Usually when I pick up a patient’s chart, it’s pretty clear what the problem is going to be before I even walk in the exam room. But once in a while, I get something vague, like “I need to talk to the doctor.”

Sometimes this means they are too embarassed to talk to anyone else about what the problem is. Such was the case when I saw a middle aged man who presented with his wife after some trouble with a flashlight.

I introduced myself to the nervous fellow and asked what the problem was.

“I was fooling around with a flashlight,” he sheepishly reported. “Now I can’t get it out.”

“You mean you put it in your bottom?” I asked. He nodded.

His wife was looking at him with such contempt, I really felt sorry for him.

I tried to make him feel better about the situation, and let him know that he was certainly not the first person with a rectal foreign body, but it didn’t seem to help. “When did you put it in there?” I asked.

“A week ago.”

At this point, his wife’s jaw dropped open, evidently this was news to her as well.

An xray confirmed the location of the flashlight, which fortunately had a plastic edge just perfect for grabbing with a clamp. A little sedation, and a couple pulls later, and problem solved. We discussed some strategies for avoiding this in the future, and the dangers of puncturing the colon. He assured me that I wouldn’t see him again in the ER. So far, he has been right.