Over the years I have collected many journal articles and newspaper clips, some sent by readers who obviously have too much time on their hands, about injuries that are strange, unusual or otherwise remarkable. As references, the clips are well intended but useless. Most are related to emergency medical services in the merest tangential sense. For no particular reason, the articles have accumulated in a file folder as a sort of anthology of morbid curiosities.
I have a New York correspondent to thank for a news story I would have otherwise missed, a page ripped from the July 1988 issue of Dental Management magazine. It seems that a rash of unintentional toothbrush swallowings was reported at Duke University Medical Center. Not exactly an epidemic, mind you, but certainly a significant and disturbing outbreak. Okay, four cases were reported. The typical case involved an adult “brushing while intoxicated or [suffering] a seizure or violent coughing spell,” according to the magazine. The toothbrushes were removed in surgery, none passing through the digestive system. I was never able to work this alarming report into a “Current Research” column. Swallowing a toothbrush is doubtlessly traumatic, but the EMS angle just wasn’t compelling.
One of my favorite clips is a brief undated Associated Press item about a Toronto building contractor who fell from a stepladder and landed on his power drill, impaling the 3-inch drill bit into his skull. After regaining consciousness, 54-year-old David Wright struggled to his feet and staggered to a bathroom mirror, holding the drill carefully against his head so he wouldn’t jiggle his brains. Seeing the drill bit buried to the hilt, Wright calmly flipped the drill into reverse and gently pulled the trigger to unscrew the bit from his skull. “I kept saying, ‘Oh my God, whatever I do, I have to do right because any mistake could be fatal,’” Wright told reporters. Heck, that’s the sort of pressure I work under every month with this column.
There is an August, 1984, AP story about Forthman Murff, a 74-year-old man in Monroe County, Miss., who nearly decapitated himself with a chain saw and lived to talk about it [Read my update on Murff here]. Cutting timber alone one day, Murff was knocked 10 feet into a ditch by a falling tree, shattering bones in his leg and foot and causing the spinning chain saw to tear into his neck. The chain saw blade ripped through Murff’s windpipe, esophagus, several sets of muscle, both external jugular veins and one internal jugular vein. The only structures holding his head to his torso were the cervical spine and carotid arteries.
Murff never lost consciousness. With his head practically hanging by a thread, the spunky Murff dug himself out from beneath the fallen tree. “I saw a stream of blood about the size of my little finger,” he told a reporter while recuperating. “It wasn’t coming in spurts, so I thought I might have a chance.” Despite numerous fractures, a profusely bleeding neck and a severed windpipe, Murff drove his truck one-half mile to his neighbor’s house. Doctors at North Mississippi Medical Center successfully reattached his head in surgery. “He is the most amazing patient I’ve ever had,” said Dr. Robert Lowrey. “Just think about walking the length of a football field with your head half cut off.” Well, I did think about it, and I’m certain nearly any editor could do it.
A lot of people seem to be fascinated by penis injuries. I’m not one of them. No more penis injury citations, please. It’s enough to make you want to weld your zipper shut. You can’t begin to imagine the sorts of things that can go wrong. Men have been shot or stabbed there, suffered frostbite, and had it nibbled by fish. One case study reported on a man who slammed it in a car door. Don’t ask me how.
Although technically inaccurate, “fracture of the penis” painfully describes the acute distress resulting from rupture of the corpora cavernosa (Godel C, et al: “The erect penis: injury prone organ.” Journal of Trauma 1988; 28). Under certain, uh, physical conditions “the patient hears a cracking sound and significant bleeding takes place” into fascial compartments. The “eggplant deformity” is an important diagnostic sign of penis fracture. Oh good. Something else to worry about.
Of course, I’ve always known that food and sex are a volatile combination, so I really didn’t need to read about masturbating with spaghetti for further documentation (Bacci M, Porena M: “Masturbation injury resulting from intraurethral introduction of spaghetti.” American Journal of Forensic Medicine and Pathology 1986; 7). At Italy’s Perugia University Hospital, a 20-year-old man showed up in the emergency department (there’s the EMS angle!) with a foreign body in his urethra. The guy enjoyed inserting a strand of uncooked spaghetti into his urethra while he wanked. You know what happened this time: The spaghetti broke. According to the doctors, “intraurethral stimulation with different tools” is not uncommon. Among the objects reported in a brief literature review: needles, animal feathers, crochet hooks, knotted string and metal springs.
Finally, there is that rare report that combines the elements of food, sex and EMS and is almost very nearly suitable for a “Current Research” abstract. Frankly, I don’t understand why this one never made it into print. It has to do with a 15-year-old girl in Zimbabwe who got pregnant by fellatio (Verkul D: “Oral conception.” Journal of Obstetrics and Gynecology 1988; 95). This young woman was born with an unusual defect — she had no vagina. I know, it’s inconceivable, but there was no connection between her womb and the outside world. Still sexually inquisitive, one day the girl was engaged in oral sex with a man when her boyfriend discovered them and angrily stabbed her in the stomach (See? An EMS angle!).
She was sewn up and discharged uneventfully from the hospital, but returned nine months later with a full belly and “acute, intermittent abdominal pain.” Diagnosis: term pregnancy. During the physical exam, “inspection of the vulva showed no vagina, only a shallow skin dimple” where it should have been, her doctor reported. A live normal baby boy was delivered by C-section. As incredible as it seems, the most likely explanation is that the girl conceived during her very first ovulation, when sperm washed out of her digestive tract by saline lavage during treatment of the stab wound made their way southward, taking the scenic route to the uterus. Says her doctor: “The fact that the son resembles the father excludes an even more miraculous conception.”
I’ll tell you why I like this job: It’s indoors, requires no heavy lifting, and I get to do some really terrific reading.
Adapted from “Current Research,” JEMS 10th Anniversary Special, February 1990