The Sickling Concern



By  Yemi Sanusi

This is purely a work of fiction, a result of the writer’s imagination. Any similarity to any individual or individuals is definitely not intended.


Very few cells had seen Hart, commander of the circulatory system, cry. The tough, short, stocky and red cell had no time for such frivolities and believed tears were for baby-cells who didn’t know their onions or what was expected of them.

But the day Hart took a casual walk towards the knee and saw her red blood cells pooling behind one another, their forms contorting into the shapes of sickles, fear gripped her; and months later, when she recounted her experience to Caeca – the commander of the digestive system – the bottled up emotions she had kept sealed that day surfaced and the tears flowed freely.

The memory of that day had stuck too well in Hart’s mind and she had vowed that it would never happen again. She could barely understand why it had happened but she made sure there was no repeat of the incident… until the body was two years old and there was yet another crisis.

A troubled Hart had known the body had played very hard on that day, exerting itself in excitement; having very little time to drink water or catch breaths after the rigorous exercise it had been subjected to. But it was not until the alarms started going off about a swelling on the right wrist because the red blood cells going through that area had been unable to cross to the other side did Hart’s dread begin to envelop her once again. The nightmare resurfaced. The first had been at about the sixth month following delivery, shortly after several guardian cells from the mother-body which had remained within the baby’s body to ensure proper hand-over had left Hart and her colleagues to carry on the duty of steering the body through its planned course. Hart had never thought there was anything unusual about her cells. They were all the same beautiful red spherically structured red cells, bouncing with life and working diligently to provide the body with all the nutrients and oxygen it required while taking out the waste products which could clog the cells if such remained.

She was very proud of her cells and so it had struck her as a blow when she saw them for the first time unable to flexibly cross the blood vessels on their way to carrying out their usual duties, piling up stiffly as though there was some strange contest for occluding the blood vessels. Hart had watched her cells die for reasons she could barely fathom and had gone in search of answers, getting none per se, until the second crisis hit. That was when Audita, the ears controller and Memorii, the head of memory department explained to her what the doctor had told the mother-body during the time of the baby’s first hospitalisation.

It had been one of those rare days when Hart had stopped over at the chief commanding cell’s office to debrief him about a minor incident concerning one of the heart valves. Bain had been quite responsive and had granted most of her requests, enabling her leave his office early. However, on her way back to the heart, she met the controller of memory department along the corridor and shortly afterwards, the head of the hearing unit walked past both of them, saying a quick hello before joining their rather cordial conversation. Memorii wondered if she could just get a little dash of red from Hart in preparation for Valentine’s Day but Hart had laughed it off, stating it was simply reserved for members of the blood group and would interfere strongly with the brain’s impeccably white existence.  The only time a dash of red could possible exist on any brain cell in any part of the brain, Hart stated, was if there was an incidence of a burst blood vessel and that, she emphasized, was something she would rather die than see.

That seemed to give Memorii and Audita some degree of reassurance although they were a bit concerned about the death issue. Afterall, Hart’s cells were suffering a massive loss with each crisis that rocked the body. What was Hart actually doing about it, they questioned. In one of the rarest moments of her life, Hart didn’t really have an answer. In fact, she had more questions than those two cells could ever understand… and Memorii seemed to sense it. Making a quick decision, Memorii invited both Hart and Audita to her rather spotless office, some distance away from Bain’s though. Perhaps she could answer some of Hart’s questions, she thought as she flipped her computer on, searching until she found the recorded episodes of both red blood cell crises. Audita sat comfortably, trying to recollect what would be valuable information to Hart and what would be irrelevant, considering all the information that had passed by her ears all day, all week, all month and almost all year. There was just too much to retain and she was just glad that Memorii kept very good records. What could they all ever do without memory?

Memorii looked thoughtfully at the reports, her mind chewing on the words. The visit to the doctor was most critical and mother-body’s instructions after the emergency were also of utmost importance. She noted a few files from the body’s eye controller as well but felt that she had enough to try to make Hart take some necessary measures. It was really a pathetic experience losing one’s cells and it was even worse if one was so powerless watching them die quite painfully. She knew that if her cells died… she shuddered; amnesia would be the only option.

Hart waited patiently. She wasn’t one to sit in an office and spend so much time in front of a computer but she knew she had to wait and listen to Memorii especially as the small white cell started recounting what the doctor had said… in great detail. Memorii knew that Hart had probably received a summary in previous months and had read through it while juggling her constantly busy schedule. But now, it was time to tell the usually overconfident red cell the truth about her sickling cells. It all lay in the blood’s haemoglobin structure and the manner of inheritance from both the father- and mother-body.

Hart listened… and kept listening. Her cells were dying because the body had been exerted too much and had suffered some degree of dehydration. More cells would still suffer or die if proper precautions were not taken. Memorii told her that the doctor had said conditions like infections or fever, emotional disturbance, physical exertion, extremes of weather and even dehydration could prompt the sickling forms of the body’s red blood cells. Audita agreed with Memorii’s statements while Hart remained dumbfounded. How was she going to make sure that the body avoided all these things? She would lose focus and failure would be upon her in no time; Hart rationalised. Only Bain could help out. He was the commander of the human body. He would speak sense to all the commanding cells at the monthly executive cell meeting; and he would know how best to respond to the mother-body’s instructions and doctor’s advice. Afterall, he was commander of the brain as well and had a vision to pursue. The death of delicate red blood cells meant less nutrient and oxygen supply to the brain and the body which translated invariably to poorly accomplishing the many dreams of a body that was poised to achieve the best; not to mention all the time that would be wasted trying to recover from an illness that could have been prevented.

But it was not until Memorii explained the mode of inheritance that Hart felt the frustration well up inside her. How could that have possibly occurred, she wondered as Memorii explained, with the aid of her files and Audita’s incessantly nodding brown head, that inheritance of the sickle cell disease (SS) occurred when a father-body had a sickling trait (AS), the mother-body had a sickling trait as well and the child, who had a 1:2 chance of having the sickle cell trait (AS) or a 1:4 chance of normal AA genotype or a 1:4 chance of having the sickle cell disease (SS) during that pregnancy ended up with the SS genotype.

Hart was troubled. Her department’s dream of a near perfect existence had been shattered by a decision which was taken long before she even had any say in the affairs of saving her team from calculated destruction. Her red blood cells would have to face the life-long battle of avoiding the sickling process simply because a man and a woman with sickle cell traits had come together and their respective sperm and ovum had opted for the 25% chance of SS instead of the 50% chance of AS or the other available 25% chance of the AA that came with that pregnancy. Hart stilled herself as the thoughts flooded her mind, her memory holding on to the period in the womb when they had worked tirelessly to ensure that the baby came out with little or no hitch, remembering the joy of having been delivered to a new journey in a new world that promised so much but not realising that the gene experts had failed her and her team in one painful area.

She would trudge along, no doubt; her cells would fare well. They would take the necessary precautions and this body, this being they all lived to sustain would reach its goal, and tell many others its story… especially how to prevent the risk of the 25% chance.

Just then, Memorii’s words pierced through her heart. For the sake of prevention, the doctor had advised that intending couples should know their genotypes and take the best possible decisions in the interest of their offsprings if they ever found out they both possessed the sickle cell trait (AS). Hart knew it was too late for the body she so strongly defended. Yet, as she stood up to leave Memorii’s office, she knew that was the best prevention strategy, the ultimate price for the love any parent could possibly profess.


Yemi Sanusi is a medical doctor with a Master’s in Business Administration degree from Lagos Business School. She loves writing and hopes to make positive changes through her works. She is the author of ‘Heads and Tales’, a medical fiction.