Armchair Anonymous: Foreign Object in Butt II
43 min
•Jan 30, 20263 months agoSummary
This episode of Armchair Anonymous features healthcare professionals sharing stories about foreign objects retrieved from patients' rectums. The episode includes accounts from nursing students, surgical technologists, and emergency room physicians dealing with unusual cases involving vibrators, screwdrivers, pears, and other items, highlighting both the medical challenges and human stories behind these incidents.
Insights
- Healthcare workers encounter rectal foreign body cases at surprisingly high frequency (approximately 3 per year in rural settings), suggesting this is a systemic issue rather than isolated incidents
- Shame and embarrassment are primary drivers preventing patients from seeking immediate medical care, often resulting in more severe complications requiring surgery and permanent lifestyle changes
- Medical professionals develop compassion and non-judgmental approaches when treating these cases, recognizing patients as people dealing with personal struggles rather than objects of ridicule
- Substance use (particularly methamphetamine) correlates with increased risk of rectal foreign body incidents, suggesting addiction treatment could be preventative
- The medical community uses humor and storytelling as a coping mechanism for processing traumatic and unusual cases they encounter regularly
Trends
Increasing normalization of discussing sexual health and exploration in medical settingsGrowing recognition of shame-based medical avoidance as a public health issue leading to worse outcomesHealthcare worker burnout and coping through dark humor and peer support networksSubstance abuse correlation with high-risk sexual behavior in emergency medicine presentationsRural healthcare providers managing complex trauma cases with limited resources and specialist access
Topics
Rectal Foreign Body RetrievalEmergency Medicine ProceduresSurgical Intervention ProtocolsPatient Shame and Medical AvoidanceNursing Education and Clinical RotationsHealthcare Worker Coping MechanismsSexual Health and ExplorationSubstance Abuse and Risk BehaviorRural Healthcare ChallengesMedical Ethics and Patient DignitySurgical Complications ManagementColostomy and Permanent Ostomy CareAnesthesia in Emergency SettingsTrauma Center TransfersHealthcare Professional Resilience
People
Dax Shepard
Host of Armchair Expert podcast, moderates the Armchair Anonymous segment featuring medical professionals
Monica
Co-host of Armchair Anonymous segment, participates in discussions with healthcare professional guests
Quotes
"My wife died 20 years ago. A man's got to do what a man's got to do."
83-year-old patient with vibrator in rectum
"When you know more, you grow more."
HubSpot ad read
"Shame is so powerful. Not only did he not want to tell his wife, now he's got a fucking colostomy bag."
Debbie (ER physician)
"They literally cheered."
Hannah (surgical resident, describing hand retrieval of pear)
"I'm now known as Tiny Hands."
Hannah (surgical resident)
Full Transcript
Welcome, welcome, welcome to Armchair Anonymous. I'm Dan Rather and I'm joined by Monica Mouse. Hi. Hello, Fun Mouse. Today we have part two of quickly becoming our favorite prompt, foreign object in but. Ugh, we've yet to hear one that's not fantastic. They're so good. And this one, there was some blood in one. Blood warning. There's sadness. Yeah, there's humiliation. There's like a tenderness to one of the stories. And then there's some hilarity of you would expect. There's no female president Barbies up the button. This one, thank goodness for once. Right, but every other conceivable option is there. As you'll hear, please enjoy foreign objects in but part two. We are supported by HubSpot. Did you know that most businesses, Monica, only use 20% of their data? That's like reading a book with most of the pages torn out. Yeah, or paying for a coffee that's one fifth full. Yuck. Point is you miss a lot unless you use HubSpot. Their customer platform gives you access to the data you need to grow your business. The insights trapped in emails, call logs, and transcripts, all that unstructured data that makes all the difference. Because when you know more, you grow more. And when you get a full cup of coffee, you can do more too. But I digress. Visit hubspot.com today. This podcast is brought to you by Squarespace, the all-in-one website platform designed to help you stand out and succeed online. When we were building the armchair expert website, Rob actually used Squarespace to get it up and running, which was a smart choice because they've got everything you need in one place to create something that actually looks professional. What really stands out is their blueprint AI feature. It's like having a design assistant that helps you build a site that doesn't look like every other cookie cutter template out there. Answer a few questions about what you're trying to do, and it creates something that actually fits your vision. If you're someone who offers services, whether that's coaching, consulting, creative work, whatever, Squarespace handles all the business stuff too. Payment processing, scheduling, client management, no more juggling five different platforms just to get paid for what you do. The whole thing is designed so you can focus on your actual work instead of wrestling with website tech, which, let's be honest, most of us would rather avoid. So, head to squarespace.com slash DAX for a free trial, and when you're ready to launch, use code DAX to save 10% off your first purchase of a website or domain. All times, come and go. Good times, take them slow. My life, I had them both. Remember one thing you gotta know, I'ma keep on shining. Laura? Is it connecting audio? No. Can you hear us? Give me a thumbs up if you can hear us. And don't panic, everyone has problems. Panic. Don't panic. Well, now you guys can probably hear me. We can. Now we can hear you. You seem to be in a little person's bedroom. My daughter's, she is five years old, and she turned six January 31st. My birthday was yesterday, and my wife was on the second, so happy belated birthday DAX. Wow. She's a J2C. Also, you guys are two days apart, three days apart? Three days apart, yeah. I find that to be very rare. Am I the only one that thinks that? I've never thought about that. Couples generally are not, in my experience anecdotally. She is 16 years older than me. So I think that kind of plays a part in it. We are an age gap family. Good for her. Oh my God, you were a sweet 16 birthday present to her, and then it just came late. Yep, that's how it worked. Also, she's a baller way to get a young chick. Yeah, she actually got her driver's license on the day that I was born. Oh my God. But she's a hottie. You wouldn't know that she was that much older than me. She's beautiful. Wait, how old is she? Are she and I the same age? I am 44, so she just turned 60. Okay. Nice. Okay, tell us about the foreign object in a butt. Okay, so I went to Georgia Southern University, and when I graduated, I was having a hard time finding a job. So I started working for a trucking company, and my dad was not happy. He was like, I want you to be a teacher. I want you to do something that you can fall back on. So I decided to go to nursing. I went to a two year school. I'm not gonna tell you which state it is in, but there are ranges from 18 years old to like 50, people going back to school. And I was so not wanting to do this in the first place. But I get into the program and I have most of my math and science and all that stuff done. They do clinicals, okay? So in these clinical rotations, you start with geriatrics, then you go to med surgery, progress. Wait, can I ask an inappropriate question? Yeah. Do you start with geriatrics because they're expendable? Like if you fuck up, they're already at the end? I think most of it is because it weeds out, you're wiping so many butts and you're taking out garbage, and you're doing a lot of stuff that you don't necessarily do as an RN, but you do need to know how to do it and you really should do it. So it kind of warms you up. But my second rotation, which is the first in a hospital, is at this low income area. The very first day, they have us come in at five o'clock in the morning. And you don't actually technically start until seven a.m. But because it's the first day, you have to go through orientation and they're telling you about OSHA and HIPAA and all that kind of stuff. And they're very professional and say, hey, this is a low income area. You're gonna have some people that come in with a earache and you're gonna look in it and it's gonna be a roach. It's gonna be a spider. Oh my God. That just made me so itchy. Monica just threw her headphones out and dug in right here. I just felt like there was a real spider. Look in your cup for a mouse. Stop. Oh. Mice, bugs, snake in your butt, be careful. Oh, is that where this is gonna go? No, thanks God. And they're also like, hey, you're gonna get all different kinds of patients and it is what it is. This is not a fancy place. This is not gonna be comfortable for you. So we go upstairs around six thirty in the morning. We meet our nursing precept for the first time. There's five of us nursing students and they hand you your patient for the day. And it's your very first time, first time in scrubs. It's super uncomfortable. I don't know where anything is. Yeah, are you excited or scared? I was panicked. So they hand you a patient and you only get one at your first day. They don't overwhelm you, but it is still overwhelming. You're getting their patient history. You're getting their medications. You're getting all the information that you need to know about this person. And then you go sit down and you write down their medications and what the side effects are and all this stuff. So I'm watching all these people get their patients and it's like one page. I have five pages of a medical history on a 83 year old man. I start reading and I get to the final page and it's for an object near the cecum, all the way up there. Wait, what's this cecum? It's been a long time, but I think there's like five levels to your intestines. Your first one is your sigmoid and then it kind of goes around and around and around. And your cecum is pretty close to your appendix. Because I'm an older student, my brain doesn't go to, oh, this is something he swallowed. I automatically go, this is sexual. I get that a nurse has to deal with all this stuff, but as a student, I'm like, no, no, no. First step back. I knew it wasn't a joke, but I'm like, are they trying to fuck with us? So I go to the nursing precept and she doesn't know me. She looks at my name tag and she's like, Kristen, are you kidding me? It's your first time ever. And I was like, oh, okay. And I'm panicking because I'm like trying to do this for my parents. Oh no. So I go into the room for the very first time. He's laying down, again, 83 years old. He looks completely healthy, but he's half asleep and he doesn't want me in the room. And the first thing that you do as a nurse when you go into a room is a head to toe assessment. And the last question I ask him is on a scale of one to 10, where are you at? And he goes, I have a bike handle up my ass. Oh, why would you ask me that question? He's pissed at me and I was like, I'm so sorry. If there's anything I can do to make you more comfortable, let me know. And he's like, they already gave me my meds because he was in so much pain, they had given him meds overnight. So I end up going into his room over the next couple of hours and he warms up to me. He's just an older man that's grumpy, but he is like a grandpa. Anyone would be grumpy with a bike part of their ass, probably, yeah. I kind of agree with him when he said, why would you ask me that? I didn't know what it was in his page of history. It just said foreign object near Sikkim. And then he warms up and he basically starts telling me every time I go in the room a little bit more about this story. So he ordered a magic bullet online. Do you know what I'm talking about? To hold cocaine? No, I'm like, what? It's a vibrator. Oh, oh, oh, yeah. It was too small for him. So he decided to go to his bicycle, take the rubber handle off of it and put the vibrator into it. To give it some girth? To fill it out. Right. So he takes it, puts it in the bike handle, it gets lost. Oh my God. He has a bicycle because he cannot drive. He either uses his bicycle or public transportation. Well, the hospital was too far for the bicycle. He was so embarrassed that he decided to wait until the battery died. Oh. Oh. What? Hold on, let's just comprehend his. Hold on, so it's going off inside. He lost control of it. I hope he at least has some enjoyment. Me too, that's what I'm like. I wondered if while he's panicked every now and then he's like letting in little rays of pleasure. And how long does a battery last with a vibrator? My last pretty long. Me too. But if it's going nonstop. Maybe four hours? I don't know. Rob has chat, how long a magic bullet. I'm going to take a couple of weeks off and I'll get back to you guys on a real fact check. So he had to wait till the battery died, got on public transportation, basically the bike handle stopped and stayed in his sigmoid and the bullet just kept traveling. He had to have surgery and he ended up being just such a great patient that day. I did ask him because we ended up having this kind of relationship. I was like, why? You know, he said my wife died 20 years ago. A man's got to do what a man's got to do. Okay. By the time they came in to get him for surgery, which was around two PM that day, the nursing precept realized that I had not been kidding and it was not appropriate for me to have that relationship. And she was actually extremely nice to me going forward. So the experience of working at that hospital was awesome after that. I highly recommend not going to a low income hospital if you don't have to, but the people were awesome. Yeah. Oh my gosh. It's a happy story because you made a friend. It's unfortunate for him, but one person's foreign object is another person's great start. You know what they say. But that was my very first day. Oh, wow. It definitely broke the ice as far as dealing with patients. Did you get home and immediately call your dad and tell him? A hundred. Yeah, of course. Like, okay, I did what you wanted me to do. And look where it led me. I'm digging in some old-timers buns to find a magic bullet. Exactly. There's something also incredibly sweet about that story. I know. That's what I'm saying. Yeah, I could see like an Alexander Payne movie where like there's an old-timer. He starts at the store asking for a little bit of shy to ask for the magic bullet. But the real story is about the friendship. Oh, well, Kristen. That's a great story. Yeah, we loved it. It's rare that these foreign objects and butt are life-affirming. Make you feel happy and tingly. You warm fuzzies. I was happy to get to share a huge fan, Monica, you being from Duluth and my step-brother and sister who actually went to school with you, one of them graduated with you. What? Every time you bring up Skad or you guys talk about the 5A, I played sports. And so, yes, they had 5As on the shirt. Thank you. Yeah, and that was back when it was 5A. I don't know now that they have like six and seven. I don't know if they're fitting all that on, but I graduated in 99. Yes, I'm so glad you're here to affirm me. Well, this was so fun. So nice to meet you. Really nice meeting you, Kristen. Thank you guys so much. Have a great day. All right, bye-bye, take care. Magic Bullet vibrator runs on a single AAA battery and can last up to 4.5 hours of continuous use. Did I guess four? Yeah, you said four. Now you charge them, you don't have batteries. Well, no, there are still many that you put the thing in. The rechargeable one lasts 49 minutes to two hours. Okay, less. But what's nice about your kind is you can leave the charger cord on it so you can pull it out of your butt. No, but if it's too far up there, then it's just on. I know, but you got the cord attached. That's why I'm saying use it with the cord attached, and then if it gets up your butt, you can pull on the cord and bring it out. The cord comes out, but she's still up there. She. She. She. She. She. She. She. She. She. She. She. She. She. She. She. She. She. She. She. She. She. She. Hello. You were like as ghost you were as dark. I know. I'm in the room that has a light activator, so I have to wave it on every couple of minutes. Oh, fun. Sure, like those bathroom lights that go on. Yeah, it can't see me in the fort. And I know immediately you're a Monica's superfan. There's a brand sweatshirt. The friend sweatshirt has been worn. I love it. It's a Chandler and Joey sweatshirt. Doing one of their silly boy things. And funny. Misunderstanding one another. Yeah. What fake name are we going to go with? You guys can pick. Rachel. Oh, I'll take it. So you're Rachel. Besides unauthorized evacuation, this is our favorite prompt. It's a fun one. Do you know what we've unfortunately never had? And I doubt we ever will have, unless Rachel is that lucky person. We've not had someone call that they themselves had a horn on. I do want to hear from the horses. I asked one of these times. Me too. I really would commend their bravery and vulnerability. And I would treat it with very respectfully. Unless they put a presidential Barbie, then that would be tough. I will say this is not my only story of this. Oh, you lucky girl. You might call back. Are you in the medical profession? I am. So I'm actually in PA school right now, but I am a surgical technologist. So I actually work on the ORN. So I'm kind of the person that they call after the mysterious item has failed to come out in the ER. Got it. OK. OK. You're really boots on the ground in this situation. I'm like elbows deep, literally. Oh, my. Oh, this is exciting. This is very exciting. To give you a little bit of background, I am a mom and I was trying to finish my bachelor's. So I was working a lot of nights and weekends, working the odd shifts. And that kind of requires me to do a little bit more. So I was actually helping run the front desk. So I get a lot of the phone calls. So this particular weekend, I have a surgeon on call and he's a new doctor. He's maybe been out of residency for like nine months, salt the earth, one of the most humble, kind surgeons I've ever met. I thought maybe he was going to be super arrogant because he was new and he wanted to prove himself. Well, also all surgeons are arrogant. We've already discovered this. Yeah, they'll admit it to you. Yeah, they have a little bit, but I'm pretty fortunate. I work with a lot of really, really good people and he was just the best and was so kind to all of his patients. So he's on call and he gives me a phone call and I answered at the front desk and he's like, hey, I have an inguinal hernia downstairs and I just am waiting for the scan. And I said, okay, that sounds great. I'll get stuff ready. And inguinal hernias are a dime a dozen. We do them all the time. Where is that tarot? Yeah, where's the location of that hernia? They're mostly in men because it's in your groin area. Oh, there goes the light. Ah! Ah! So they're kind of in the inguinal area because men's spermatic cord actually goes through your peritoneum. So sometimes that hole can get bigger and things can get down in there. So I'm kind of like regular case, no worries. And he calls me back and I'm like, we ready to go. Did you get the scan? And he was like, so I think I need to change the procedure. So I'm kind of thinking sometimes it can get down until the scrotal sac, maybe the testicle came up. And he was like, no, no, there's something in there. And I said something in where? Yeah, yeah. What pray tell? He's like, there's something in them. And I don't think they know that it's there. Oh, no. He was like, I'm just gonna come up and I'm just gonna show it to you. Part of my job is anticipating the supplies that we need because I scrub in and I help them. So I kind of need to know what's going on so that I can prepare. So he comes up and he pulls up the scan and I'm looking at it. And this guy does have an inguinal hernia, which is what he came into complain for. But he also has this bright white, which usually means it's metal, eight to nine inch thing and his abdomen. And his abdomen, not his rectum. Well, so my first thought was, did this guy get stabbed with like a ship? Because I've seen a lot of scams where things are stuck in people's rectums. They're usually near the bottom. This one was kind of off to the side, not a hundred percent on the bottom, but far enough that my first instinct wasn't, this guy stuck this up his rectum and he didn't swallow it. So I'm like, okay, what are we dealing with? So we're trying to come up with a plan because we're like, is this a pen? Is it a butter knife? We're not a hundred percent sure. A wrench? Yeah, I'm like, I don't know what it is. So I'm just going to prepare for everything. And I said, well, how did it get in there? And he said, your colon's kind of like a vacuum. I guess he put it in there and then forgot about it in order for it to travel that far up into your colon. And I was like, how do you forget? Unless he just accidentally sat on it. Also, we're clearly all thinking, for us putting an enormous thing up our butt would be the first time, so it'd be very memorable. But you might be forgetting, if you do this 20 times a month, all year, I guess, yeah, you might forget. Yeah, because actually we can kind of relate to this maybe tampon. You would think how on earth could you forget you have a tampon? Exactly, but you can't. At this point, if you have a sharp thing in your abdomen, we're not dealing with your hernia. He went down, he consented him. We bring this patient up to the operating room and we kind of get started and I don't want to get too gross. This is my job, so it's not gross to me. But we open this person up. When you say opens him up, you dilate his asshole or you've cut into him? This one, because it was so far up, we just do an incision right down the middle. And at this point, we don't know what it is, so we're kinderly feeling around. It could be a bomb like in Grey's Anatomy. Also, isn't it crazy that you can just open up a human and feel around for stuff? It's so weird. We can even move things out to get to things. So we're feeling around, we kind of feel where it is. And by some miracle, this person hasn't perforated their bowel by having this thing in there, because usually when you move around, it'll poke through. So we gently open it and I'm holding it open and he reaches in there and he's like, oh, it's slippery. So I give him a clamp and he pulls it out and it's a screwdriver. A screw, I was on the right track. Oh, crap. And I was feeling mechanical, a flathead or a Phillips head. So this was a specific headed screwdriver. Honestly, I went home and I told my husband, I'm trying to explain it. And he was like, oh, this is an industrial wear head. We couldn't see the plastic handle and that's why we didn't know that it was a screwdriver because that didn't show up on X-ray. Unfortunately, this man was unhoused. So we figured he actually might be using the screwdriver to try and get into buildings to sleep in the winter time and didn't want anyone to take it from him. So that was kind of our conclusion. Oh my God. That's a big leap. That's a leap, Rachel. You guys are medical geniuses, but this is a very bad detective theory. Cause you're giving a lot of benefit of the doubt, I have to say. Also, there's a lot of places to hide a screwdriver before we go rectal. Did you ask? I did not ask. The surgeon asked, but he was on meth. You called the right person. Okay. It was a thousand percent sexual because the whole addictive quality to meth is once you pair it with sex, it's turboed. So definitely he was on meth banging his prostate. I mean, there's just no question. But then forgot about it? Yeah. Well, because he's just on meth. I mean, that's true too. I was trying to be like, okay, this is very specific. You can't go buy one of these screwdrivers at the store. Where'd you get it? Oh no, it's probably rusty too. Well, I mean. Did you give him a tetanus shot? Yeah, that's what I mean. He needs a lot. It was so covered in other stuff. Ew. Oh, shit. Pooper. Shit. Wow, man, a fucking nine inch. That's a lot of metal. Like when you're bending over, you're feeling that. It's insane it didn't cut. That's kind of why I was thinking, how did he forget about it? Because it probably had to be in there for a week or two. Oh my. Or maybe even more in order to travel up as far as it did. Because your colon kind of goes this way. But then at the bottom, you have a sigmoid colon that's literally shaped like a S and it was above the S. It went through the twisties. It was actually really impressive. Anything's possible. Meth will help with all that. I guess so. It loosened everything up. It's one of the few benefits you can ignore. Quite a bit of discomfort. When he comes up to the OR, he was the nicest person ever. He's like, oh hey, what's up? Thanks for helping me. I gave him the benefit of the doubt. So I actually had the screwdriver cleaned with the rest of the instruments and gave it to the surgeon to give back to him. And the surgeon was kind of like, use with caution slash if you were storing it, maybe find a different spot. Wow. If you were storing it. It's quite a theory you guys came up with. Oh, that's great. Well, Rachel, that was delightful. Thank you so much. So I need to shout out my little sister, Nicole. She was super upset that she couldn't skip work. And then my other siblings, Kelsey and Ben, we kind of have a sibling chat. And we all listened to armchair and I got everyone hooked and they were like, you have to submit a story. And then we also did a poll for which one I should tell an embarrassment of riches. Oh, a whole family. I love that. An embarrassment of riches. Oh, wow. That's good. OK, well, shout out to the family. Thank you so much. All right. Take care. Oh, my God. You're in scrubs. I just walked out of the OR. I'm so sorry. Oh, wow, that's great because we were a little late. Amazing. We've never talked to someone straight out of the OR. What if we had a real time? That'd be exciting. Because you knew the surgery was going to take place at a certain time. And you like told them I like it would be ideal if we could talk at 1155. Hannah, where are you other than the hospital, obviously? I'm in Western Massachusetts. Western Mass. And this hospital looks nice. The bed is like wooden. Have you ever been to Western Mass? The whole place is a storybook. It is. This is the call room. This is the best I could do. Yeah, it looks like you're in a civil war hospital. I know. That wooden bed frame. That wood is like really bad as far as collecting germs. But this is where the doctors hang and sleep. I mean, we don't sleep here much. There's just no time. People have definitely fornicated on that bed behind you. Rest assured. 100%. Yeah. Also, would you agree with me and I say this with love and fellowship? Nurses and doctors are perverts. Absolutely. Well, yeah, you're choosing to get inside the body and deal with goo. So also, I'm a general surgery resident. You're so smart. I feel jealous and scared. I want you to operate on me someday. OK. What do you want me to do? I love general whatever pops up, I guess. OK. Parnia, gallbladder, appendix. I'll take it out. Also, I wanted to say my first patient of 2026 was a rectal thorn body. That's not this case. No way. It's going to be a great year. Yeah, that's good luck. I walk in 5 a.m. and they're like, oh, do we have a case for you? And it's not the one you're going to tell us. This is I get the wrong job. So my co-resident will call him KD. He was on the night shift. He gets a consult from the ED rectal thorn body. OK, fine. It's like 4 a.m. He's almost done and he's like, OK, I'm going to go take care of this. So he calls and says I've got this patient down here. About 50 year old guy came into the ED with abdominal pain. He's hemodynamically stable, but he's had a pair stuck in his rectum for eight hours. A pair. A pair, the fruit. A fruit, the pair with the stem. You know, just a pair. I get it. It's a little bit calling. Stop saying you get it. You've been getting all of these. The pair is very inviting. Think about it. Not for butts. Sure, because it's a little narrower at the front. OK. Never mind. You're disappointed. Inserting wise, I guess. OK. It's nature's butt plug. OK. OK. Yes. So I'd been there eight hours and he was having abdominal pain comes into the ED. So the ED had gone in X-ray to see kind of where the pair was to see if there's any free air. And really quick, did the patient say, hey, it's a pair or from the X-ray in the pair shape? It was concluded it was a pair. The patient said there is a pair. OK, great. OK. Sorry, I got to add one more thing. Sorry, Monic. Mine is just grabbed the bridge of her nose. I just want to hear it. I know, I know. You got to be really careful when you're using a pair, because if you've eaten a lot of pears, you know when they get ripe, they get so soft. Like he definitely was using an unripened pair, because you can just put your fingers through it on accent. Like those pears get so tender when they're ripe. I mean, we had somebody else on earlier who had a vibrator, a magic bullet up there, and he was respectful enough to wait till the battery died before he came into the hospital. So I'm surprised that he didn't just feel like I'm just going to wait till this disintegrates in me. He was in pain, though, right? It was the pain. And also my first case was a vibrator. This year. Oh, wow. OK. And it had died. So anyway, they got an X-ray. OK, it's in there. There's no free air, meaning unlikely that it's perked. CT is a lot better for looking for free air, but it wasn't indicated. He's hemodynamically stable. So KD, he goes down to the ED. He evaluates the patient. Guy looks OK, gets the story, goes to grab some supplies to try and get the pair out. They give the patient some medication. They can't do full sedation in the ED. They can just kind of relax them a little bit and he gives it a shot. He does the fully catheter, inserts the fully past the pair, blows it up, tries to pull it out, but it's slipping past the pair. He tries ring forceps. These are it. I brought them. Are those the exact ones he used? They're the exact size he used. But not the pair. I mean, oh, the pair. Wow. Double entendre. The pair was not ripe enough. It was like slipping off. The guy's rectum was getting a little bit irritated, so they got another X-ray. He's still stable. X-ray still looks fine, but the pair is still in there. So next up is KD has to call the attending surgeon. So as residents, we have to staff consult with our attendings. And if there's someone that needs to go the OR, we have to call them. Let them know it needs to go the OR. Going to the OR for rectal reform body doesn't necessarily mean you're getting an operation. It just you can use more sedation. They can monitor the airway, make the patient more relaxed. Do they have a speculum for the anus? Like, is there a way to get in there and spread the whole thing out? There are anal dilators. It's like a speculum. I've also used an actual speculum. So we're all rolling in at like 5 a.m. for our shift. And we hear KD on the phone calling in this console, like, hey, I've got this guy in the ED. He's got a pair stuck in his rectum. I've done everything I can. Like, I can't get this pair out. The attending has a full day of cases. So he's like, OK, I'll call the OR, see when they can add it on. It's not an emergent case, but it needs to be done. So they added on after his second case. The guy gets prepped and is taken to the OR. So he goes on his way. This is where I come into the story. So I was in the OR, dropped my patient off in Paki, the recovery unit. And I head over to the OR board, see what's going on, see what other cases have been added. And then one of the anesthesiologists said, hey, they need to do an OR 5 stat. And I was like, oh, funny, ha, ha, that's where the pair was. And then someone comes in and I was like, where is my intern? And they're like, oh, he's an OR 5. They've been in there for what feels like forever. They've got to be done. So finish up what I'm doing. Still not back. So I'm going to go check out the situation. I wasn't really prepared for what I saw when I walked in the room. So the patient's in lithotomy position, which is when you're giving birth, your legs are up in the stirrups, which isn't abnormal. Like when we're doing rectal surgeries or we're down in the pelvis, it's very common to be in that position. My intern should stand up. He's on the side of the patient, like pushing down on the abdomen. Right. Trying to like squeeze it out. Yeah, like some counter pressure. The attending's at the foot of the bed. He is trying everything he can. He's so frustrated. Like they have the anal dilators. They have the speculum type thing. They're trying to like get out with everything's just like slipping past or they can't get to it. If this was an episode of Grey's Anatomy, this is what they would do. I hope I'm not spoiling the story, but they would take a teeny, tiny mouse. Okay. And then they would stick him up there. Okay. Because then the mouse would go eat it. Oh, but then they'd have a fat mouse to get rid of. You'd have to keep the tail attached to something. Exactly. You have a handle on the mouse's tail, so you're able to pull him back out. But he goes up there and eats some of the pear. Now, isn't that a kind of good idea? I think it's a great idea. Thanks. I have a different one. I just want to throw one out there. This is a novel of competing theories. Okay. I think you need to screw into this pear. Now, obviously it's going to be very dangerous to try to get like a wine screw in. But if you could see it directly, if it was that dilated and you could get a wine opener in there, you could bear into it and then pull it out. But what if you push it further up? Well, you'd have to be real delicate, screwing it in. Okay. We have the counter pressure. We have the attending surgeon at the foot of the bed. There's another resident scrubbed. The scrub tech, the circulator, nurse or bull, it's just dead inside. Everyone just wants this pear out and they cannot get it out. So I start walking towards the end of the bed and my chief resident is in there and he's like, hey, what size are your hands? Oh yeah. So I hold up my hand. He holds up his hand. My hand is like half the size of his hand. He's like, okay, you want to give it a try? Oh boy. So I look at the attending and I was like, I can give it a try. He has lost all hope. But they're about to open this guy up. He's like, sure, okay, fine, give it a try. So I scrub in, I get my gown on, get my gloves on and grab a big pile of lube. Oh, sure. And I go into the rectum. I'm like this far. Oh my God, tear elbow. So you could never got a wine screw in there, no way. No, it was pretty far in. So I'm in there. I grab the pear. I have the pear in my hand and I try and pull it out and I get stuck on the pelvic green. Like my knuckle holding the pear, there's not enough room. There has to be enough room. Somehow I adjust my fingers. Oh, you're a hero. Did people cheer? They literally cheered. So as everyone's cheering, I realized I felt something at the tip of my fingers when I was in there. Uh-oh. And so I go back in. Now you're just doing it for fun. Yeah, you're not even showing off. The pear was kind of tattered from all of the attempts. So I was like, it was probably just a piece of pear that had like flown off, got like pushed up. And I grab it. It's perfectly round. And that this is probably just a stool ball. Sure. Ew, a stool ball. I love that. That's cute. So I pull it out. It's a Clementine. Oh, it's a fruit salad. Oh my God. He's just missing peaches. He's just sticking up so many fruits up there. I bet his ass smelled wonderful. But when fruits turn, ew. They didn't tell anyone about the Clementine. Oh my God. A Clementine. That is wild. Well, you must have thought I should go up for a third time. Exactly. You did. You pulled out a banana. Strawberry. Banana. OK, because now you thought he was so smart with the pear because of the shape, but not the Clementine. That's just a circular object. It does unravel my original argument. Yeah. But why didn't you use a banana? Like if you're going fruit. Too easy. Amateur. Yeah. He's like been there, done that. Yeah, BDDT. Wow, fruit salad. Can people buy you a drink after work for this kind of thing? No. I think they still probably owe me one. I did get applause throughout the day. I'm now known as Tiny Hands. Oh. Oh, that's great. Can I do one honorable mention that I was not part of this case, but I wish I was. It was a pool noodle. Oh my. No. How? People are so creative. So they cut the pool noodle, obviously. Full circle. Full circle, but not. Yeah, but they're three feet long. In fact, I bet that's what happened. He was using it and then it broke off. He's probably holding on to the big end of it, you know. Jesus, why do you understand these brains so well? Seems all very natural and organic to me. That's all intuitive. Oh, wow. This was fun. Oh, I loved this. Thank you. I have to do a shout out to my husband. He was a for sure day one arm cherry. I wish I could say I was the day one, but he was day one in the gummy hook. Oh, so you got a genius on your hands. I do, yeah. I guess you both do. A couple of geniuses. Lovely meeting you, Hannah. You too. Thank you so much. Bye. Bye. You're in the hospital too. Yes. Oh, we love it. We do. This is our second person on the scene. Hard to get days off in respiratory season, that's for sure. Oh, my bad. I heard about the bad flu. Is there a bad flu? Yeah, there's a bad flu, right? What's the name of it? Flu. Flu. Comma bad. I think it's like a K variant, but I don't remember the name of it. It's bad. We don't like it. What name are we going to use? I don't care. You guys can pick one for me. I'm going to say Debbie. It's a great choice. What if you go, no, you got to pick another name. Like I don't like it. No, she goes, that's my real name. Oh. I know it's not. OK, so Debbie, you're in the medical profession, unless you borrowed some stethoscope for this. I'm currently in the on-call room of the hospital where I work at. I'm an ERPA. This story takes place about six years ago, just before the pandemic. I used to work the night shift and the shift that I worked. When I went off shift, I was just leaving the doctor alone, right? So as I'm going off shift, if there's an ambulance coming in, I tended to wait to just make sure that the doctor wouldn't need help with the rest of the other patients in the department or whatever is in the truck. So we get this pattern from the ambulance and they say, male in his 50s, stab wounds, a lot of blood loss. Vital seemed pretty good. So that's obviously something I'm going to stay for because the other piece, right, is I work in very rural Vermont in New Hampshire. Stab wounds, gunshot wounds. I'm normally seeing a man caught under a tractor or like a cow hit a car. So that's normally what I'm seeing. So when I heard stab wounds, I'm like, OK, like this could be really bad. I'm going to stay and help out the doc. As the stretcher comes in, the first odd thing is the gentleman is on the stretcher in the fetal position. They're normally on their backs. And I'll never forget, I've not even seen this since there was just blood pouring off the stretcher. Oh my God. So we get him settled in the room for the volume of blood loss that we're seeing. It's remarkable because this guy, his vitals look great. He's doing OK. He's talking to us. Is his blood pressure low? Blood pressure is a hair low, but he's mentating great. He knows where he is. He knows who he is. He's able to tell us the story. Thank goodness, because we're like, what the heck is going on here? Does mentating mean he's mentally sharp? Yeah. Oh, that's a new word for us. Context clues. Did you know what mentating meant? I mean, we figured it out, but it's a great new word. Also sounds like menstruating, very close. Similar. And he was bleeding. OK, continue. Yes. So this gentleman in his 50s, his wife went out of town, was out for a couple of days. They shouldn't do that. Men need that external brain, unfortunately, I found. She's gone. He's like, I need to explore this kink of mine that I've had for years that I don't want to talk about with my wife. And being a man in the small town can't go to a sex store, obviously. I don't know if six years ago he didn't think he could get it delivered in a discreet box or what it was. But he was like, I'm going to use an item from home. Looks around his house. They own a dog. So he finds one of those Kong toys. Are you guys familiar with those? Is that the kind you fill with peanut butter or something? It's like shaped like a bee's eyes, almost big rubber. It's a butt plug. Yeah, and like much wider at the base. And then you can stuff things inside of it. So this guy thought, OK, can't find a sex toy. I want to try this. And it's really smart because there's a hole in it. So I'll be able to grab the hole and pull it back out. Right? Yeah. I was thinking some things through. Yeah, no, this is like the most thought I've ever seen into a rectal point. So this is great so far. He puts it in as the butt does. It kind of suctioned it right up, right? And kind of took it a little bit further up. So he was no longer able to reach it. Wife calls. She's on her way home. Oh, yeah. She sensed it. So he's like, I've got to get this out right now. Oh, my God. So he gets some grill tongs. He tries some tongs. He tries a hand, right? He tried like a vacuum cleaner at one point. Oh, he's a smart guy. Yeah. Tries a lot of things. Engineering, right? He's panicking now. And so he finds a knife and he says, if I hear it. No, no, no. I'll be able to pull it right out. I'm going to one step away from if I take a shot. I can blast it out. He's so panicked. It's also like a comedy set piece. It's like he gets this thing in, it goes sideways. Now the wife calls. It's like the stakes are building. A knife? A knife. So this poor gentleman at least did not get the knife stuck in there. But the tong was still quite lodged in there. We obviously weren't able to get out. We ended up flying him to a trauma center where he had to have all that repaired. And he ended up with an ostomy. What's that? They rearrange your intestines and you have the hole on the front with the bag. Oh, my. He was no longer able to use his rectum. That's not called a colostomy. Colostomy is coming out of the colon. The ostomy is like the actual hole. Kind of like a stoma. Yep. So he's just stabbed himself a bunch up there. Sure did. And then the wife comes home and there's blood everywhere. I like to keep these comedic, but I do have to explore how sad this is. Like shame is so powerful. Not only did he not want to tell his wife, now he's got a fucking colostomy bag. You know, he's got to tell her the whole thing. And he's in all this damage out of fear of shame. It breaks my heart. I want to feel something against my prostate. You're not a weirdo. That's fine. Right. Did you guys have to pump him full of blood before you transported him? Yeah. So he got transfused with blood and fluids. I don't think he ended up needing any medications to like keep his blood pressure elevated. He actually compensated really well. That's like a huge thing I remember about is like he did great with a lot of blood loss. Well, the adrenaline of getting caught and the trouble he was in. Was the wife at the hospital? The wife did not come. Oh, no, I don't know if she met him at the trauma hospital later. Oh, I hope she was kind to him. Me too. I mean, she's probably dealing with a lot. That's a lot to process. You know, you come home and your husband. Hey, no. That is a lot to process. It is a lot to process. And he's bleeding out because he stabbed himself in the butt. And then you feel guilty because it's like, why didn't you just tell me? But you know, I didn't tell you. Oh, that's horrifying. Debbie. Yeah, that was the first time I had ever seen that in the ER. And it's definitely been the worst time I've ever seen it to all the other stories are a little bit later, but that one was a heavy hitter. And that's the first time I ever saw that. Now, if you had to give a ballpark to how many rectoform bodies you've had in your career, how long have you had this job? Seven years. I've been in the ER. And so in seven years, if you had a ballpark, how many of these you've experienced? How many would it be? I'd say probably like three a year. Oh, three years or 21. That's a lot. It's a lot. And she's in a rural area. Yeah, the volume's pretty low. We learn a lot in these people are doing this. This is not a one off. No, this is a feature, not a bug. Anywho. Oh, Debbie, thank you for that. Thanks for sharing that. My pleasure. Yeah, thanks for having me, guys. It was so great to meet you. Yeah, you too. Truly, from the bottom of my heart, thank you so much for what you do. Yeah, the things you're dealing with. I know, and you just do it. They don't even blink. And soldier on. It's really, it's really impressive. Thank you. Take care. Nice meeting you. Another fun one in the books. You know, I wonder if this prompt encourages people to do it or scares people away from doing it. I don't want anyone to listen to this and try it. And then they end up in the hospital. OK, I don't either. OK. OK. OK. All right, I love you. I love you too. Bye. I want to tell Kristen to not buy any pears. Don't go out of town, Diller. Whatever you do, do not go out of town. Or if you do, take all the naïve. And the pears. All right, love you. Do you want to sing a tune or something? I'm going to listen to a theme song. Oh. OK, great. We don't have a thing song for this new show. So here I go, go, go. We're going to ask some random questions. And with the help of our cherries, we'll get some suggestions. On the fire-rindish. On the fire-rindish. Enjoy.