The Root of Sequestration: Travels with biology through literature to life

A flowering hybrid Magnolia in bloom outside my window; Spring 2020

You have heard it called ‘isolation’ and ‘quarantine’. ‘Reset’ and ‘lockdown’ even. All these words have different and nuanced meanings and yet, they are used interchangeably in our fervid times. There, however, is a more apposite word — sequester/ sequestration.

This word has a specificity of meaning and a sense of gravitas; characteristics that have led to its cooption in academia (medicine and law) and in government. Language moults with time and culture and so it might have fallen out of use; but it is unfortunate that this well-crafted word languishes in the shade when it rightfully should bask in the sun as the descriptor-term of our new surreality.

Sequestration’s acuteness of meaning derives from its lack of qualifiers. All three words – isolation, quarantine, sequestration – refer to distancing and seclusion. However, in the context of health, unlike isolation (which indicates the presence of disease) and quarantine (which indicates contact or exposure to disease), sequestration refers to the state of separation alone. It makes no reference to the presence/absence of disease or to its exposure. In a situation that calls for social distancing due to a community spread of infection — a spread that occurred despite the lack of definitive evidence of exposure or contact — ‘sequestration’ has the most pertinence.

World over (in some places imposed and enforced; in others, voluntarily embraced); we are in the middle of an unprecedented sequestration.


Sequester’s root is in the PIE ‘sekw’ and the Latin ‘sequi’. Sekw means ‘to follow’ and has sense-felicitous derivatives – a long list of words that includes: sequence, sequel, consequence, sect, obsequious, pursuit, second, society and segue amongst others.

On the face of it, sequester seems like a misfit in this list. How it came to belong to sekw is revealed by a little digging around the roots. The answer is found in its verb form and idiomatic use — ‘sequestered in the middle’ for something that is caught betwixt and between. This sense of the word derived from the old Latin sequestrare which was the term for intermediate or that which followed another.

Up until here, the sense of ‘to follow’ was preserved. But with use, and as has happened with innumerable words, its meaning underwent a slow metamorphosis. Over time, Sequestrare came to mean trustee (an intermediary holder of an instrument, property or money) and since a trustee is an executor, a custodian, someone who is isolated from ownership it also came to mean isolated, removed from, separated, etc., thus birthing the English ‘sequester’ and ‘sequestration’.

The road to separation began at follow.

Sequestration’s avatars

Traceried denudations of oaks eagerly await the warm weather; Spring 2020.


First year of med school is an explosive learning moment for language. I suspect it is the same with law school. New recruits are met at the door by the implacably formidable visage of ‘Human Anatomy’ – a subject whose every book has a couple of new words in every line. Anatomy’s words do not come to make friends. They come as an endurance test. As multi-syllabled words with tongue tripping Latin roots.

For a lover of language and etymology, it is paradise gained. For one less enthused, it takes some months of palate pounding repetition to melt its medieval hauteur. Happily, through this fiery rite of induction, complex Latin constructions become de rigeur usage, turning every novitiate into a seasoned pro by year two..

This is where I landed on ‘sequestration’ in medical school – in the first year of anatomy and under the subdivision of embryology (the study of the development of the embryo). In a not so happy coincidence for our times, the word was introduced in the context of the development of the lungs as Pulmonary Sequestration.

This happens to be a not insignificant embryological anomaly. A small portion of the lung detaches from its connection with the bronchi (tubular passages that transport air between the lungs and the nose) and has no longer any route for air to enter. This portion becomes unaerated and solid. Since this portion of the lung separates from the rest of the normally developing lung; it is called a sequestered lung or pulmonary sequestration (pulmo — Greek for lung).

This is a congenital developmental anomaly because it is present at birth. Medicine has two other kinds: pathological sequestration (related to disease; from pathos — Greek for disease) and iatrogenic sequestration (caused by a physician; from iatros — Greek for physician).

The disease Osteomyelitis (infection of the bones and marrow; from osteon — Greek for bone and myelo — Greek for marrow) is the textbook example of the process of pathological sequestration. An infection in bone, if left untreated, can get severe enough for a portion of the bone to succumb and die. This fragment of dead bone then separates away from the rest of the healthy bone and is called a Sequestrum, a diagnostic hallmark of infection in bone.

Iatrogenic sequestration is rare and is the result of an invasive medical procedure (surgery) which, unintentionally, becomes the route for external skin cells to travel into, and lodge inside, the body.


In law, sequester is commonly used in the context of a jury sequestration when a jury retreats into seclusion from society to arrive at a judgment that is free of the bias of media and public opinion. This move to sequester a jury is to ensure the impartiality of their decision.


Sequestration in government (largely confined to usage in the US) is a dreaded indicator of budget cuts with significant implications on economy and lifestyle.

Lastly, biological sequestration is a term that is finding purchase in discussions on climate change. It refers to the removal of carbon dioxide from the atmosphere by natural carbon sinks — trees, forests, soil, shrub-land and oceans.

Literature: A poet, a theologian and a physician with a banned book

Portrait of Sir Thomas Gray; source: Wikipedia

The poet: 

When I bumped into sequestration in anatomy; it was a happy re-acquaintance with an old friend after many years. I learnt the word ‘sequester’ from my beloved father, from a poem beloved to him — Thomas Gray’s ‘Elegy Written In a Country Churchyard’.

Far from the madding crowd’s ignoble strife,

Their sober wishes never learn’d to stray;

Along the cool sequester’d vale of life

They kept the noiseless tenor of their way.

The word is ‘sequestered in the middle’ of this exquisitely lyrical poem as an adjective to describe the remote and circumscribed lives of impoverished peasants who, literally and figuratively, lived far from the ‘madding crowds’ of the cities.

Gray’s masterpiece — the Elegy — is, in many ways, the masterpiece of eighteenth-century English poetry. It is written in a rhythmic iambic metre and builds its emotional cadence with rhyme and tempo from the hauntingly vivid imagery of the opening stanzas to a masterful explication of the metaphysics of chance, ending in a glorious epitaph that is either perhaps his own or an allusion to an unsung poetic hero interred in a bleak churchyard.

It would be too much of a segue for me to dwell on the richness of Gray’s verse but it is for no ordinary reason that his poem, with its richness of thought and language is regarded as the literary benchmark that sparked the shift to Romanticism in English literature. Three centuries later, it continues to be read and venerated across English speaking lands.

The Elegy is pregnant with pensiveness. Gray’s tendency to melancholy has been described in literary critics as a ‘constitutional languor of temperament’. He himself called it ‘white melancholy’ and wrote of it as distinct from the ‘black’ form in a letter to a dear friend, Richard West:

“though it seldom laughs or dances nor ever amounts to what one calls Joy or Pleasure, yet is a good easy sort of a state … There is another sort, black indeed which I have now and then felt that has somewhat in it like Tertullian’s rule of faith, credo quia impossible est; for it believes, nay is sure, of everything that is unlikely, so it be but frightful; and, on the other hand, excludes and shuts its eyes to the most possible hopes and everything that is pleasurable; from this the Lord deliver us! For none but he and sunshiny weather can do it.”

My rumination on the word ‘sequester’ started with this letter. I came upon it in a book of literary correspondences and while reading Gray, was transported to the Elegy and to a link between his reference to Tertullian and a seventeenth century physician, Sir Thomas Browne.

The theologian:

Tertullian was a Christian theologian in the dark ages; one of the earliest to write in Latin signifying the Church’s definitive break with the intellectual and spiritual tradition of Greece. While much of his work continues to be relevant in theological circles, he remains remembered in the public domain for his dictum — Porsus credible est, quia ineptum est; certum est, quia impossibleIt is entirely credible because it is impossible; it is certain because it is impossible. For Tertullian, the dictum’s meaning (inspired by Aristotle) was rooted in man’s capacity for reason. He gave the logical and rational capabilities of human thought the benefit of the doubt.

The physician and his banned book:

Centuries later, his dictum was resurrected, and re-imagined by Thomas Browne, a seventeenth century polymath and medical doctor in his book Historia medici — (The Religion of a Physician). Like Tertullian before him, Browne was a man who could seamlessly blend reason and faith. His time witnessed the widening chasm in the Christian doctrine between Protestants and Catholics which was the frame of reference for his interpretation of Tertullian’s rescript.

He refashioned Tertullian to the context of his times to explain Catholicism’s belief in ritual and liturgy as: ‘the more incredible the dogma the stronger is the faith’. What shifted between the original phrasing and the new interpretation was the objective understanding of human nature. In Tertullian’s time, human nature/belief/behavior was credulous enough to shrink from the implausible. After the medieval ages, it swung to blind faith and doggedly asserted the primacy of faith over logic and reason. The skeptic in Browne cleverly reinterpreted Tertullian to reflect the new dogma.

Medicine today is much removed from faith but until a mere 1500 years, there was little difference between a man of faith and a man of medicine. Both were called in at dire times and both resorted to measures of alleviation that were different in approach but equal as acts of faith. Little science was behind any of the methods used by its earliest practitioners.

Thomas Browne stood against this tide. His standing in the intellectual firmament is borne out by his ratiocinating approach to both disease and faith in a time that ill supported it. Despite his many public iterations of sincere faith; Browne’s stance was deemed heretical by the Church and resulted in the banning of his book.

The two Thomases — Brown and Gray — represent the archetypal intellects of the late seventeenth and eighteenth centuries. They were scholar-aesthetes who professed a non-judgmental faith and whose melancholic temperament was (unlike the Romantics) suffused with stoic acceptance; the kind eloquently described by Gray as ‘leucocholy’ (Aside: the word melancholy — a state of dark despair — is derived from the Greek ‘melan’– black and ‘chole’ — bile. Leucocholy is its antonym; from ‘leuco’ — Greek for white).

A phrase and a word – literary lenses for our time 

Interlacing branches of a blossoming cherry tree. Word roots are like this full of inter-weavings allowing felicitous crossings from meaning to meaning binding each to each in idiom, nuance, phrase, thought and language

We are now in the throes of an unexpected and fast moving pandemic which has catapulted us into uncertainty and upended our usual habituations. The experience is acute and mind-numbing.  It is a truism that past is prologue; but this moment’s sudden and surreal nature does not lend itself to useful contemplation. Instead, it leads me to the comforting familiarity of literature and language and does so, perhaps with the hope, that meaning or some sense of meaning would follow from there. They, in turn, led me to a word and a dictum; both of which seem to encapsulate this moment.

Centuries after Tertullian, Browne and Gray; the dictum credo quia impossible est is perhaps the best frame for the unreality of our sequestration. What was disregarded as impossible and unimaginable until a couple of weeks back, has been abruptly set aside in a matter of days to become credible, present and startlingly real.

While the phrase is a more material descriptor of our situation; the word – sequestration – has a deeper story to tell through its etymological root that manages to enmesh disparate contexts. Gray bisected the melancholic state and the root sekw seemingly diverged down two paths —on fork led to follow/couple; the other to separate/uncouple. Science, however, has little regard for the neat lucidity of these dichotomies. It muddles and muddies them with its revelations that: a) roots form reticular networks and rarely, if ever, split equally and, b) melancholy’s state is multifarious.

Melancholy nestles in the many crannies of our apportioned life in often irreconcilable compartments. In states we classify as – private, public, private-in-public and public-in-private. I suspect the ascendant degree of our social separation will not harm our inner lives a great deal, as we have become somewhat accustomed to fragmentation. The ease with which many have been able to switch to technological solutions for both work and social connectivity is a good indicator of the same.

But the roots have a little more to tell. It needed the mandate of a sequestration to clear the undergrowth around the root ‘sekw’ and see its intriguing insight: the paths to separate and follow are not divergent. They are reticulated with a common and deliberate purpose. For, if our sequestration is to quell this viral pandemic, we all – to a man – must submit to follow its rules. This philosophical understanding is embedded in hardy linguistic roots:

The road to separation begins and ends with follow.

.    .    .

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