“People are People” Part 1 of 6
Disclaimer: This post is R-rated for adult content. When I write posts, I imagine writing to strangers who are interested in Medicine. I do not think about my former elementary or Sunday school teachers reading them. But some of them do. And with this post, that makes me want to blush a little. This is an honest glimpse into the totally NOT-PG world of Medicine. These keystrokes were made with the intent of celebrating the broad spectrum of the human experience and the privilege of being exposed to it through the practice of Medicine.
Some foreign bodies (like bullets) can be left inside. Frequently, it could cause more damage to remove them. So we leave them wherever their trajectory ended. People don’t like this. Shells, splinters and other organic material have to be removed. And they are always deeper than you think! Sometimes we simply can’t remove them in the ED. Surgery for a splinter is a pity, but it happens.
I’ve removed several broken condoms from vaginas and pulled out one hair ball (I have no idea why that was in there). A surgeon I know removed a Teflon “pearl” from an unconscious guy’s penis because he wasn’t familiar with the practice of “pearling.” (Don’t Google it unless you’re prepared to see some bumpy penises.) I’m betting that guy didn’t get it put back in.
In my opinion, the best ear foreign bodies are bugs. People are so, so happy when you get them out. I have had little gnats fly in my ear and the “eeeeeeeeeeeeeeeeeeeeeeeeeeeeee” sound was pure torment! I can’t imagine the agitation of something bigger making a ruckus right up against my ear drum. I have extracted small roach sized bugs out of people’s ear canals. It is amazing. And rewarding.
Ears and nostrils are like pockets for kids. The only internal thought process I can imagine is this:
“Hey! There’s an M&M on the floor! My mom told me I’m not supposed to eat things I find on the floor. I guess I’ll just put it in my nose for safe keeping.”
The classic presentation of a nasal foreign body is a foul-smelling kid with unilateral nasal drainage, but classic exam presentations are often rare in real life. Usually parents show up the night it happens with full knowledge that there’s something in there.
The first thing we ask parents to do is plug the unaffected nostril, put their mouth over their child’s mouth, and blow. Hard. The child’s vocal chords close reflexively and the blast of air dislodges the foreign body. Or so they say. I have never actually seen this work, but it is always the first thing we try.
Kids put things in their ears and noses and grown-ups… Well, grown-ups put things in their butts.
It’s not such a mystery why adults do this. Really it’s mostly men. To be honest, I have never been in the department when a woman has come in with something stuck in her rectum. Maybe this is observational proof that women don’t like things in there as much as men like to think they do. Maybe… Just sayin’…
Common rectal foreign bodies include vibrators, dildos, bottles, and various vegetables (zucchini and cucumbers top the list). There are a fair number of jokes about rectal foreign bodies. Things like:
“I could hear him buzzing from the door!”
“I wasn’t sure if he wanted me to take it out or change the batteries!”
But the truth is, it is probably one of the worst days of that person’s life. And sometimes their wives & children are in the waiting room.
If we are unable to remove whatever it is that shouldn’t be there, that means a trip to the OR. Surgery for a rectal foreign body is probably universally considered the makings of a no good, very bad day.
The bottom line (no pun intended) is this:
People are people – whether they put things in their nose, ear, butt or vagina – and it is a privilege to care for them.
This post is the last in a series about some of the parts of medicine that aren’t suitable for dinner-party chatter. Every post ends with what a privilege it is to care for people – because it is. It is a privilege to care for people with a wide range of penchants, pasts, body types, abilities, injuries, and life expectancy. Thank you for reading.