Although I have seen many strange cases in the ER, every so often I am confronted with a situation that is so unusual that I begin to wonder if the patient is putting me on, or if I am being secretly videotaped for the ER version of Candid Camera. This began as such a case, but I soon realized that the patient was not kidding. Strange cases are often not responsive to standard medical therapy, but I was able to help this fellow. Let's meet him.

Dr. Pezzi: Hi, I'm Dr. Pezzi. How may I help you?

Patient: I have a sore tongue.

Dr. Pezzi: How long has it been sore?

Patient: Since last night.

Dr. Pezzi: Any idea as to what triggered it?

Patient: Yes, I do.

Dr. Pezzi: What is it?

Patient: Well, I'm embarrassed to say.

Dr. Pezzi: You can tell me anything.

Patient: I, uh, I had oral sex with a woman. You know, I went down on her.

Dr. Pezzi: (Encouragingly) Go on.

Patient: I did it for quite a while, too.

Dr. Pezzi: How long is that?

Patient: 8½ hours.

Dr. Pezzi: Hours?

Patient: Yeah, hours. 8½ hours.

Dr. Pezzi: (Surely a new world's record, I thought.) OK.

Patient: After flicking it for so long, my tongue is sore. But that isn't the worst part. What bothers me is that my tongue feels a bit swollen or stiff, and that's interfering with my speech. My voice is off—I just can't enunciate words like I could before. That will interfere with my job.

Dr. Pezzi: What do you do?

Patient: I'm a television newscaster.

Dr. Pezzi: (Curious, since I'd never seen him on TV.) On what channel?

Patient: Channel 8.

No wonder I'd never seen him. I always watched the news on Channel 7 because their female reporters were much better looking.

Hmm . . . ER textbooks are not exactly crammed with information on treating tongues that have become sore because of protracted cunnilingus. Nevertheless, I reasoned, the tongue is primarily a muscle with a thin coating of taste buds. Since this muscle was sore as a result of overuse, couldn't it be treated as any other overworked muscle? Eureka! Of course it could! I advised ibuprofen, ice chips, and vitamins C and E. It would have been better if he'd been taking the vitamins beforehand, but they would have some effect. Incidentally, the patient was taking an antihistamine drug with a common side effect: a dry mouth. Remember that.

Curious about the success of my therapy, I decided to watch the evening news that night on Channel 8. His voice was slightly slurred when I saw him in the ER, but now it seemed normal. Click. Back to Channel 7.

A week or so later, I was approached by another ER doc, Jim. “Hey, Pez, want to hear a story for that book you're writing?”

“Sure,” I said.

“I had a lady come in last week saying that her vulva was sore. She said that she'd had oral sex with some new partner, and she wondered if she had an infection. I doubted that, since the discomfort developed right after she'd been with the guy. I didn't find any discharge, and the smears and cultures were normal, too. I told her it was probably just because they had sex for so long.”

“By any chance, was it for 8½ hours?” I asked.

“How the heck did you know? You? Was it you? You lucky guy!”

“Nope, wasn't me.” I told him the story, omitting the patient's name and occupation.

A few minutes later, as Jim was about to leave, he said, “You might want to watch the news on Channel 7 tonight. If the meteorologist is still walking funny, you'll know why.”

Normally, saliva provides enough lubrication during oral sex to prevent abrasions. However, the newscaster's antihistamine gave him a dry mouth. 8½ hours of being rubbed with a dry tongue . . . ouch!

OK, I know what you're thinking: oral sex for 8½ hours? BS! Well, I once did it for 8 hours, so I know that 8½ hours is not out of the realm of possibility. During my first year of medical school, I dated a woman whose vagina was so tight that I could not enter her. Since I'd already read The Merck Manual, I thought she might have vaginismus, so the obvious thing to do was to relax her and, above all else, not rush intercourse. After 8 hours of cunnilingus, it was still a no go, so I began to see the wisdom of using progressive dilation as recommended by The Merck Manual. Time for Plan B.

I was an hour late getting to medical school that morning, and when I walked in I couldn't have been any more self-conscious. The skin around my lips was red and chapped, and my voice was so slurred that I sounded drunk. Coupled with the fact that I'd had no sleep that night, my slurred speech and grogginess made a few of my classmates wonder if I'd been drinking. If they only knew!

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