What I've Learned

 I, like millions of others, had my tonsils out as a child. This was a lousy idea.

We need our tonsils. They are part of our immune system. Sure they get inflamed. That's their job.

Here's how it works. A key element in our body's ability to fight off disease-causing bad guys is the lymphatic system. This system is very complex – more than I can describe here – but I'll give an overview. Important players in the lymph system are lymphocytes, a type of white blood cell. Lymphocytes detect disease-causing bacteria and viruses and attack them by creating antibodies.

What we want is lymphocytes to come into contact with any invading bad bacteria so they can knock 'em out. To do this, a fluid called lymph washes bacteria out of tissue and into the lymphatic system, a network of tiny tubes and nodes all over the body. The tubes carry lymph to the heart where it enters the blood. On its way to the heart, lymph passes through nodes where lymphocytes are hanging out, waiting for bad guys to arrive.

Lymph nodes remind me of an incident a few years back when a couple of not-too-bright robbers put on ski masks and went into a bar to rob it. When they pulled their guns and said, "Nobody move. This is a robbery," twenty patrons pulled out guns of their own and said, "Oh really? You're under arrest." The bar, it turned out, was a favorite hangout for off-duty police officers. Lymph nodes are kind of like that, except the lymphocytes are not off duty and they know the robbers are coming.

When bad bacteria show up, lymphocytes are ready for the fight. Lymph nodes become swollen because the number of lymphocytes increases in the battle zone as they work to overwhelm and kill the intruders.

So where do tonsils come into all this?

Tonsils are not lymph nodes, but they are part of the lymphatic system and have lots of lymphocytes. Their job is to sample the bacteria in our mouths, identify bad bacteria, and let lymphocytes have an early go at them. Removing tonsils removes an important early warning device, allowing evil critters freer entry into our systems.

Without tonsils, bacteria and viruses that would have been detected and dealt with early make it into our bodies and have a greater chance to multiply before being attacked, making the battle more costly.

In my youth, the removal of tonsils was common practice. These days, it's less common, though plenty of tonsillectomies are still done. Before agreeing to lessen a child's sore throat tendencies by cutting out the tonsils, study the literature, get a second opinion, and make an informed decision.

There are certainly cases in which removing the tonsils is necessary, but modern studies indicate this is the exception, not the rule.