Thursday, May 22, 2008

Is That a Bezoar in Your Pocket...?


Insane people are cool. Who else would systematically pull out their hair, eat it, and end up with that thing (pictured above) lodged in their stomach? And all for MY entertainment.

That thing is called a trichobezoar. Tricho = hair. Bezoar = nasty mass of indigestible stuff. We get these with reasonable frequency in the pathology lab. The one you see above, you may have noted, is cast in the shape of a stomach. Those who eat their hair are said to suffer the from the so-called “Rapunzel syndrome”. I’m trying to figure out a catchy name for those who eat their own pubic hair.

Hair is not the only material we get. I have seen phytobezoars (plants), plasticbagobezoars, paperclipobezoars and CornNut®obezoars (OK, I made that last one up – shockingly, the other ones I did not).

This came up recently on a scalp biopsy from a young woman with patchy baldness. “Well, of course”, you are probably thinking, “could be telogen effluvium, alopecia areata, like ya know, wha-eva’”. Well, I diagnosed trichotrillomania, or, for the non-medical types, freakshow-who-pulls-out-her-own-hair. Maybe I’m being too critical. Maybe Head-and-Shoulders tastes like fucking maple syrup. So I apologize for the offense I have caused. Go ahead and eat that plastic shopping bag from Wal-Mart. Who am I to judge.

54 comments:

  1. How do you deal with stuff like this without wanting to vomit? My daughter used to suck on the wet ends of her hair after her bath and just that made me want to puke. (she hasn't done it in years, probably because of my violent reaction each time)

    And I know this is just a tiny piece of what you see each day.

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  2. Gawd, is there anything worse than the power of suggestion? I took one look at that photo and my brain suggested that my lunch should be round trip meal ticket. Pukingly great photo, Etothie...

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  3. Maybe the hair its own special flavor! hahaha Although, there are some brands of shampoo with plenty of nice scents. Then there is Bath&Body Works scented body washes, some which smell nice. I can't see sampling them upon my palate, but one might think they would taste better than hair! People are so strange that there are few things which surprise me anymore.

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  4. "COMMENT MODERATION NOW ENABLED. SORRY. A MENTALLY ILL PERSON FORCED THIS UPON US. HOPEFULLY, WE CAN TAKE THIS DOWN SOON." --- Please share the details on this one. I've been reading this blog for months, but today is only the first or second time I have posted. We all need a good laugh.

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  5. Of all the nasty things I see every day, there are 2 things that regularly make me want to retch: opening a fresh colon that has warm shit in it; certain cheesy cysts that smell like, well, cheese; and that crotch shot of Britany Spears. OK, three things.

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  6. That society's little snowflakes eat their own plastic bags/pennies/hair comes as less of a shock to me than the fact that you haven't dressed it up in "Mr. Potato Head" garb and taken wacky/raunchy pics along with a kermit puppet or some big ass, Jabba-the-Hut desmoid tumor. A sad commentary.

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  7. I agree. Put a hat on that bezoar. It could become your Wilson (Tom Hanks-castaway). You could talk to your bezoar in the lonely basement of the hospital. I have actually seen this in med school. Chronic vomiter, took 3.5 lbs of hair/gum/monchichi dolls from her gullet.

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  8. Did you see the girl a couple of years back in India, who had one that weighed over 10 lbs I think. She said her hair tasted like curry and so she ate it!

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  9. Thanks! That brought to mind the story my sister told about a Barbie hairball. That made my day.

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  10. She ate her hair because it tasted like curry? This reminds me of the time I asked my class WHY they weren't supposed to eat playdough. They responded, "Because it tastes like salt."
    What other body parts has this girl been taste-testing, and do we even want her opinion on what it all tastes like?

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  11. mottsapplesauce6:52 PM, May 22, 2008

    Eeewwwww! On the other hand, a big cheesy sebaceous (sp?) cyst would make me retch, too.

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  12. hey doc etotheipi,
    could brittney have a spermatobezoar? i mean, is that possible with like bukkake and shit? didn't elton john have one of those or rod stewart or something? and what exactly does one do to "pump a stomach". i'm in the biz and don't know what "pumping a stomach is"?
    curiously.
    me

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  13. 911: Spermatobezoar, indeed (-: Don't you people go to church?

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  14. Etotheipi: I can't believe the young woman didn't just TELL her doctor that she had trichowhatever--she let him cut her scalp before she'd admit to this? What was she hoping for, a cancer diagnosis or something?

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  15. Did the bezoar consent to having his(her) picture taken, you know with HIPPA and everything. But I guess, not to sound racist or anti-bezoar or anything, but all trichobezoars pretty much look alike.

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  16. And men have always told me that oral ingestion of the stuff prevents cancer. This is true, right?

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  17. Sure, that and it's just good manners.

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  18. kat,
    i hesitate to name the person because that will make them come back. i tried to turn off the moderation once and they came back like a dog to its vomit.

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  19. uh,
    something about stones and glass houses comes to mind here. etotheipi, if i'm not mistaken you are prone to epidermoid inclusion cysts. in fact, if i'm not mistaken or my memory clouded by half a handle of jim beam, i may have been involved in an impromptu surgical removal of same from your nasty ass thin body while onlookers gasped at some four star resort within the past few years. sure was fun though, and, if you choose, you may tell the rest.

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  20. Wow.

    Serious question here: How does this not get passed through the system -- I mean... Do you have to eat all that at once for it to get stuck or...

    Mom always said not to swallow gum because it would get stuck and fill up your stomach. I know this isn't true because I've ... er... seen the evidence of it's passing.

    So, seriously -- how does one get such a mass of crap in their gullet?

    Enquiring minds want to know!!

    DD

    PS: It should be trivial to block your psycho's IP address... You mentioned turning off moderation brought her back, maybe shaming her publicly would drive her away?

    Enquiring minds want to know!!

    =o )

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  21. Ok, so finally M.D.O.D. jumped the shark. 911, did you actually just use the Rod Stewart bukkake reference that I heard in the fifth grade...many, many years ago?

    E to the eye pie, I'm truly repulsed, super funny. "Dude, I don't want to sound like a queer or nothin', but I think you got a hot ass." (This one has to stump you...)

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  22. Damn, I thought the purpose of this post was to help you come up with catchy names for those who eat their own pubic hair. Just so I don't feel like I wasted my whole afternoon, I'm going to offer you my suggestions anyway:

    Carpet munch-owwwser syndrome

    Pube-alicious Syndrome

    Mons-opecia

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  23. how about

    pubitrichotillomania causing a pubitrichobezoar?

    it's not sexy, but i think it's right.

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  24. and yes, i was referring to the urban myth re rod stewart that we all heard in 5th grade or thereabouts.

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  25. come to think of it... that looks more like something my CAT would cough up. A person? I've heard of this sort of thing, but it's still mind boggling

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  26. 911, I learn something everyday on this Blog. I thought it was Freddie Mercury.

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  27. Lot's to address here:

    Peter: You got me... I hang my head in shame.

    As to spermatobezoars, they are usually found in conjunction with gerbilobezoars.

    As to the mechanics of this happening it's just like when your daughter and wife (not together you sick fucks) take a shower and you have to clean out the drain... well you get the idea. Just a simple mechanical clogging. And, no, these are not "passed", they are surgically removed.

    As for the pube thing. I think some variation on the "carpet munchowser syndrome" sounds good. I like the Munchausen reference...

    And finally, this is not a HIPPA violation because I have "de-identified" the bezoar by trimming it.

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  28. E,

    No need to hang your head in shame. That was a tough one. "Orgazmo" from Trey Parker and Matt Stone (South Park). It is a horrible movie, but every time it is on encore I find myself watching it. I just read this post again...I used to really like CorNuts(R), but never again.

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  29. I'm doubly shamed as I actually OWN Orgazmo!

    Got to get my head in the game....

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  30. All I know is that you could probably sell that thing on eBay and make a ton of cash. I think I see a picture of Mother Teresa in the upper right corner.
    Either that or you could put some hair spray on it, sand down the rough edges, and use it as a bicycle seat.

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  31. Did you know that bezoars are supposed to have magical properties? But, hey, it didn't seem to work for the bezoar girl, did it.

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  32. I'm doubly shamed as I actually OWN Orgazmo!
    Why does this not surprise me?

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  33. From this photo, the bezoar in question, has a striking resemblance to a partially used S.O.S. Pad.

    E,

    If you own it, you should be ashamed! Choda Boy, OUT.

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  34. ETOTHEIPI - YOU funny round eye. You are so much about QUALITY, not QUANTITY. Great post. Me? I think I just post sometimes just to hear myself type. Have you ever seen a Boston Baked Beans candy bezoar? I bet I had one as a 6-year old. Couldn't stop eating the damn things.

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  35. It does look like a steel wool pad.

    I'm out of the loop, please tell me more about the Rod Stewart urban legend?

    Peter, is that your dingy hanging out?

    I suppose we don't hear about those who eat their own pubic hair because most of it probably gets stuck in their teeth and never makes its way down to the stomach.

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  36. RN-husband has said if the patient had learned to pace herself, this may have actually passed. It's not the quantity, it's the hurried nature of the ingestion.

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  37. Trauma, when I heard the Rod Stewart story as a kid, it was Freddie Mercury, but same scenario. Rock singer rushed to ER, victim of apparent overdose. They pump the stomach and get man-juice, not pill fragments.

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  38. Thanks Frank,I'm sooo glad I asked......

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  39. And, if they get by the teeth, it seems that the uvula is an extremely powerful hair trap, easily irritated, and the irritation is likely to interrupt some activities not generally supposed to take place in church.

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  40. 1. Thanks to Zofran and the fact that I'm almost done with my 1st trimester my morning sickness was gone.

    2. Somehow, the combination of the bezoar and "carpet munchowser syndrome" brought it back.

    3. E^i*pi, dude, you gotta post more shit like this! I love it!

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  41. I hate to be the "stick-in-the-mud" here, but how about a little empathy for someone who obviously suffers from a pretty substantial mental illness. Sure, it's odd, but who among us doesn't have an odd quirk or two? Granted, the vast majority of us don't eat our own hair, but try to imagine what obsession might drive someone to do this to themselves. Whether she "wants" to or not, it is clearly pathological. Would it be so funny if she had a gastric adenocarcinoma? How about schizophrenia? Doctors see lots of weird stuff; I'm a med student and I've seen lots of bizarre things already - often among physicians. Physicians are supposed to have empathy for their patients, not contempt. There are plenty of "sane" people who do contemptible things with perfect clarity. Try to preserve a little humanity for someone who obviously needs help.

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  42. anonymous:
    You are hysterical! That is some brutal sarcasm! Keep it up! Hilarious!

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  43. Etotheipi: I wanna respond to this to, but I gotta go make some drug money. I'll post later.

    PS On yer side, dude

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  44. Oh come on Anon, you gotta admit,schizophrenia is kinda funny. Except for that one time when my undiagnosed schizophrenic friend came at me with a butcher knife. And even that was funny after we found out she was schizophrenic.

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  45. This comment has been removed by the author.

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  46. Anonymous, There is a time and a place for everything, and this blog wasn't created as a forum for understanding and analyzing human quirks. That's why it's MDOD, or Medical Doctors OverDosing: It's more of a safety valve for good doctors to vent frustration.
    Other blogs exist for considerate and kind examinations of human frailties, you must have taken a wrong turn. No one's job or life exists without a dark side, and if you don't have one you're really boring. I love teaching, but today a kid kicked me in the stomach, and I don't give a shit why or how she felt about it. Same deal. Out.

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  47. Old Fart: Could you please come to California immediately and um, speak to my student before I end up with rabies or something?

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  48. make mine trauma,

    They don't even need a medical excuse to come after me with a butcher knife. You need to downplay the charm a bit. :-)

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  49. id just like to say this is the most insensitive garbage i've ever read, trich is a real problem and if you suffered from it do you think you would be able to just come out and say yeah i pull my hair out and eat it, i didn't think so, regardless of how gross you think it is its not a choice it just happens and there's no one who suffers from it that is proud you all make me sick, to think i wanted to be a medical doctor years ago

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  50. dear anonymous,
    sorry you have trichotillomania. be careful not to tay you have 'trich' as that is usually 'trichomonas vaginallis' ande is a sexually transmitted disease.

    but further, i do not recall seeing your name singled out in this post so i'm not sure why you are offended.

    in fact, if you want to ban all such 'insensitive' blogging and public comment then you should form a group to ban, first, free speach, then all stand up comedians, then all people saying anything, anywhere, anytime. after all, someone within their earshot might have logophobia.

    also, unless you are psychotic or possessed by a demon you DO, in fact, have a choice whether to pull your hair out or eat it, but it's hard not to.

    best

    (and sorry we kept you from going to medical school)

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  51. wow..! i find this bezoar thing all too interesting....wonder how they feel and smell like??? hey!! can anyone sell be some for my personal collection???

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  52. Wow. So I happened to stumble upon this, and I must say that you MD's are exactly what I aspire not to be as a doctor. There is plenty of lewd humor in the world that exists without being an abomination to that from which it arises- ie practicing medicine. There exists and abundance of sick and funny things to prod at, but some amount of dignity for your profession and the oath you take should be maintained. So this is what goes on in your head as you are treating your patients?

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  53. dear 'anonymous',
    look mom, you promised not to drop comments on my blog and i promised not to show up drunk at thanksgiving dinner. please keep your end of the deal or it's going to be a vodka-soaked holiday and that won't be good for anyone.

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