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Well, No Body's Perfect

Imagine the writer's shock when she's told that her insides are incomplete. Missing or misshapen organs aren't so rare, it turns out.

September 16, 2003|Rosie Mestel | Times Staff Writer

On a lazy Friday afternoon last year my doctor informed me that I was missing a major internal organ.

"Everything is normal except for the absent left kidney," he said, referring to a recent ultrasound examination.

I was stunned -- then downright disbelieving. It seemed ridiculous that I could have lived 43 years without knowing this.

The doctor quickly allayed some fears. Although the remaining kidney was extra vulnerable and should be protected from injury -- rugby, never a serious consideration, was now out -- in other respects life could go on as usual. There was every expectation of a normal lifespan. The body can get by with half a kidney or less.

"If you're going to be missing a body organ, this is the one to miss," another doctor said.

As it turns out, a surprising number of us do lack a kidney -- roughly 1 in 1,000, according to autopsies, medical dissections and one exhaustive 1989 study of 132,686 Taiwanese schoolchildren. And that is just the beginning. Many thousands are walking around with other oddball configurations: extra vertebrae, duplicated or oddly placed blood vessels, absent or multiple muscles, little supernumerary spleens, bladders shaped like hourglasses, even 12-lobed livers.

Of course, many oddities tossed up by nature are serious, even deadly, birth defects. But other differences are benign or just inconvenient, sometimes undetected for years and fortuitously found by radiologist, surgeon, medical student or coroner. Often, they are never discovered -- secrets that crumble to dust with their owners.

It is a lesson all good surgeons take to heart: None of us are possessed of Gray's Anatomy perfection -- we are all variations on a theme. But it is still hard to accept when you are the anomaly.

"We are all amazed when we discover that no two humans are exactly the same. Sometimes we have extra parts and sometimes we were shortchanged," said Ronald Bergman, professor emeritus of anatomy at the University of Iowa, who has been diligently cataloging human anatomical variations for decades. "No two faces are alike -- it's the same inside."

A quick survey of friends and co-workers revealed that my lone kidney was only the tip of the iceberg. People admitted to (among other things) an extra rib sticking out from a neck bone, a double ankle bone, an extra finger, extra and fused vertebrae, missing toe bones, absent or extra sinus passages and extra ureters. Of special interest was a miniature third kidney "piggybacking on an existing kidney," a trait that was presumably inherited, because a father and niece have the same oddity.

It was reassuring to discover I was surrounded by nonstandard humans, but it only made me more determined to find out how I had gotten this way.

In the 19th and early 20th centuries, anatomists and medical museums would eagerly amass such curious specimens. But the fascination with human anatomy was eventually overshadowed by the marvels of modern molecular biology.

Even Philadelphia's Mutter Museum, keeper of such items as the "megacolon" of a young man with a congenital bowel disease and the shared liver of conjoined twins Chang and Eng, has sent many specimens to the trash can.

The double bladder: gone. The kidney with the giant drainage duct: long gone.

"They even threw out the two-headed chicken," sighed museum director Gretchen Worden. "What were they thinking?"

There are plenty of potential specimens out there should she wish to restock.

One of them is 29-year-old David Knowles of Springfield, Ill., who discovered his abnormality last year by chance. He had been suffering from mild discomfort in his right side and went for an ultrasound.

"Everything's fine except there's something about your left kidney," his doctor's office told him. It didn't exist.

"I was shocked," Knowles said. "This is a major organ."

Knowles later learned of a cousin with the same oddity, and now accepts that in the grand scheme of things, missing a kidney isn't so bad.

He gave up his motorcycle on a doctor's advice but is glad, in a way, of his ignorance all these years. In high school he played football, which is discouraged, sometimes prohibited, for people with single kidneys.

Ruth Santiago of Long Beach is relieved that doctors discovered her single-kidney status when they did.

In 1964 she suffered excruciating pain, and doctors discovered that her right kidney was enlarged. They suspected it was cancerous and were considering taking it out.

Santiago's husband wrapped her in a blanket and took her for a second opinion. She soon learned that her enlarged kidney was her only kidney (a small nubbin is all that exists on the left) and that the pain had most likely been a kidney stone.

"Imagine if they had taken it out without checking the other end," said Santiago, 76. "I would have been up the creek without any kind of paddle."

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