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.”

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