Day 7 – Toedeledokie & Medicinal Chemistry

Everyone knows the image, of a prisoner whose locked up in his confined space, scratching a line on the wall, to mark either the start or completion of a brand new day. That image never really touched me, couldn’t really understand why someone would really do that. But today, I get the point! If everyday feels the same to you, you need to create something, something to mark progress. That time is not standing still, and that the sun rises and sets every single day. My mind is still clear, but I feel I am loosing the track of the number of days I have been locked up and that I have to stay here, here in this quarantine hotel. If, and I repeat if in mind, I have to be locked up anywhere again for more than seven consecutive days, I want to start day one, with a line on surface, to mark the first day. And repeat the process till the end of the confinement. It not only marks progress, but also provides a target, a target to remind you that this stage is not forever. It is not an endless and hopeless situation, you need to stay strong and don’t give up. Even when you feel down, lonely or frustrated, try to find to small elements of joy and put yourself together. And have trust, that that will help to get stronger. Like your muscles, you need to train them, and while training them, you might feel pain directly, or even 72 hours after the event, better known as ‘delayed onset muscle soreness’. I know, our brain is not a muscle, but we still can train it. As humans we are so fortunate, that we are able learn new things such as playing an new instrument, learning a new language or learn to fly an airplane. There are so many things that we can do and learn.

It is 7.15 am, and I hear knocking on my door. I open my eyes, and realize that the breakfast has been delivered earlier than the days before. Open the door and unfortunately, it is again the Daily Breakfast logo on the packages. Disappointed, and reluctant I bring the products to my desk and inspect them, as Sherlock Holmes who is checking carefully a dead person on the crime scene. A little angry, I open the plastic wrap, and see three dry white slices of bread. Slices without a crust. In my home country, we are taught to always eat the crust, we are not allowed to remove and discard them. Only when you loose all your teeth. Yes that is the only excuse. I look down to the product, and see that between the first and second layer, there is a slice of probably fake cheese and a small slice of a vegetable that looks like cucumber. Between the second layer and the third, I recognize a chicken patty with ham. Next, I open the small cup, and the potato parts are looking to me. They are drowned in a yellow sticky concoction and the smell of Herbes de Provence is slowly moving through my nose hairs. I take with the plastic fork that came with the breakfast a bite, and chew on the potato. It was indeed a potato, but undercooked, half-done, and the sticky yellow materials tasted like a far far away family member of cheese. I ditched, the sandwich and cup directly to the garbage, while I say ‘Toedeledokie‘, referring to a Dutch comedy that was aired some years ago. In that show, one of the main characters threw away his sandwiches in the bin, that his wife carefully prepared for him, while saying ‘Toedeledokie‘.

My stomach not only feels empty right now, although there is a homeopathic amount of starch in it because of the potato, but I also feel hungry. I look around me and walk to my fruit area. I have saved two bananas, one apple and a water pear. I decided, that eating fruit for breakfast is right now a perfect alternative for the terrible products that were delivered earlier. Those fruits must be more than sufficient for me, to feel fueled again. Fruit, rice, noodles and eggs, they all contain important building blocks for our body. Blocks that can be use directly to fuel our brain, to be stored to be used for future purposes or as precursors for other essential processes in our body. I remember vividly, at university, an assistant professor taught us about medicinal chemistry. That is a discipline at the intersection of chemistry, pharmacology and various biological specialties. I absorbed with pleasure all the information like a super dry large sponge. It was amazing to read and understand, what and why chemicals have influence on specific biological processes. The lesson about the so-called “selective serotonin reuptake inhibitors (SSRIs)” was, without doubt, my number 1 lesson for this discipline. Without going to much in detail, serotonin is a neurotransmitter that is involved in processes like modulating our mood, cognition, reward, learning, memory and various physiological processes. Most of the serotonin in our body can be found in our gastrointestinal tract, where it regulates intestinal movements. Less than 2% is located in our central nervous system. In the latter location, it regulates our mood, appetite, and sleep. Communication between our cells can take place by neurotransmitters that are released, and travel toward another cell, where they can be taken up in the so-called synaptic cleft. Taken up, like the Japanese Pac-man game, eating the dots. So the level of the serotonin neurotransmitter between the cells, is amongst others, dependent on the amount that is released, and the amount that is taken up by the Pac-mans on the other side. People that suffer from depressions, might have an imbalance of these levels. A way, to change this balance, is to use the earlier mentioned ‘inhibitors’. Basically, these ‘inhibitors’ prevent that the Pack-mans will eat the serotonin, resulting in a higher local level of the neurotransmitter between the cells. Subsequently, this can improve the mood of the individual. For me, this was almost like science-fiction! Again, I don’t want to go deeper in the chemical structures, biochemistry and pharmacology involved, but trust me, the better you understand it, you feel more and more like Neo in the movie The Matrix. Like you feel, you have the key, the better understand, manage and control specific processes. It also reminds me of the first time, I was learning to write software program when I was about 11 years old. You will get the ability to create, to modify a piece of code that you can execute, and it will do, what you told the program to do. However our body, our brain is of course much more sophisticated than the programming environment on the Commodore 64. Nevertheless, that course about the neurotransmitters showed me, that you can have influence on our mood by changing just one parameter in our body. On the other hand, I also immediately understood, that that our body is so complex, and that it is very difficult to predict, not only the immediately side affects, but also the long term effects, such as addiction to the drug. Everyone has only one body, one brain, although we can currently substitute some organs by either an artificial unit, or from a donor individual, but we still need to take care of ourselves at the first place. Drugs can have a direct effect on our mood, so we might feel happy again, but probably it won’t solve the underlying problem.

It reminds of a patient that visits the doctor. Patient says: “Doctor, I have a terrible pain in my eye, when I drink my coffee with sugar” The doctor replies: “Well, I advise you to stop drinking sugar in you coffee.” I week later, the patient visits again the doctor, but this time with a big bouquet of flowers to thank him, because she didn’t feel any pain anymore. In this case, it is true, that because of the help of the doctor, the ‘pain’ problem was solved, but the doctor didn’t understand the underlying problem.

The real problem in this case, is that the lady left her spoon, to stir up the sugar, in her cup. So every time, she took a sip, the spoon was poking in her eyes, causing the pain that she was describing to the doctor earlier. Of course, this example is over simplifying the cases that we see in our daily life. In this day and age, we are under a lot of pressure, we need make decisions, faster than ever before, of course we have more tools to assist us, but we should keep using our brain, to keep on thinking carefully, and keep try to find and solve the underlying problem of a case.

Changing one parameter, such as the neurotransmitter levels by taking certain drugs, might trigger a whole chain of events, like the butterfly effect: the flapping of the wings of a butterfly could cause a tornado weeks later with devastating results. So please be careful. Don’t live in fear, enjoy life, and again, please be careful of yourself and others. Thank you.