61 Frames Per Second by John Constantine Today in Hooksexup's videogame blog: We get misty on the Chrono Cross soundtrack and ponder the return of Chrono Trigger.
The Remote Island by Bryan Christian Today on Hooksexup's TV blog: Dance, Hipster, Dance! Plus: our latest NewsCrush — and why one army brat is breaking up with Army Wives.
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posted 6/3/2002
Keanu Reeves and David Geffen never married. The Go-Go's didn't simultaneously overdose. A woman my cousin's friend used to work with didn't have a bump on her face that grew bigger and bigger until one day a mass of baby spiders popped out. A friend of your friend's friend never brought home a little dog from Mexico that turned out to be a
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rat. Richard Gere never well, we'll get to that. Urban legends, seductive though they may be, are just that: legends popular, unverified stories assumed to be historical.
What's not a myth, and can be easily corroborated, is that an individual once sought medical attention to have an "oven mitt" removed "transanally." In layman's terms, that's a "potholder taken from the ass." Not only that, but subsequent examination of said someone revealed internal tearing that "was probably caused by a wooden stick used to forcefully introduce the glove through the patient's anus." That event actually happened. I'd rather not say how I know, but, well, there was a lot of alcohol involved, a dare involving a steaming pot pie, and the ensuing need to remove the item without burning my hand.
Kidding aside, the mitted one lived in Bulgaria, was a twenty-year-old male, and was treated at the military hospital in Sophia. A full discussion of the medical issues raised by the case is available in the Journal of Emergency Medicine (Jan-Feb 1999). A listing of that paper, along with a brief abstract, can be viewed online through the National Library of Medicine's exhaustive MEDLINE database, catalogued under its index number, 9950383. The point is, rectal foreign objects (RFO's, also known as rectal foreign bodies), as even the most cursory research reveals, are a documented fact of life.
The healthy mind naturally struggles to accept the reality of the retained RFO, and the visual evidence accompanying Dr. David W. Munter's e-medicine article, "Foreign Bodies, Rectum" (www.emedicine.com/emerg/topic933.htm), may raise more question than answers. The X-ray reveals a lower torso the outline of a lower spine, hip and pelvic bones along with what is best explained by the image's caption: "The patient attempted self-removal [of vibrator] with a pair of salad tongs, which also became lodged, resulting in two rectal foreign bodies. Multiple attempts at self-removal are typical in patients with rectal foreign bodies." The image, stupid as it may be, is immortalized, but could it really be called typical?
In a 1986 Surgery magazine report, Drs. David B. Busch and James R. Starling tabulated the RFO's that had been referenced in scholarly works. They found 182 cases. According to their research, the most popular object to emerge was a bottle, cleaning up with thirty-three entries (one with attached rope). Running a respectable second were vibrators, at twenty-three mentions, followed by the vibrator's cousin, the dildo, with fifteen. The last object to achieve double-digit status was the stick/broom handle, with a perfect ten. The remaining melange included virtually everything except a rodent (the gerbil story, according to the journals, is, in fact, myth): a frozen pig's tail, a kangaroo tumor, pool cue ball, snuff box, and a variety of fruits and vegetables, including a plantain (with condom). Perhaps Mark Twain said it best: "Man is the only animal who blushes. Or needs to."
More arresting still, Busch and Starling's tabulations represent only a fraction of cases: those that make it into medical scholarship. No one has attempted a survey to determine the cumulative frequency of retained foreign bodies encountered in emergency departments (ED's) or among the populace at large. I had to ask a grand total of one doctor before hearing an eyewitness account. He recalled his first day of ED rotation, when he noticed a man in a hospital gown, perched "owl-style" in his chair and looking incredibly uncomfortable. "Two hours later," the doctor said, "I saw a bloody, Zip-locked specimen in the pathology outbox, labeled 'one baking potato.'" This single doctor's subsequent RFO encounters on one lone ED rotation included two spoons, one butter knife, and a coil of copper wire, all of which, he said, "made for fascinating X-rays." This led me to a conversation with an X-ray technician, who responded to my query by saying, "Are you kidding? We have a drawer full of our favorites."
But the fact remains: no one has any idea how common the RFO is.
The cumulative effect of this research is enough to give even the hardened journalist vertigo, instilling the sense of a great conspiracy at large: our fellow citizens are internally stowing anything they can get their hands on an assemblage of objects that one paper cited as "limited only by the human imagination" and, in the process, making themselves into human junk drawers. The urge to joke is almost irresistible: "If anyone has my car keys, or all those socks I lost keep them." Even doctors must remind each other to avoid mirth, as Dr. Munter writes: "Physicans should refrain from making disparaging or comical remarks concerning the nature of the problem," but in the end it is not a laughing matter. The activity provides challenges to the medical community beyond fighting the giggles.
First among them, according to a report by the National Center for Emergency Medicine Informatics (NCEMI), is that patients often "will not volunteer that any object has been inserted," creating the unique situation where patients are withholding the information most pertinent to their diagnosis. Also a concern: normally the easiest type of examination, rectal exams can be dangerous for the medical professional because sharp objects, including knives, are often involved. When patients do confess to what has occurred, NCEMI points out, they often "give outlandish explanations such as having sat or fallen onto the object." From the medical perspective, there's a qualitative difference between accidentally sitting on a bottle of perfume and taking on the bottle intentionally, followed by a prolonged period spent attempting removal with another object, like a back scratcher (article No. 3738771). The latter scenario is much more likely to have complications.
Once an RFO is diagnosed, treatment is also unpredictable. As one doctor suggests, there are only slightly fewer approaches than objects. Most often, treatment can take place in the ED. Patients are sedated to ease rectal spasms and encourage dilation, allowing the doctor to, "slowly insert as much of your gloved hand as possible to grab the object and gradually extricate it," as NCEMI puts it. When manual removal is impossible, doctors improvise, employing everything from toy suction-cup darts (for light bulbs), to plaster (in the case of jars, filling the jar, with a tongue depressor in center for a grip), to soup spoons. Tools from the delivery room have also proven effective; both forceps and vacuum extraction appear in the literature. The latter, as reported by doctors S. O. Johnson and T. H. Hartranft, "provided a safe, cost-effective method of glass foreign body removal by the transanal route."
In cases where the object is successively removed in the ED, doctors must be on the lookout for patients to "elope," discounting possible complications and the need for a follow-up exam. Where ED removal has been unsuccessful, surgery may be required, including possible laparotomy, in which the abdomen is opened to give the doctor the access necessary to push the object gently toward the rectum. In cases of colon perforation, mortality rates climb dramatically. When there is extensive damage, a colostomy may be required. Some incidents are beyond help, including the man who employed a shoe horn rectally and bled to death, as well as an apparent suicide victim who introduced a bullet to his colon, fired from a gun.
Medical journals are clear that the trend of anal eroticism is "increasing," has resulted in "increased" retained RFO's, and, as Dr. Munter concludes, that "their occurrence is expected to continue to rise dramatically." But one issue that receives little mention is why as in, why are so many people sticking things up their butts? The only journal that dares touch this issue, Archives of Sexual Behavior, points out that, "the recent liberalization of attitudes toward sexuality has brought with it the desire by some individuals to seek alternate methods of sexual stimulation and gratification, among them an exploration of anal eroticism."
That reference to liberalization only speaks to acceptance. It leaves unanswered the question of whether this is a case of mankind, the restless explorer, discovering a region of previously uncharted pleasure, or if the growth of the retained RFO is symptomatic of a shift in the populace's psychology, a possibly telling breakdown in what Freud identified as the second stage of infantile sexual development: the anal phase.
The tantalizing "why" may go unaddressed, but the medical community is explicit about the consequences of RFOs. "Because of the potential complications, rectal foreign bodies should be regarded seriously and treated expeditiously." From this, it follows that, "Patient education of the dangers inherent in the insertion of objects into the colorectal area should be more prevalent." And yet, because of the odd nature of the RFO really, it's as unbelievable as folklore it's no stretch to imagine this could be a stealth crisis facing our society: running rampant, but too stupid to be believed. Ludicrous as it seems, the time may have come to confront the culture's love of placing things up their behinds and raise public awareness of the practice's inherent dangers.
It's difficult to imagine such a campaign taking place, no matter how widespread the problem, but it's worth noting that an ideal mechanism does exist for educating the public something better than affixing warning labels to every object smaller than a breadbox. Television network NBC is home to, in their words, "the longest-running, most comprehensive and powerful public service campaign in the media landscape," one which "has received numerous awards, including the prestigious Peabody and Emmy Awards."
Simultaneously, they have the fortune of airing the critically-acclaimed hospital drama ER, a show that has incorporated the retained rectal foreign object into multiple plot lines over the years, always to comic effect (and thus arguably adding to the problem). It's a fortuitous coincidence, and all that is missing is the message, which could be taken verbatim from Dr. Carey Martin's writing on the subject:
"If you know you have a foreign body in your rectum, or think you do, seek medical help to remove it as soon as is practicable," an ER actor would sensitively intone, adding, "If you engage in erotic play, then use a vibrator or erotic toy designed for the purpose of insertion into the rectum. These items usually come with a flange to prevent them from slipping into the anus."
Cue thought-provoking theme music, shooting star logo, and tag line: The More You Know.
Leif Ueland received a Master's Degree in the Professional Writing Program at the University of Southern California. He has written for public radio's Marketplace and several newspapers, and had a play produced in Minneapolis. His first book, Accidental Playboy, was published by Warner Books in November 2002.
Journal of Emergency Medicine (Jan-Feb 1999). A listing of that paper, along with a brief abstract, can be viewed online through the National Library of Medicine's exhaustive MEDLINE database, catalogued under its index number, 9950383. The point is, rectal foreign objects (RFO's, also known as rectal foreign bodies), as even the most cursory research reveals, are a documented fact of life.
hospital gown, perched "owl-style" in his chair and looking incredibly uncomfortable. "Two hours later," the doctor said, "I saw a bloody, Zip-locked specimen in the pathology outbox, labeled 'one baking potato.'" This single doctor's subsequent RFO encounters on one lone ED rotation included two spoons, one butter knife, and a coil of copper wire, all of which, he said, "made for fascinating X-rays." This led me to a conversation with an X-ray technician, who responded to my query by saying, "Are you kidding? We have a drawer full of our favorites."
another object, like a back scratcher (article No. 3738771). The latter scenario is much more likely to have complications.
individuals to seek alternate methods of sexual stimulation and gratification, among them an exploration of anal eroticism."
