What makes a scrub nurse cough?

As a youngster I was troubled by a serious dental problem having  teeth twisted this way and that way. Two teeth were extracted to make more room, and then braces worked well to straighten things up. As a young adult, I still had orthodontic bands on my back molars to pull them back into position with small rubber bands. The bands were attached by small hooks on the buccal  (I learned that cool term for cheek from an oral surgery fellow)  aspect of the molar. The only time I removed the rubber bands was for eating.

I was scrubbed on a long case with my favorite neurosurgeon, Dr. Oddo, and was getting distracted by a full bladder. I really needed to pee. As visions of a beautiful white toilet danced in my head, I must have opened my mouth in a weird way and one of the orthodontic bands popped off.

Before I could even process what was happening, it ricocheted off a tonsil and sailed down my trachea. My concern with having to void was overshadowed by a string of violent coughs. Dr. Oddo asked with  concern, "Are you OK."  "Yes,"  I lied in a feeble restrained voice as I tried to  stifle the cough.  I managed to hold it together until the end of the case. I was coughing like a TB patient as I ran to the bathroom.

Dr. Oddo was there when I exited from the bathroom and showing genuine concern, wanted to know what was wrong. I explained to him what happened and he immediately consulted a nearby thoracic surgeon.  After a cursory look he suggested a quick bronchoscopy.  Any time a neurosurgeon is concerned about your health, you are probably in deep trouble.

Dr. Clobber, an anesthesia resident, I knew well from being on call with wanted to have a go at the rubber band with a laryngoscope and a Magill forceps. That sounded better than a bronch  and he had a bottle of Cetacaine on the ready to numb up my throat. I was skeptical  of this and asked him, "What if you blast that rubber band further down the trachea with the Cetacaine spray? "Good point, I never thought of that," he replied.

By this time a crowd with expertise in just about every surgical specialty had gathered. I was really more nervous about the gathering gang of surgeons than the stray rubber band. Somewhere from the back of the gaggle of surgeons came the voice of reason. "Have that fool suspend his upper torso over the table for some postural drainage."

I suspended myself upside down over the side of a table and after several minutes the rubber band slid out by gravity. I came away from this experience with  two lessons. The simple, staightforward,  approach to a problem is best and never wear orthodontic rubber bands in the OR, especially when you really have to pee.