brought along and sweeps it outside. While you are asleep, the vibrating cilia of this sweeper work throughout the night and in the morning you get rid of the outcome of their propulsion by clearing your throat. However, every draw of a smoker kills 800–1,000 of our ciliated epithelial cells. After some time, they become unable to sweep the toxins (carbon, sulfur, lead, etc) inhaled with the air. I can’t stand it anymore! The increased air pollution is already putting enough strain on us… this habit is just too much for a lung to handle! It is just… an open invitation for cancer! Sorry, Peter, I didn’t mean to be rude. I appreciate that you don’t smoke, but I wish those who do would realize how splendid a mechanism they are destroying.
Now let me tell you about what a work of art I am. As you also know, art in a structure becomes more meaningful with functionality. As is the case with my other friends with which I work in your body, I am perfectly made to fulfill my duty. In other words, never mind forming an organ like me as a consequence of molecules and cells accidentally coming together, even a single protein molecule in my structure does not come to existence through unconscious causes.
With every breath you take, the pressure of the oxygen within the air inhaled rises, so it passes through my membranes by diffusion and into the adjacent capillaries; there it combines with hemoglobin molecules. At the same time, the carbon dioxide passes through the same membranes into me, and I dispose of it. Both of these are easier said than done! You breathe 13–14 times a minute and the whole thing is repeated over and over. As I keep expanding and contracting during breathing, which you are unaware of most of the time, first of all I need to be very flexible. Together with this flexibility, my most important quality is having the largest possible surface area within the smallest volume. My surface area of around 100m2 (as large as a tennis court) is made to fit into your chest cavity in the form of thin membranes so that my large surface allows gas diffusion. These membranes need to be kept wet; a special fluid is secreted as a precaution and respiration is realized smoothly. Without this fluid, my membranes would just stick together, unable to carry out their duty.
You can compare the course of the air inhaled to that of a car passing from a highway onto increasingly smaller roads and in the end reaching a dead end in the small sacks named alveoli. The air coming in through the mouth and nose unites at the expressway named the trachea, or the windpipe, which is 15cm long and 2–3cm in diameter. Incidentally, I have a couple of things to tell you about the way you breathe. As a matter of fact, inhaling is the duty of the nose. I’m sure it also has a lot to say as well, but let me just mention a simple fact about it. Now, you should inhale through your nose, so that the air you take in gets warm, wet, and is cleaned from dust. If you try to breathe this way, you do not trouble me much, and reduce the risk of catching a cold or an infection of upper respiratory system. Inhaling through the mouth helps dust and germs get into me and you might contract various illnesses from bronchitis to pneumonia. Now you know why kids who have adenoids who sleep with their mouth open get ill so easily. Sorry, I couldn’t help speaking on behalf on the nose.
Well, what were we talking about before that? Oh yes! The ways through which the inhaled air passes. As the name suggests, the windpipe which makes the air reach me is a cylindrical tube surrounded by 16–20 cartilaginous rings. As it is placed beside the esophagus, one side of the rings is made of soft cartilaginous tissue instead of hard, so that they don’t hinder swallowing. The muscular tissue near these rings helps them widen and narrow during respiration or coughing. I sometimes warn you by making you cough. Maybe it seems to be a disturbance, but if I don’t push out air by coughing through the contracted windpipe, contaminants can clog me up and cause you to suffocate. Therefore, the burst of air-what you call a cough-is a great blessing to you.
The sound system at the tip of the windpipe is another wonder. The used air I send out vibrates the cords in that voice-box and produces such melodies, gives voice to such speech! The air divides into the two lungs. My two sides are not symmetrical; the one on the right is divided into three, and the one on the left into two. I think this was meant to make room for the neighbor on the left, the heart. In addition, if there’s any cancer growth in me, the diseased part can be taken out by an operation and I can keep on functioning. God knows the wisdom behind this form. After that, these main bronchi separate into 8–10 thinner branches, like highways connecting to narrower roads. This branching resembles a tree turned upside down. At the tips of these thin branches are the respiratory bronchioles resembling clusters of grapes. The small spheres which make up the cluster are the end of the road and are the most vital parts. These spheres named alveoli are made of very thin membrane and they are surrounded by a net of capillaries (picture 5). These are the functional spots where gas exchange is realized.
I hang in the thorax with veins and arteries all around. There are two layers of protective membrane over me. One of them is stuck on me, whereas the other is stuck on the ribs which form the chest cavity. There is a fine and slippery fluid in between these two layers and it neutralizes the friction every time I inflate and deflate. If it hadn’t been placed there, I would wear out and be damaged. As I inflate during inhalation, the chest cavity should expand simultaneously to make space for me. If it weren’t given a flexible form, I would fail to breathe and you would eventually die. Fortunately, the protective set of ribs and their connection with the spine are flexible enough to make me work comfortably. In addition, the dome-shaped muscular partition (diaphragm) separating the thorax from the abdomen contracts and pushes down the organs in the abdomen. Thanks to the simultaneously programmed movement of both the ribs and the diaphragm I inflate with air and expand.
Being in constant contact with the outer environment makes me susceptible to various diseases. Coughing is among the foremost signals I give in the case of disease, and sometimes-excuse me-I produce a mixture of blood and phlegm. Also, I may have difficulty in breathing and warn you with chest pain. You should be alert to my signals. If bacteria and viruses infect me, they might reproduce inside my air sacs, and cause stiffening and suppuration.
I am particularly sensitive to allergic disorders. When the straight muscles on the walls of my bronchi contact an alien substance, pollens for instance, the consequent histamine secretion makes my muscles contract. In addition, allergic diseases, which can affect blood vessels, affect me a lot since I happen to be one of the major organs contributing to blood circulation. As a result of the contraction of my bronchial muscles and difficulty in disposing of the mucus I secrete to defend myself, I have trouble with breathing-you call it asthma.
In addition to this, we can mention diseases like emphysema, acute or chronic bronchitis as problems I frequently face. Even your anger has a great impact on me. Breathing becomes more difficult immediately.
Peter, I’m sorry, it is not possible to summarize a work of art like me within a few pages, but I need to stop now… but please, keep away from polluted areas and cigarette smoke! Send me as much fresh air as you can. And even though you mostly take me for granted, like my other teammates, please reflect upon what a blessing I am.
Irfan Yilmaz is a professor of biology at Dokuz Eylül University, Izmir, Turkey.