Say what?

During my second year of ear, nose, and throat residency at LA County Hospital, one of our chiefs (call him el Jefe) did a study on ear foreign bodies. Very simple study: he reported on the first one hundred ear foreign body patients to walk in our clinical door. It took el Jefe only three months to rack up 100 cases. If you're easily grossed out or still have nightmares of the Night Gallery earwig episode, skip the next paragraph. The number one foreign body? Not earwigs, but Blatella germanica, the German cockroach. But don't freak out. LA County Hospital's patient population can't be generalized to the world at large. Here's my favorite ear foreign body story. No bugs.

No Elmos, either. 10 PM on a Saturday night. I trotted out my broken Spanish on a 28-year-old guy who had just told me he'd put a piedrito in his ear. Piedrito? A little rock? "Why are you putting rocks in your ears?" I said in my not-half-bad Spanish. "Little children put rocks in their ears. You're an adult. What's the matter with you?" What is this damned thing? I thought as I looked at his ear under the binocular microscope. White. Hard. Wedged in pretty tight. "I can't believe it," I said, still in Spanglish. "A grown man putting a rock in his ear. What were you thinking?" My patient started talking a mile a minute to my nurse's aide, and he started laughing. "No, Dr. Hoffman. Not a rock. A rock of cocaine." Aha. Well, that explained it. (In case you're thinking Huh? These folks stuff the rock in their ear when they think they might get busted.) This solved my problem, though. I irrigated his ear with alcohol, dissolving the rock. My patient was not a happy camper. He'd expected to get the rock back.

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That's not my favorite mangled Spanish story, though. This one is. I told this one to Michelle not long ago, but I don't think I've shared it with the rest of you. Let's backtrack a few years to my last month in medical school, when I did an Emergency Medicine rotation at Santa Clara Valley Medical Center. Like LA County Hospital, SCVMC served a poor, largely Spanish-speaking population. As we go back in time, we also go downhill in the quality of my Spanish.

My attending physician asked me to do a pelvic exam on a sixteen-year-old girl with vaginal discharge. "It's her first pelvic," my boss said, "but don't worry. From the sound of it, she's been very active." So what if she's sexually active, I thought. This is her very first pelvic exam . . . it's bound to be stressful. I vowed to put her at ease by speaking slowly and calmly, doing my best to reassure her and let her know this was all very routine, nothing to be afraid of. I'd tell her in great detail what I was about to do before I did it. After explaining to her the general idea of what we needed to do, I held up my gloved and lubed hand, my index and middle fingers standing at attention like proud little soldiers, and said, "Voy a poner dos piernas en su vajina." To save you from having to Babelfish that one: "I'm going to put two legs in your vagina." Ever hear the expression bug eyes? We somehow managed to sort out the misunderstanding, and to her credit, she let me go ahead with the exam. And, yes, I used my fingers. D.