Hard to Swallow

sword swallow, emt, swallowing, lips, sword, gaggingWorking in the emergency room comes with it’s own set of unique challenges. One of the common struggles that we must overcome- the tendency to become calloused with our mental health population. I often want to say, “quit whining, get a job, stop looking for attention- you’re wasting time and resources.”

Many times, what can appear as “attention seeking” is really a cry for help with a much bigger issue.


A patient presents to the ER – they’ve swallowed a pen. Although I’ve seen two cases of accidentally swallowed toothbrushes, this was no accident. This person, when stressed and upset, chooses to swallow things. They say that, it’s how they manage their anger- they used to cut. Now they swallow things.

This is certainly intriguing to me- swallowing a pen is a pretty bizarre way to cope with life’s stresses and I’m interested to find out more. The patient is extremely cooperative and more than happy to talk while they wait for x-ray results (which will show a pen lodged in the esophagus.) I find out that they’ve been hospitalized around fifty times for swallowing something (inedible!) Nine major surgeries have left their body scarred and mutilated, from the waistline- to the neckline.

“Isn’t it hard to swallow a pen,” I ask.

“No, it’s easy.”

“Do you always swallow pens?”

“No, other things too. Broken pieces of cds, hooks, nails.”

“Wow, what the worst thing that you’ve swallowed?”

“Probably a hook for a shower curtain.”

The patient shows me a massive scar that goes from the top of their sternum, along the neck- almost to the ear.

I ask the patient if they ever get tired of this? The answer- yes. They want to talk to someone before they get to this point. While waiting for endoscopy to come to try to remove the pen, I get to spend a good amount of time in conversation with the “world’s worst dieter.” I come to realize that they aren’t a total idiotic attention seeker- simply hurt and in desperate search of a way to heal their pain.

It was good to get fresh perspective on mental health- Lord knows, it’s not always easy. Every day is different.

There’s a reason we stock “spit hoods.”

The last few crazies…

Being a dad/husband, working in the emergency room, making music, and writing about work life has proven to be a challenge. Luckily, I enjoy a challenge- so this blog won’t be going anywhere- anytime soon. Here’s what’s been happening lately….

  • Pt checks in because they are suicidal. After ten or so minutes of being “anxious,” they begin convulsing and wimpering like they are having some sort of seizure/they are  in the midst of an exorcism.

They get some ativan and their “symptoms” start to resolve…then they unplug the                          monitoring screen that they are sitting under and “try to shock themselves” with the cord. Now patient gets moved (mostly so that we don’t have to worry about them damaging our all-important patient display monitor.)

I’m watching multiple “mental health clients”- and not “easy” relaxed patients either. Now I see the “spazoid electrician” with something in their hands- and their visitor begging for them to give it back. I approach just as the patient opens a small pocketknife- my ninja reflexes kick into play. I snatch the offenders hand so fast and with such force- that I immediately had control over that limb- and was gonna take it home with me if they didn’t give that knife up quickly.

“Guess what, now that you’ve displayed that you can’t be trusted- you get to have someone in the bathroom with you to watch you pee.”

  • I’m monitoring a young man who’s come in because he’s having a psychotic break. He’s completely co-operative, but also- completely disconnected with reality. He get’s off his bed, I tell him to get back on his bed, he’s “smoking cigarettes,” puffing on his fingers and flicking his imaginary butts around the corner. He requires constant re-direction and I’m hoping that I don’t have to wrestle with him in order to maintain order.

One of the nurses says she’s got something that she needs to share with me- regarding the patient.  She says, ” Earlier, I heard him say to his guest- where’s that hot male nurse- the one that brought us back from triage?…” Just great, the cruelest of all jokes- I’ve just been told that the psych patient who I’m tasked with keeping calm and controlled- has the hots for me. And I’ve got to hang out with him for hours after receiving this awkward update…. I do my best to use my words effectively and keep him placated until I leave- even more strange situtation- averted.

  • If your friend hits you in the head with a hammer- it’s probably time to move on from that relationship. Don’t let the fight progress until your entire thumb is being bitten off in a fit of rage. Lesson learned- if your homeless friend is crazy enough to hit you in the head with a hammer, you should probably do your best to keep things of physical importance- away from his filthy mouth….