So, A Roach Walks Into a Local Emergency Room…


“She thinks there’s a cockroach in her ear,” I hear the triage nurse announce over the annoying portable device we all wear. It’s 4AM.

“Hmm.” I immediately think back to the one other episode indelibly etched in my mind of the 5 year old with a roach in his ear. It’s always an interesting story to recount to any listener. Something about removing a roach from a person’s ear gets people’s attention.

That morning, I had just come on shift at 6AM. My first patient was a 5 year old boy brought in by mom with the complaint of an earache. “Probably otitis” runs immediately through my mind; it’s a child, it’s an earache, it’s an off-hour ED visit.

Not feeling fully awake or intellectually alert, I go through the motions.

“Hello. What brings you here?” I say to mom.

“He woke up crying his ear hurt. He’d been fine before this.” says mom.

Child is sitting up, doesn’t look particularly uncomfortable. I reach for the otoscope and for the umpteenth time peeked in the ear.

To my utter shock, I see very clearly 2 insect tentacles. I don’t think I physically jumped nor made a sound, but my inner self jumped and screamed. I turned and looked at mom and said,

“There’s a bug in there.”

After extracting the small insect, I looked again and to my surprise and disappointment, there was a roach limb still inside.

Disgusting, tenacious little things. Nothing some more irrigation couldn’t get rid of.

That was probably 10 years ago. Removing foreign objects from different orifices is bread and butter for the ED physician. It’s always a good story.

“I think it’s a cockroach,” said the woman as she sat there grimacing. As she talked, she would stop suddenly and cry out, shake her head a little, cover her left ear with her hand in agony. They’d been spraying for roaches.

“Ahhhh, I can feel it move!”

Well, let’s just get this stupid thing out. I’ve done this before. After instilling viscous lidocaine which killed/drowned the beast, I looked.

Once again, I don’t think I physically jumped nor made a sound, but my inner self jumped and screamed. I was staring down at the HUGE butt of a roach. I think I threw up a little in my mouth. It. Was. Absolutely. Disgusting. It was wedged in there.

This one was a bit tougher to get. It took a few attempts at it, but the roach came out in one piece. Or, so I thought. Once again, disappointment and nausea was all I felt when I saw with magnified clarity a single roach limb and its hairs wedged in the external ear canal. Ugghh. Really?


This time, try as we might, with copious irrigation and attempts at grasping it with forceps, I just couldn’t get it. Eventually, it occurred to me that what I see as this GIANT roach limb was in actuality a teeny, tiny little innocuous keratinaceous thing in her ear canal. Rather than risk any more damage, I decided to just stop the madness of rescue and retrieval of the limb. She was more than fine with that idea.

Just another day in your local ED.


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