Wendy claimed to be in labor. My cynicism, engendered by years of ER work, said otherwise. She did not appear to be in any distress, and she did not look pregnant. However, I have seen a couple of women deliver babies who were so slim—from intentionally starving themselves—that they barely looked pregnant. So I had to examine her.

Sure enough, the head was already coming out. Not bothering to suction the nostrils, I completed delivery of the body. “Well, Doctor, is it a boy or a girl?” she asked.

I responded, “Um, it's a girl, alright.”

She was joyous. “What should I call her? I haven't even given any thought about naming her!”

Hmm . . . that golden blonde hair, those blue eyes, that plastic body: “I think you should call her Barbie.” She had “delivered” a doll.

I never cease to be amazed by the things women insert in their vaginas. This patient was clearly mentally ill, but most vaginal foreign bodies (see box below) are inserted by the woman as a means of obtaining sexual gratification. In some instances, though, the patient would adamantly deny any knowledge of how “the thing got inside me.” They would claim that their lover was “playing around down there” and apparently inserted something, unbeknownst to them. Maybe, but I have a hard time buying that. I've seen golf balls, Ping-Pong balls, assorted vegetables, and a silver dollar—still legal tender, I presume. I have had two or three patients with hot dogs, perhaps not surprisingly. I've discovered that these hot dogs have not fared well with the rigors of simulated intercourse; all were fragmented. I have seen broken-off douche nozzles (or whatever they are called), decaying condoms and “French ticklers,” long-forgotten contraceptive sponges, and . . . no, I won't say. It's too gross to mention. It's not what you're thinking; it's even worse.

I will mention the contraceptive sponge story, though. If nothing else, it illustrates an important medical principle that is germane to this topic of vaginal foreign bodies. I've seen two patients with problems attributable to such sponges. Naturally, I will present the more interesting story.

Paula was in jail for stealing something from a local mall. Our facility had a contract with the police department to provide care for police prisoners, so when Paula developed lower abdominal pain and a fever, she was brought to see us. The female police officer who accompanied the patient stayed in the room as I performed the pelvic examination. She wasn't eager to watch, so she stood by the wall near Paula's head.

After inserting the vaginal speculum, I saw a large, white object deep within the vagina. This puzzled me for a second, and then I recognized what it was. “Paula,” I inquired, “do you use contraceptive sponges?”

“Yes I do. Why?”

“You have one still inside you.”

“Darn!” she exclaimed. “That's the second time I've forgotten to take the thing out!”

“How long has it been in there?”

“Two weeks.”

Yikes, I thought.

I grasped the sponge with an instrument and slowly withdrew it. As it left the vagina, a sudden gush of yellowish-green pus poured out of her. The smell would have nauseated a grizzly bear. Wafting toward the police officer, she sniffed once or twice, her eyes fluttered, and then she slid down the wall, unconscious. She hit the floor with a resounding thud. The patient, who couldn't see what was going on, bolted upright and began screaming, “What happened? What happened?”

Hearing this, the nurse ran into the room to see what was going on. After we revived the officer and I calmed everyone down, I asked the nurse for some culture tubes. To make a long story short, the patient had an infection with a nasty type of bacteria, Pseudomonas. The infection had begun spreading through her body, and she required admission for IV antibiotics.

Moral of the story? Do not leave things in the vagina, since they can cause horrendous infections. If this patient had not been treated, she easily could have died. From a sponge!

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