The most important element is...

...oxygen. Not water (which isn't an element anyway), not even glucose, and certainly no vitamin, mineral, or foodie/quack "superfood".

Our bodies are essentially oxygen delivery and utilization systems. We cannot store it so every nanosecond of our lives is dedicated to getting it and using it to create energy. Every cell needs it, every process requires it. Without it death begins within seconds. 

There is no "why", there just is. Homeostasis is basically the situation in which all systems that require oxygen are getting enough. Disease always involves some sort of oxygen delivery or utilization problem.

So, look to the O2. 

Without it there can be no life, but with it we have real power. In a very real sense, the practice of medicine is all about oxygen.

Deep breath...

...enjoy the weekend!

Metabolism, shmetabolism

"Metabolism" is a word the foodies, charlatans and quacks love. It is impossible to go anywhere in our food-and-fat obsessed culture without seeing headlines screaming about the latest easy way to "boost your metabolism". Bah-low-nee!!

Metabolism consists of anabolism, which is the process of taking in  (in chemical or nutrient form) and storing energy, and catabolism, which is the conversion of this stored energy into kinetic energy, or "heat" as the diagram calls it. This energy is used by the body to do all of its work, internal and external. More in than out = weight gain (stored energy); more out than in = weight loss (excess energy expenditure). 

In between anabolism and catabolism lie a number of genetically programmed and environmentally influenced (epigenetic) PHYSIOLOGIC processes, like digestion, absorption, transport, protein synthesis, and on and on. None of them can be magically bypassed by blueberries, complex carbs, non-gluten pretzels, or anything else. Supply and demand is the rule, via an organism that evolved mostly in nutrient-poor environments and so is highly effective in absorbing and storing calories (energy). This energy can only be used as such--it cannot be willed, wished, eaten, or otherwise magically shifted to the non-existent "away". Anyone who says otherwise is either ignorant or lying or both.

The first law of thermodynamics says that there is no such things as a free lunch, i.e. energy/mass--which we now know are the same thing thanks to "dearest Albert" #2 (#1 was Queen Victoria's consort)--can neither be created nor destroyed. All those calories have to be used by work-creating processes or stored; one food cannot cause the "metabolism" of another, for example. This latter myth is a favorite of the diet quacks because it sounds so plausible. If something sounds too good to be true, especially in biology, it is

Metabolism. Live with it...or don't, in which case it won't matter one way or the other.

Ultimate beauty, precision, and elegance....

...in a single cell.

The human zygote!

Flail! How to not....

This wicked-looking device is a flail. I don't think I need to say that it is a weapon of great destructive power.

It is the origin of the term, "to flail", which means, "to beat or thrash about, as with a flail". The implications is that "flailing" causes a lot of damage.

I have seen medical situations that lived up to the term "flail". Generally this occurs when too many people, or too many INEXPERIENCED people, are involved in a medical emergency or situation that suddenly goes "wrong". In such situations the great advice given in The Hitchhiker's Guide to the Galaxy comes to mind, "Don't panic!"

It took me a long time as a physician to resist the urge to panic when confronted with a medical emergency. One of the principles that helped was my "OXYGEN, GLUCOSE" mantra--it doesn't matter what you do to the patient if they are not being oxygenated and are not getting any usable energy. The procedurally perfect "code" is useless if the person's heart never starts beating.

I had a professor in med school say that, "...everyone should be allowed to die in perfect metabolic balance." The problem with this maxim, though, is obvious. 

A few key principles can mean the difference between saving a life, which is often simpler than it seems, and failing. DON'T PANIC, OXYGEN, and GLUCOSE are mine.

The real stuff of life....

The brain uses 20% of all we inhale; the kidney dies rapidly without it. No matter which body system we study, that system runs on, depends on, has many systems to conserve, and dies without  

oxygen.

Combined with glucose it creates the energy each and every cell needs to transcribe and translate DNA into protein, which is all that a cell does. From there we get what we call life.

Every homeostatic mechanism is prioritized to preserve oxygenation. Every organ has several systems to protect itself from oxygen's temporary reduction or loss.  The brain will sacrifice all other organs to get it. Beside it water is a waste product (literally). Glucose is useless without it. A billion people will die within minutes if the oxygen zombies suck it up.

So, make sure you get your oxygen. 

Smokers are chronically starved of it,
drinkers use it unwisely,
the obese waste it.

Sniff it up and enjoy!

Cherchez le O2!