Posted in Psychology & Medicine

Viscera: Brain

(Learn more about the organs of the human bodies in other posts in the Viscera series here:

(NB: I have written MANY ARK posts about the brain and all the delightful ways it screws up. Some of them are probably the most interesting posts on my blog. Please click the hyperlinks to check out the various related articles! 😀 Alternatively, here’s a convenient list:

Among the many organs of the human body, no organ comes close to the magnificent complexity that is the brain. The brain acts as the command centre of the body. It receives massive amounts of information through the various senses, processes it and sends out electrical signals to control how the body operates. Not only does it control “basic” functions such as movement of muscles, controlling organ functions and regulating homeostasis, it is also responsible for the so-called “higher functions” such as consciousness, emotions and cognition. It is the true seat of the mind and soul.


The brain is the only major visceral organ not located in the trunk (body). It is enclosed in the cranium of the skull, which acts as a protective casing. Because it is a closed box, even a small increase in volume (such as due to a bleed or a tumour) can cause extreme pressures to build, causing severe problems. The entire brain and spinal cord are bathed in a fluid called cerebrospinal fluid (CSF), all enclosed by a sheath made of three layers (dura, arachnoid and pia maters). The brain sends out nerves to the rest of the body, which act as electrical wiring transmitting signals. These include the cranial nerves and the spinal cord, which leaves the bottom of the skull down the spine. The spinal cord branches off into many nerves that supply every nook and cranny of the body. The brain itself is made up of two large hemispheres, which are connected by a bridge called the corpus callosum. Despite popular belief, the actions of the two hemispheres are much more complicated than “analytical vs. creative”. The brain also encompasses the cerebellum (the small stripey structure at the back), which controls coordination and speech articulation, and the brainstem, which is involved in autonomic control of life-sustaining functions such as breathing, and also the source of the cranial nerves.

In the last century, scientists have learned that specific parts of the brain play a specific role. This thought started with the field of phrenology, where small areas of the brain were mapped to a certain mental faculty, such as love, wit or destructiveness. Although this turned out to be complete hokum, the idea stayed and we now know the actual functions of each part of the brain. The brain is broadly divided into four lobes: frontal, parietal, temporal and occipital. The frontal lobe is the domain of thought, personality, motor function and other higher functions. The parietal lobe is related to spatial awareness and sensory functions (such as touch). The temporal lobe is linked to hearing, comprehension of language and storing new memories. The occipital lobe is primarily associated with vision. The brain can then be subdivided into more focussed areas, such as Broca’s area that governs speech and Wernicke’s area that governs listening. It should be noted that the four lobes only describe areas on the surface of the brain (cerebral cortex) where the higher functions belong. The inside of the brain is just as complicated and has many different parts, such as the hypothalamus that is involved in homeostasis, and the hippocampus that converts short-term memories into long-term memories.

How does a lump of cells weighing around 1.5kg produce such wondrous abilities such as philosophical thought, deduction, emotions and calculation? The truth is that we still do not know how the brain functions exactly. However, we know that the brain is composed of a large number of neurons (nerve cells) – about 100 billion of them. These neurons connect to one another via a synapse, which is a gap between two nerve cells where neurotransmitters travel to and fro (allowing electrical impulses to jump from one neuron to another). Using these connections, neurons form an unbelievably intricate and complex network of electrical activity. Because one neuron can connect to many more others, the number of synapses is estimated to be around 100~1000 trillion – significantly more powerful compared to any computer in the world. The number of synapses directly correlates to intelligence and it seems intellectual activities such as reading a book increases the number of synapses in the brain. We have yet to understand exactly how the brain uses this incredible computational power to produce cognition and self-awareness.


(Video of neuronal activities in a zebrafish brain)

Because the brain uses electrical impulses for most of its functions, a common abnormality that is seen with the brain is when the electrical activity becomes disorganised and out of control – a seizure. This abnormal electrical activity may be due to a focal problem such as a tumour, or a generalised misfiring of neurons or altered regulation of electrical activity. When a seizure happens, the disorganised activity results in the brain not being able to function normally. For example, the most common consequence is a fit (tonic-clonic seizure) where every muscle spasms out of control, because the muscles are overloaded with chaotic signals. Focal seizures can cause fascinating symptoms depending on the location, such as temporal lobe seizures causing religious visions (hallucination). This also disrupts consciousness, which is why most epilepsy patients do not remember the event.

Posted in Psychology & Medicine

Viscera: Small Intestine

(Learn more about the organs of the human bodies in other posts in the Viscera series here:

Abdominal organs are often grouped into the colloquial term gut. “Gut” also refers to a specific organ – the small intestine (or small bowel). It is an important part of the gastrointestinal (digestive) tract, connecting the stomach to the colon and involved in digesting and absorbing nutrients. The small intestine is extremely long, roughly 7m in an adult. It fits in the abdomen by folding and packing neatly, lying under the liver, stomach and pancreas while being framed by the large intestine. The small intestine is not freely hanging so you cannot just pull it out like a rope. It is connected to the body by a fan-like membrane called the mesentery, which provides blood supply to the gut. The mesentery is attached along one side of the gut the entire way through.

The small bowel is composed of three parts: the duodenum, jejunum and ileum. Although people think digestion mainly happens in the stomach, it is actually primarily performed in the duodenum. The duodenum not only receives liquefied food from the stomach, but is also the place where the pancreas and liver drain digestive juices such as pancreatic enzymes and bile. The enzymes breakdown large molecules like fat, protein and carbohydrates into smaller building blocks, while bile acts like detergent to allow fat to mix better with water (emulsification).

The digested food then travels down the GI tract through a process called peristalsis, where the gut squeezes behind the bolus of food to push it forward, much like squeezing toothpaste out of the tube. The broken down products are mainly absorbed in the second part of the bowel (jejunum) via the walls. The small bowel wall looks like a carpet due to microscopic finger-like projections called villi. Villi allow for a much greater surface area for enhanced absorption. In coeliac disease, these villi are flattened by an autoimmune process and the patient cannot absorb as much nutrients (including vitamins).

By the time the food reaches the ileum, most of the nutrients have been absorbed. The ileum finishes the job by absorbing some extra things like vitamin B12 and bile salts, then sends the food through the ileocoecal valve, which is the door between the small and large intestine.

The small bowel is used by various cultures for culinary purposes. Other than simply eating the bowel itself after cooking, it is often used to pack different meats or other food inside, such as sausages or soondae (Korean sausages, filled with chop sui noodles).

Posted in Psychology & Medicine

Viscera: Pancreas

(Learn more about the organs of the human bodies in other posts in the Viscera series here:

The pancreas is probably the most central organ in the human body. It is situated just under the liver and stomach, surrounded by the duodenum (first part of small intestine) and lies in front of the aorta. It is shaped like a fish and thus is divided into parts named the head, neck, body and tail. The head of the pancreas tucks into the loop of duodenum and drains its contents via the pancreatic duct, which joins with the common bile duct (from the liver and gallbladder).


The function of the pancreas is divided into two functions: exocrine and endocrine.

An exocrine gland is an organ that excretes its products out of the body (including the intestines), such as the salivary or tear glands. The exocrine function of the pancreas is the production and secretion of digestive enzymes that break down proteins, fats and carbohydrates in the small intestine. Because of this, injury to the pancreas often causes a leak of this digestive juice, causing the body to self-digest the pancreas (leading to pancreatitis) and surrounding organs.

An endocrine gland is the opposite in that it secretes its contents into the bloodstream. These glands typically produce hormones, such as the thyroid, ovaries and adrenal glands. The pancreas’ endocrine function is related to an extremely common yet deadly disease: diabetes. Within the pancreas, there are millions of cells that cluster into groups called islets of Langerhans. There are various types of cells, but the most common are the alpha-islet cells that secrete glucagon and beta-islet cells that secrete insulin. Insulin acts to lower blood sugar (glucose) levels by promoting storage and use of glucose after a meal. Glucagon acts to increase blood glucose by promoting the breakdown of glucose storage units (glycogen) and the production of more glucose by the liver. Diabetes occurs when beta-islet cells fail to produce insulin because they are destroyed by the immune system (type 1 diabetes mellitus) or become desensitised by chronically elevated blood glucose levels (type 2 diabetes mellitus).

Another important disease concerning the pancreas is pancreatic cancer. Pancreatic cancer is notorious for its deadliness as it carries a 5-year mortality rate of over 95%. This is because it usually remains hidden – without any symptoms – until it as grown substantially and spread to other organs. However, this prognosis only applies to the most common type of pancreatic cancer involving exocrine cells (adenocarcinoma). There are far rarer cancers of the pancreas that involve the endocrine cells (e.g. insulinoma), which tend to have extremely good prognoses and are usually curable.

Steve Jobs (founder of Apple Inc.) had this kind of pancreatic cancer – an islet cell neuroendocrine tumour. Despite his excellent chance of cure with chemotherapy and surgery, he refused treatment for nine months and instead relied on alternative medicine for cure. However, his disease worsened and he finally resorted to having surgery. By this stage, his disease had spread to the liver due to the nine-month delay in treatment. Spreading of cancer is called metastasis and is often an indication that the cancer is no longer curable. Jobs went against his doctors’ advice and opted for a liver transplant in the hopes of curing his cancer. Organ transplant involves suppressing the patient’s immune system (which also keeps cancers in check) to prevent rejection of the donor organ, which is why oncologists advise against transplants in cancer patients. Jobs’ condition deteriorated quickly after his liver transplant and his decisions ultimately led to his demise.


Posted in Psychology & Medicine

Viscera: Spleen

(Learn more about the organs of the human bodies in other posts in the Viscera series here:

The spleen is one of the lesser known organs of the human body. If you asked the lay person, they would not know what the spleen does, let alone where it is. The spleen is a solid organ that lies in the left upper corner of the abdomen, tucked under the left diaphragm (opposite to the liver which lies under the right diaphragm). Its functions are mainly related to blood, such as removing old red blood cells (sequestration), storing platelets in case there is an emergency bleeding, making antibodies and releasing lymphocytes (type of white blood cell) to help fight infection and in times of need, creating red blood cells. Red blood cells are usually made in bone marrow in adults, but if the bone marrow fails (e.g. leukaemia), the spleen and liver can step in to create vital blood components (extramedullary haematopoiesis).

As most of the functions of the spleen are not technically necessary to sustain life, it can be removed without significant consequences. The spleen is sometimes removed when a patient has severe thrombocytopaenia (lack of platelets) or when the spleen is damaged by trauma. Because it is a solid organ, trauma to it such as a kick to the stomach can cause it to rupture (i.e. break in to pieces). Splenic rupture can cause life-threatening haemorrhage (bleeding) and may not be evident in trauma cases. A person without a spleen needs regular check-ups and immunisations to help fight infections as they have a weakened immune system.

The role of the spleen was a mystery for thousands of years and thus various cultures tried to explain various medical phenomena using the spleen. The ancient Greeks thought the spleen produced black bile, which was associated with melancholy. The spleen was also associated to anger by the English and laughter by the Talmud.

Posted in Psychology & Medicine

Viscera: Liver

(Learn more about the organs of the human bodies in other posts in the Viscera series here:

The liver is the second largest organ (next to the skin) in the human body, weighing about 1.4~1.6kg. It is found tucked under the right side of the ribcage, underneath the 5th to 10th rib in height and almost spanning the entire width of the trunk. When enlarged, the liver grows downward and can be felt in an abdominal exam (sometimes it is so large that it covers most of the abdomen).

It is a vital organ with many life-sustaining functions (hence “liver”) such as building various proteins, breaking down toxins, storing sugars in the form of glycogen, decomposing red blood cells and producing bile. The liver metabolises (breaks down) a large proportion of medications and drugs as it treats them as “toxins”. For example, the enzyme alcohol dehydrogenase breaks down alcohols into acetaldehyde, which causes hangovers and liver damage. Many Asians have a variant of this enzyme that is extremely efficient, causing a massive build-up of acetaldehyde when they drink alcohol. This is responsible for the so-called “Asian flush”.

Liver disease is associated a myriad of symptoms. The classic sign of jaundice (yellow skin and whites of eyes) is caused by obstruction of bile flow. Because of its location, pain in the right upper quadrant of the abdomen is commonly seen. As the liver is involved in synthesising various proteins, signs such as ascites (fluid in the abdomen) or bleeding may occur when the liver is damaged. A syndrome called portal hypertension is commonly seen in chronic liver disease such as cirrhosis as a major vein to the liver is blocked. This can cause an enlarged spleen, oesophageal varices that can bleed, ascites and prominent veins radiating from the belly button (caput medusae).

An interesting property of the liver is that it can regenerate at an amazing rate. A liver will regenerate to its original size even when a half of it is cut out (this is how live donor liver transplants work). What is more interesting is that the ancient Greeks probably knew of this fact as well. In Greek mythology, the gods punish Prometheus for bringing fire to humans by chaining him to a mountain and commanding an eagle to peck out his liver. The liver would then regenerate overnight and the eagle would return every morning to eviscerate him, causing him eternal anguish.


Posted in Psychology & Medicine

Viscera: Heart

(Learn more about the organs of the human bodies in other posts in the Viscera series here:

Out of the numerous organs found in the human body, the heart is perhaps the most well-known. This is probably because since the dawn of time, man has put his hand on his chest and felt the rhythmic pounding of his heart – a reminder that he is alive. The function of the heart is to pump oxygenated blood from the lungs to the rest of the body via the circuit of blood vessels (vascular system).

The heart relies on electricity to pump blood in a rhythmic, autonomous way. Because of this property, a heart will beat on its own even if you took it out of the human body. Every muscle in the human body requires an electrical impulse for it to contract. This is also the case in the heart, but unlike the skeletal muscle in other parts of the body which receive their impulses from the brain and spinal cord, the heart has its own source of electricity.

The heart has a small group of pacemaker cells in the right atrium called the sinoatrial node, which always fires electrical impulses at a set rate and rhythm (sinus rhythm). The SA node will do this without any instruction from the brain. The impulse from the SA node spreads throughout the atria of the heart, causing the atrial muscles to contract simultaneously to squeeze blood into the ventricles. The impulses then reach the atrioventricular node, which filters the signals and sends a stream of electricity through a wiring system known as the Purkinje fibres. These fibres act like a high-speed internet cables running down the centre of the heart, sending rapid signals through out the ventricles to induce a strong, cooridnated contraction in both ventricles. This causes blood to be forcefully squeezed out through the two outlet vessels of the heart: the pulmonary artery (to the lungs) and the aorta (to the rest of the body).


Although the SA node is completely autonomous, it can be controlled using hormones, nerve signals and medications. For example, adrenaline will speed up the rate the heart beats at while massaging the carotid arteries in the neck will slow the heart down.

One thing people wonder about is what the doctors listen to when they put a stethoscope to a patient’s chest. Everyone knows the heart makes a rhythmic “lub dub” sound as it beats away, but what information could that give away? A doctor can gain much information about the heart from a cardiac examination by taking the pulse and blood pressure, but listening to the heart (auscultation) may reveal a medical sign known as a murmur. A murmur is any added sound other than the normal “lub dub” sound of the heart. For example, a heart with aortic stenosis may give the sound “shhhhhhh” as if it was giving off static. This sound is produced when blood flow in the heart is turbulent and not smooth. This may be for a number of reasons but the most common reason is because the valves of the heart are not functioning properly. For example, the valve between the left atrium and left ventricle may be leaky (mitral regurgitation) or the valve at the start of the aorta may be stiff and narrowed (aortic stenosis).

By carefully listening to the sound the heart makes, an experienced doctor may pick up on such structural abnormalities even without the use of fancy medical imaging technologies.

Posted in Science & Nature


In the children’s story Goldilocks and the Three Bears, the protagonist is found trying out various porridges, chairs and beds until she finds the one that is just right for her. Because of this, the name “Goldilocks” has become a symbol for something that is “just right”. A Goldilocks economy is one where there is high growth but no inflation; a Goldilocks planet is one which is not too hot or too cold, making it an ideal planet for life; the Goldilocks effect is when success is achieved because something was not too great or too little.

The Goldilocks effect is a law of nature that is far more important than you would think. Nature always seeks consistency, as shown in the human body. For something as complex as life to exist, a cell must maintain its internal environment in a perfect, ideal state. French physiologist Claude Bernard observed that a cell’s internal environment does not change even with changes in the external environment, and commented that “The stability of the internal environment is the condition for the free and independent life”. This is the basis for homeostasis. Without homeostasis, life cannot exist and all living things put in all their effort in keeping homeostasis. Our body constantly strives to keep various factors such as pulse, blood pressure, oxygen saturation, temperature, blood glucose, electrolytes and numerous hormones etcetera in a stable range. One could possibly argue that the meaning of life is “to maintain homeostasis” – a rather cyclical argument.

To understand the importance of homeostasis, let us look at how changes in the external environment affect us. Our core temperature is maintained in a tight range around 36.5 degrees. If it is altered even a couple of degrees, we exhibit symptoms of hypothermia or hyperthermia. If the weather is too hot, we sweat to cool ourselves; if the weather is too cold, we shiver to raise our temperature. After a meal, we secrete insulin to lower our blood glucose, while we secrete glucagon when starving to raise our blood glucose. Failure of either system leads to either diabetes or hypoglycaemic shock respectively. Homeostasis is an extremely complicated and intricate self-repair system that cannot be imitated.

The Goldilocks effect can be applied beyond physiology to our lives. Everything in moderation; to go beyond is as wrong as to fall short. If we have too little money, it is a problem. If we have too much money, it causes other problems. Whether we work or play, doing too much or too little of either can be bad for us. Medicines become poison in excess and even love in excess becomes obsession. In the marathon that is life, if you run too fast you end up collapsing from exhaustion, while running too slow will mean you never get anywhere.

The secret to happiness lies in understanding what is “just right”.

Posted in Psychology & Medicine


What would happen if your nostrils were facing up instead of down? Rain would fall into your nose and when you were sad or with a cold, mucus would fill up in the nose instead of draining, creating quite a problem. Then why do we have two nostrils? The reason being, if one is blocked, we can breathe through the other (unless you have bad hay fever or a cold and both are blocked). This shows how (almost) every part of the human body has a purpose, including its shape and characteristics.

Another fun fact about nostrils is that at one moment, only one nostril is used for breathing. In other words, you can breathe easily through one side of your nose but the other side will feel stuffy and blocked. This phenomenon alternates sides on a periodic cycle (where the blocked side becomes clear and vice versa). This mechanism is most likely to protect the inside of your nose (nasal cavity) from drying out.