connect the thyroid and parathyroid, like water and sewer pipes that serve both your house and the one next door. Still, every other organ in the body gets its own name. And never mind that a number of lofty words start with para, like paramedic. To me, para sounds like trouble. Think parasite or paranoia. See what I mean? So for now, I’ll give the parathyroid gland a nickname—the PT gland.
Built-In Spare Parts
Most of us have four PT glands. They’re tucked behind the thyroid, arranged in pairs on each side of the windpipe in an upper and a lower set. Often the size of a small grain of rice, they can look pear-shaped or flat like a lentil. Their color varies from a grayish white to a reddish brown. Fat can make them look yellow. In any case, their color is not the same as the thyroid’s, which makes the smooth, shiny glands easier for a surgeon to see.
The glands control calcium in the blood. If the level is too low, they secrete a hormone that tells the bones to release calcium. If the level is too high, the glands sit back and wait for it to drop. Just like a heater with a thermostat.
The four glands all do the same thing. So one can go bad—and by that I mean it can have a benign tumor—and it’s no big deal to take it out. We’re born with built-in spare parts. A great design, except for one glitch. The four glands work like old Christmas lights. One burnt bulb makes the whole string go dark. In our bodies, one bad PT gland makes the other three shut down. Worse than that, the gland with the tumor goes into overdrive. It no longer responds to small changes in the level of blood calcium. Instead, the gland shovels the PT hormone into the blood whether it needs calcium or not. Blood calcium stays high, as my health-fair test showed. And the bones weaken as they keep sloughing off calcium. Surgery to remove the bad gland is the only way to stop the body from turning into a creature without a skeleton.
A Bat in a Cave
My doctor sent me to a cancer center for a scan of my neck to find which of my four PT glands had gone bad. First, someone inserted an IV feed into my arm and injected me with radioactive slime. Next, I was led to a room filled with scratched machines painted the colors of old gym lockers. A technician hauled in a heavy lens on a beat-up cart. The lens looked like a light for a stage or a TV studio, but bigger. When she tried to change the lens on my machine, it jammed. The process was awkward, like kicking the legs shut on a heavy folding table. The place could have been a set for Star Wars—everything both old and space-age new. An alien could have come in for a scan of an organ vital for X-ray vision or for beaming a message to Mars.
When a second technician tried to strap down my arms, I protested. She believed me when I said I’d lie still. I kept my word, but it was hard because a large camera hovered over my face and neck for a long time. During the scan, the technician asked once if I was OK. When I said “Yes,” my voice bounced back too fast from the camera, as if I were a bat in a cave, too close to a wall. At one point I swallowed, and my throat rose just enough to touch something metal.
I moved to a second camera that would photograph my neck from a different angle for a full twenty minutes. Flat plates moved in an arc around my head. On the sides, they bumped my shoulders, as if the space were too crowded for both of us.
A third technician pulled out my IV and told me to put pressure on a cotton pad over the wound. Then she led me to another room, left, and didn’t return. Feeling abandoned after all the earlier attention, I stepped into the hallway. A fourth technician, one I hadn’t seen before, gave me a puzzled look. I said, “I guess I’m done,” and walked away.
To Boldly Go
Most body parts are stuck in their assigned spots; the brain in the head, the heart in the chest, the stomach in the stomach. Before birth, the PT glands are not stuck—they’re more like free agents. They start growing near the tube that connects the nose and mouth. About the fifth week in the life of a fetus, the glands get restless. Then they break away and head south.
Another gland, the thymus, heads down at the same time. The PT glands should stop at the thyroid. But sometimes the two lower glands keep moving with the thymus. They boldly go where PT glands aren’t meant to go. This doesn’t create problems. It’s just a bit odd. In one study of fifty-four cases of PT glands on the loose, twelve sets were found between the lungs. For this tiny gland, that’s a long way to go. If your stomach moved an equivalent distance, you’d find it past your feet.
A sea captain with the U.S. Merchant Marine, Charles Martell, had the first known case of a bad runaway PT gland. Between 1918 and 1926, he had eight bone fractures and shrank seven inches, signs of a PT problem. Surgeons opened up his neck six times. But they couldn’t find the bad gland—like the gas station attendant who opened the front hood of my VW and couldn’t find the engine.
Charles read anatomy books in his free time. He decided he had a tumor in his chest. In the seventh operation, surgeons found the bad PT gland right where Charles said it was. The machines that found my tumor wouldn’t have known where to find his.
TWO
Two Forms of ID
When I worry, I turn to words. Not the spoken kind, but the kind piled on pages in a set order. So when I knew I needed PT surgery, I made my way to a library. But not just any library. This was the British Library in London—more like a church for those who worship books. These books are all the more dear for the fact that not just anyone can walk in and touch them.
Getting a British Library card is not as much work as getting a driver’s license, and not as fussy as getting a passport. But it’s hard in a weird way, because you can’t just want the card. Wanting a driver’s license or a passport is good enough. But wanting to read the books in the British Library? You better have a good excuse. Waiting in line to get a library card is not as long a process as waiting in line at your local DMV, but the look of dread on each face is the same. At the DMV: What if I don’t pass the driver’s test? At the British Library: What if they don’t like my reason for wanting a card?
The best plan is to say you need the card for research. A letter from someone official that says you need this card can help too. Plus, wear a clean shirt. Brush your hair. Smile. Don’t look scary. And bring two forms of ID. Not DVD rental cards from stores that have closed, but a driver’s license and a passport. Next thing you know, you’re smiling into a tiny camera mounted on the desk. Then out pops a card, your photo looking like they used a fish-eye lens, your nose much larger than you imagined.
The reward is that you can wander the book stacks. Or you can fill out a form asking to have books sent back from overflow storage. Some books are stored in the town of Boston Spa. These books sip perfect gin and tonics while getting foot massages. They arrive at the library well rested, eager for you to read them.
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