Cells at Work! Code Black

Episode 6

Disclaimer: The views and opinions in these reviews are observations made by the reviewer(s) and should in no way be construed as medical advice! If you have a question, please contact your general practitioner for information!

This week our poor, abused cells have a particularly painful crisis as kidney stones tear a path through the urethra. Now, I don't have personal experience with kidney stones but I know plenty of people that have suffered through it. Having witnessed what that suffering looks like first hand, I wouldn't wish the experience on anyone. So how do you end up with a kidney stone in the first place?

Well, it starts with the glomeruli. The Red Blood Cells head to the kidneys to get filtered after navigating a pretty disgusting-looking blood pathway. The organ is represented as a Japanese-style bathhouse where the glomeruli work silently and efficiently to scrub the dirt and grime from the blood. The "silence" part is strictly enforced and plays off the organ's reputation of working without complaint; I don't know how much truth there is to this as someone who has had a kidney infection before and definitely felt it screaming at me. However, a quick Google search tells me that typically chronic kidney failure can happen without much notice until it's medically advanced. So, the "silent" part of the kidney's operations isn't really to its benefit and this comes to a head later in the episode.

So glomeruli don't cause kidney stones but overwork, dehydration, and poor appetite can increase the strain which leads to less effective filtering. What we're seeing happening in the kidneys is in conjunction with the increased cholesterol from episode one, the alcohol in episode two, and the stress on the liver in episode three. The glomeruli cleaning the Red Blood Cell specifically mentions an increase in oxalic acid, one type of substance that can lead to kidney stones. And that's exactly what bursts through the ureter causing an influx of red blood cells to enter the urine. I'll pause while we all collectively grab our groins.

The kidney stone's path of terror is dealt with rather quickly, but I've long assumed that the time the cells experience is nonsensical. The host seeks out medical help and undergoes surgery to have the stone zapped with a device that is inserted through the urethra and emits lasers. If you're holding your groin again at the thought, I'm with you. After the kidney stone is dealt with, the second half of the episode switches to a more unlikely condition that I have mixed feelings about. The situation isn't impossible, but it feels like it was tacked on to add more drama to the episode.

Essentially, an infection is introduced into the body via the medical equipment used to eradicate the kidney stone. Due to how the laser tube (I refuse to call it by its proper name) is inserted, it creates a quick path to the kidneys that would otherwise not be available under normal circumstances. This puts the kidneys at risk for severe infection that could permanently damage them. As I said earlier, I have experienced a kidney infection before but was fortunate enough to seek medical treatment early enough that I didn't need to be hospitalized.

The emotional climax of this episode hinges on Red Blood Cell not doing what Red Blood Cells normally do and instead rushing to the kidneys to convince the supervisor to let the glomeruli complain. Kidney infections cause your back flanks to become painful and it's a necessary response to let the human know that something is up. Of course, Ol' Gran passes away with her final words reminding the younger cells that they must work until they die; the body depends on it. It's only with appropriate medications that the infection can be defeated.

Look, guys, I'm not sure this body is going to make it? Part of me wants it to because I've become rather attached to Red Blood Cell and his growing determination over the course of the series. Also his relationship with White Blood Cell is just REALLY CUTE.

Notes from Matt RN: Kidney stones can be made of many different kinds of materials. The most common is calcium oxalate. These can form when waste products start to crystallize when your body can't flush out enough of the waste products fast enough. Besides being extraordinarily painful, particularly large stones can get lodged at the beginning of your ureter, making urine back up in your kidneys, called hydronephrosis.

The procedure shown in the show, a transurethral lithotripsy, as the name implies, is using a device through the urethra to break up a stone, usually with sound waves, but lasers can be used, as the show did. Unfortunately, even in the best cases, infections can occur during ANY procedure. Kidney infections can be very dangerous if untreated, but it was somewhat dramatized for the show. Most kidney infections can be resolved with no major damage to the kidney if treated in a timely manner.

Drink your water, Lynzee!

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Cells at Work! Code Black is currently streaming on Funimation.