Yesterday in th evening I recieve a call from a nurse. A patient stated she has swallowed a pencil. Given the evening hours, I asked the nurse and to call the Physician Assistant on call. Today morning, I go to the floor and ask if anything was done for the patient.
Abdominal Xray was done which didn’t show any foreign body. Given the absurdity of tehe complaint, I had an option to believe the patient or not. I decided to believe her and ordered a CT scan of her abdomen. As soon as the CT scan is done, I’m looking at the films and there is the pencil somewhere stuck in her gastrointestinal track. Jessica, my 22 year old pencil swallowing patient is standing next to me. She is a petite girl with the cutest smile on her face. She looks at me and says – “didn’t I say so and you guys decided almost not to believe me”.
I call the surgeon on call and while waiting for them to answer, I start talking to Jessica. She is afraid and wants the pencil to be taken out as – ” the pencil has a sharp point and will hurt while coming out”. I look at her amazed – she is so innocent, she has no clue about the complexity of her disease and potential surgery in front of her. On questioning, I asked Jessica why she swallowed a pencil. Her innocent answer – to get attention from the nurses and the staff.
I look through her chart. Jessica grew up with parents around but who were way busy in there own lives. Her dad travelled for work and mom was an alcoholic. She struggled with her self image, she being a petite shy girl. She was always an outcast at school and no one to confide into as a child. Jessica moved out of the house when she turned 18. She was in college for a while, but quit as decided to work and move in with a boyfriend. It’s been one messy relationship after another looking for approval and attention. Last break up leads to this admission to the hospital on the psychiatry floor. And here she is, another messy situation leading to a swallowed pencil.
The surgeons come to the floor and take Jessica to the OR. And I see her getting wheeled over. All the while I’m thinking who is to be blamed for the swallowed pencil??? Is it Jessica or our modern society which has led to so much isolation. Would this behaviour continue or else Jessica will find some way to feel acknowledged in this world.