Dr Phil Hammond, GP and Broadcaster

What's the most embarrassing thing that can happen to you? I once met a man who'd burnt his ear with an iron.

Yes, it coincided with the phone ringing and no, he isn't Irish. Indeed, there is no hard evidence that facial burns resulting from PIC (phone-iron confusion) are any more common in Ireland than in other EU member states.

The victim in question is an English sound engineer and I met him at a circumcision voice-over (enough said). Although he isn’t my patient, my razor-sharp diagnostic antenna couldn't help but observe that he was only using one side of his headphones. Some do this to look trendy. Others, like Nigel, do it to allow the skin to re-grow.

He was cagey at first - as if being a sound engineer who can't differentiate between the hiss of a steam iron and the ring of a telephone was something to be ashamed of -but we gently managed to coax the truth out.

Embarrassment is a very personal thing and often completely unjustified. An iron looks a lot like a phone, and he's not the first person to have made that mistake.

Nigel was too ashamed to visit a doctor, but the wound was healing well and all I could advise him to do was to take the phone off the hook next time he's ironing. Or carving the turkey/stoking the fire/plunging the toilet. In fact, it’s probably safest not to have a telephone at all, Nigel. Just in case.

The human and economic toll of accidents is vast. Seven and a half million people a year take their mishaps to casualty. However, most are not caused by unlucky twists of fate, but rather ignorant, stressed or foolhardy Brits in a hurry. Which is why they're embarrassing.

At school, there was a boy who was missing one middle finger. He and his Dad were sorting out a very long string of Christmas lights and, without realising what the other was doing, they each put a plug on the end. Dad finished first, flicked the switch -and you can guess the rest.

Another pupil got his penis caught in a milk bottle. This was less down to bad luck than bad judgement and an ignorance of the basic laws of expansion. For some reason, his mother called the fire brigade rather than a doctor, and the bottle was removed in a very professional and non-judgemental manner.

Alas, the traditional treatment for unwanted erections (a sharp tap from Sister's pencil) is no use in situations like these they have to be dealt with by careful syringing with a small needle. At times like these, you're thankful for the British obsession with discussing the weather.

Straying ever downwards and backwards, we reach, in the tradition of all medical columns, St Elsewhere. A colleague recently sent me a helpful article from the Annals of Surgery (sic) entitled 'The management of rectal foreign bodies.'

Included is an exhaustive list of retrieved items that reminds one of the Generation Game conveyor belt (spectacle case, tobacco pouch, can of Impulse body spray -men can't help acting on it -potato, cuddly toy, coffee percolator etc, etc).

Some of the objects seem unfeasibly large, especially when you consider that the male G spot is only a few inches up in the prostate. Why use a candelabra when a carrot will do?

The article describes the mechanics of removal, but -in true surgical style -there is no advice on how to handle the embarrassment either for doctor or patient. In today's patient-centred NHS, sniggering in the coffee room and copying the X-ray for the mess party simply won't do. You have to acknowledge the whole person and the light bulb. And if he says he swallowed it, then so should you. Just don't expect him to vomit it back up.

For those on tenterhooks who'd like to know how to get the light bulb out again safely, the author advocates the use of papier-mâché strips (remember your Blue Peter?) These are carefully laid over the bulb until it is fully encased. It takes an hour or so to set -you can't just produce one you made earlier -so there's time for more weather chat.

Then you crack the outer casing, the bulb smashes and you retrieve it in one careful tug. Nice work if you can get it.

Guidelines in Practice, May 2002, Volume 5(5)
© 2002 MGP Ltd
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