Foreign Objects

Beep...beep...beep....

I sleepily rubbed my eyes, being rudely awakened by my pager's shrill tones.  It was about 2:15 a.m., and prospects of a good night's rest was effectively ruined for the night.  I managed to stumble out of bed without waking my wife, groped for my pager, and checked the message.  It was the emergency room.  As I picked up my phone, I made a quick mental list of why the ER would call a pediatric gastroenterologist at such an hour - maybe it was a child who was vomiting blood, or a teenage girl with a bad stomachache who refused to leave the emergency room without seeing a specialist (oh please, not that!), or...

"Hi, are you peds GI on call?  This is Dr. Lee from the emergency department.  We have a 15 month old girl who was found by her parents at home choking on something about an hour ago, and they thought she might have swallowed a coin or something like that.  The kid's doing fine now, but we did chest and abdominal X-rays on her, and it looks like there's a coin stuck in the esophagus.  It's about 2.4 centimeters in diameter, and it's about a couple of centimeters above the diaphragm...."

Translation - toddler was crawling around...toddler saw loose change on the carpet...toddler picked up shiny quarter...toddler played with shiny quarter...toddler put shiny quarter in mouth...toddler choked on shiny quarter...toddler swallowed shiny quarter...quarter got stuck in no-man's land in the esophagus, too big to fall into the stomach, but too far down the esophagus to vomit it back up.  It's a fairly common scenario that I get called about a few times a month.  The swallowed foreign objects (that's medical-speak for stuff that normally don't belong inside our bodies) may be different, but the stories tend to be similar.  Besides quarters, I've removed pennies, dimes, nickels, various foreign currency (mostly Canadian and Mexican), marbles, hair clips, bobby pins, broken pieces of dental retainers, magnets, and a few batteries (getting a slippery AAA alkaline battery out of a 2 year old boy's stomach was particularly memorable).

I instructed Dr. Lee at the emergency room to have the child hospitalized, and later during the day I made arrangements for the coin to be removed endoscopically under anesthesia.  The quarter, no longer shiny, was eventually returned to the anxious parents in a small specimen jar.  Hopefully it wouldn't end up in the kid's mouth again.

After years of picking shiny foreign bodies out of kids' innards, I have developed the habit of always warning parents and caretakers of young children about the little ones' propensity to find things on the floor and put them in their little mouths.  Like most doctors, I assume that it is the adults' responsibility to make sure that their children don't sit around with a pocketful of loose change on the floor, and any suspicion of their failure to keep an eye on the kids would often result in prompt messages to the hospital social worker to investigate for possible child neglect.  It is a toddler's nature to put little shiny things into his or her mouth, and disaster can easily result if such a nature is allowed to run its course unchecked.

Just as toddlers are prone to place themselves in potential harm, we humans in our natural state tend to take actions that lead to death and destruction.  We were created to worship God and for His glory; however, the indictment on our sinful nature is:

For although they knew God, they did not honor him as God or give thanks to him, but they became futile in their thinking, and their foolish hearts were darkened. Claiming to be wise, they became fools,  (Romans 1:21-22)

As a result, God allowed sinful mankind to succumb to its own nature:

Therefore God gave them up in the lusts of their hearts to impurity, to the dishonoring of their bodies among themselves, because they exchanged the truth about God for a lie and worshiped and served the creature rather than the Creator, who is blessed forever! Amen.  (Romans 1:24-25)

In the end, such actions result in inevitable destruction:

Though they know God's righteous decree that those who practice such things deserve to die, they not only do them but give approval to those who practice them.  (Romans 1:32)


May we perish the thought of rejecting God to do our own thing, because if God allows us to do so, it would be the most unthinkable punishment.