Monday 27 April 2015

Foreign body

NOW I've seen everything.  No, I'm really seriously serious this time.

I know I've said this before, but this time I really really mean it.  I just don't see how the Call Gods can make up anything new.  Surely they are reaching into the very depths of their imaginations now, scraping the absolute bottom of their creative barrels, and they must be completely out of ideas.

But wait, I'm getting ahead of myself.  My apologies.  I'll start from the beginning.

I get some bizarre phone calls at 1 AM.  Nothing good ever happens in the middle of the night, and surely the emergency physicians know this.  In an attempt to soften the blow, they almost always start out the conversation with "Hey Doc (not your real name©), I'm sorry to bother you, but . . ."  Sometimes with difficult cases they know the blow can't be softened, so they begin with something more like "Hey, sorry but I got a complicated case for you."  That's never a good sign either.  But when they lead off with this:
So, uh, I have a weird question for you. . .
That is Guaranteed Not Good©.  Very very not good.  Whatever it is will be so not good that I am tempted to retire on the spot, just so I don't have to hear the end of that sentence and then deal with whatever catastrophe they're about to drop in my lap.

As I'm sure you've guessed already, I got just such a call recently.  And you've probably also surmised that I didn't give into early retirement.  There's no good way to summarise the conversation, so I'll simply present it exactly as it happened with as little paraphrasing as possible.

Emergency physician: "So, uh, I have a weird question for you."
Me (under my breath): Oh, fuck.
EP: What was that?
Me: I said 'What can I do for you?'
EP: Right. Must be a bad connection.  So anyway, I have this young lady here who, uh . . . she, uh . . . I don't know exactly how to say this.
Me: . . .
EP: She, well, uh . . . she swallowed her glasses.
Me: . . .
EP: Hello?
Me: . . .
EP: You there?
Me: Yeah.  I'm sorry, I thought you said she swallowed her glasses, but that must have just been the peppers I had for dinner, right?  Right?
EP (laughs): No, that's exactly what I said.
Me: Ok, she swallowed . . . did you say her glasses?
EP: Well not the whole pair of glasses.
Me: Of course not.
EP: Just the arm.
Me: Well of course.

If I wasn't awake before, I certainly was then.  I paused and thought about it for a few seconds, trying to figure out A) how the fuck that was even possible, and B) what the hell I was going to do about it.  Once something is in the stomach, there are only three ways to get it out: 1) Make an incision in the stomach and remove it directly, 2) get it out the way it went in, or 3) wait until it comes out the other end.

I told the emergency doc that if I had swallowed some glasses, I would want a gastroenterologist to try to remove it non-surgically (with an endoscope) before a surgeon cut me open.  If I had swallowed glasses.  If I had . . .

I couldn't believe I had actually just said those words in that particular order.

First thing the next morning after I woke up and had my cappuccino (yes, I spent 4 minutes making and enjoying a cappuccino.  I do love my morning cappuccino), I went straight to her room to check on her.  Her nurse informed me that she was already in the endoscopy suite with the gastroenterologist.  PERFECT!  I walked down one floor to endoscopy and ran right into my friend and colleague Dr. Ken (not his real name©) just as he was leaving the procedure room.

"Hey Ken, did you get it out?" I asked him.

Without a word (and with a big grin) he held a specimen bag right up to my face.  I expected to see one of those glasses arm covers in it:
HAHAHA no.  Instead, I saw one of these:

Yes indeed, an entire glasses arm.  As is usually the case with these foreign body patients, I was rendered nearly speechless.  I did manage to stammer out one nearly-coherent phrase:

"But . . . but . . . how?"

Ken affixed me with a look that clearly said, "Don't ask questions to which you don't want to know the answers."

And so I didn't.  I shook his hand, turned around, and left without another word.  But as I walked away, thankful that I wouldn't have to operate on this young lady, I realised I did have one more question:

Ok Call Gods, what the fuck is next?


  1. That girl either needs to lay off the drugs, or be put on them.

  2. Bulimic. She probably used the glasses arm to try to induce vomiting but accidentally triggered the swallow reflex and BAM, ended up in your ED. Sad, and so weird. Thanks for your awesome blog!

    1. That is surprisingly logical. Are you Sherlock?

    2. indeed, it makes sense. - although to be blunt, the original doctor DID SAY she swallowed a glasses arm. so I was expecting the whole arm.

  3. That almost activated my gag reflex!

  4. Hahaha! I remember many years ago a guy came into the ED who claimed to have swallowed his dentures. Yes, the WHOLE upper plate. The surgeon took him to the OR and the H&P was a whole discussion how it was "theoretically possible for the dentures to have traversed the transverse colon etc etc and lodged in the patient's rectum".
    A month later the same patient presented to the ED with an orange juicer in his rectum. Case solved

  5. Oh and another one. This was several years ago too. ED again when films were still on film and sat on a view box in the department for all the world to see. Guy came into triage in considerable distress. Triage nurse figured out quickly that the situation was more "delicate" than could be described freely at triage. Lo and behold the guy had a TOOTHBRUSH lodged bristles first in his urethra. There was a string attached to it. After xray they removed the toothbrush with considerable hemorrhage. What was really priceless was to see the other docs as the passed through the ED glance over at the viewbox idly and after a second stop dead in their tracks....drawn inexorably toward the image, mouths agape

    1. I didn't think the urethra expanded that far. Not sure I wanted to know that it apparently does...

  6. Hahaha damn this story was hilarious. Mean whet the fuck how does this even happen but great story, thanks for sharing doc.


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