Dax Shepard kicks off the episode with his characteristic theme riff and introduces Monica Padman before flagging this particular episode as one listeners should keep away from their children — not for explicit language, but for the sheer sensory horror of the subject matter. Monica agrees, noting two stories in particular that will be impossible to unhear. Before the first caller joins, the episode runs through three sponsor integrations: American Beverage's Good2Know ingredient transparency site, Quince's premium-for-less clothing line (including Dax's endorsement of their European linen shirts at $34), and a public awareness segment about Peyronie's disease directing listeners to TalkAboutPD.com. The sponsors serve as a surreal tonal counterpoint to the medically extreme content about to follow.

Randy interrupts his Florida road trip to share a story from his decades-long career as a paramedic in a major metropolitan area. The call came in unusually described: 'self-inflicted trauma involving a foreign object.' When they knocked on the door, the mother answered insisting they had the wrong address — until they confirmed her son had made the call. Upstairs they found a 14-year-old, blanket drawn up, in serious pain. Once his mother left the room he was more forthcoming: a Super Soaker 10,000 — barrel, water tank and all — had been inserted rectally via a hose attachment that he'd presumably been using as a makeshift enema or bidet. Randy and his partner attempted removal with KY jelly, failed, detached the water tank from the tube with a blade to reduce the bulk, and transported the boy to hospital where he was sedated and the object removed under anesthesia. Randy told him simply: 'I was your age once' and that experimentation was common. Dax and Monica reflect on the unique cruelty of being 14 and having your mother discover not just that you masturbate, but how. ^{[1] — Randy "Randy responded to a 911 call from a 14-year-old boy who had inserted a Super Soaker water gun — barrel, tank and hose — into his rectum. T…" 03:48 Play} Randy closes by sharing that his daughter Megan, a film editor in California, is a devoted listener who encouraged him to submit.

Between callers, Dax and Monica deliver two sponsor reads. For Helix Sleep, Monica shares that she's had her mattress for years and it still feels brand new, while Dax highlights his customized side-sleeper cooling configuration. They promote helixsleep.com/armchair for 20% off. The SoFi read leads with Monica citing the national average bank savings rate of 0.39%, then promotes SoFi's high-yield checking and savings as earning over 8x that figure with eligible direct deposit — plus a $300 welcome bonus and early paycheck access.

This short sponsor segment for Arm & Hammer Baking Soda Toothpaste uses a coffee-order metaphor to pitch simplicity. The spot describes how baking soda particles dissolve to break down plaque and whiten teeth, positioning the product as the no-nonsense alternative to complicated oral care routines. It earns the label 'number one dentist-recommended baking soda toothpaste.'

John's story begins with a patient arriving by ambulance with abdominal pain and a small amount of bleeding, initially denying any foreign object. A rectal exam produces clear plastic on the doctor's glove — the casing of a bratwurst — and a CT scan confirms three of them, arranged in a pattern that looks like a fidget spinner. The patient had been home alone, wife out of town, and one bratwurst felt good, so he tried two, then three. Surgery was required. Days later, the surgeon casually mentioned that the same man had previously been treated at the other hospital in town. John's second and third images reveal an apple (cored and strung with a retrieval string) and a toothbrush holder — the latter requiring the surgeons to open his belly, remove dead bowel, and fit him with a permanent colostomy. ^{[1] — John "John's 2013 patient lied through the whole first visit, but a CT scan revealed three bratwursts. That already led to surgery. Then John's c…" 14:34 Play} Dax draws an immediate parallel to his own addictive escalation logic, noting that 'one pill felt great, so two must be better' is exactly the same algorithm. John then drops a bonus story about a patient who identified as a cat, wanted to experience giving birth to kittens, inserted three live ones, and died of sepsis. ^{[2] — John "John saved his most disturbing story for last: a patient who identified as a cat and wanted to experience what it felt like to give birth t…" 26:18 Play}

Pacific Life's spot uses a confidence metaphor — 'listening to your gut, moving forward even when the path ahead is clear' — to position the 160-year-old insurer as a generational promise-keeper. The ad lists Pacific Life Insurance Company (Omaha, Nebraska) and Pacific Life and Annuity (Phoenix, Arizona) and directs listeners to consult a financial professional.

Lucy sets the scene: a big-city trauma center in 2021, an EMS call for an 80-year-old with stable vitals and abdominal pain — a thoroughly routine presentation. The medic pulls Lucy aside to share two things: the patient had confessed en route that he'd inserted something rectally two days earlier, and his wife had recently died. Lucy immediately reads the room and focuses on compassion over curiosity, assuring the stoic elderly man that they'll get it out. He declines pain medication. The ER doctor finds the object on the first attempt but can't get a grip due to suction and slipperiness; the patient simply says 'just do it' as the doctor attempts a second time, going fully elbow-deep. ^{[1] — Lucy "An 80-year-old man whose wife had recently died waited two days before calling an ambulance about a large wooden banister piece in his rect…" 34:25 Play} Moments later there's a pop, and the doctor is holding what Lucy describes as a 6-by-8-inch piece of wooden banister, roughly bishop-shaped, covered in blood and stool, and not perfectly sanded. The doctor bags it and walks out. An hour later, security calls: the nephew is here. Lucy races to the room, positions herself between the door and the specimen bag, tells the nephew she has 'absolutely no idea' what's causing the pain, and slides out while dropping the evidence in the trash. ^{[2] — Lucy "After the extraction, Lucy left the wooden object in a specimen bag on the counter. Minutes later, the patient's unsuspecting nephew arrive…" 41:50 Play} George's dignity survives intact.

With the extraction story complete, the trio reflect on the unmistakable pattern: every improvised-material foreign body case — wood, glass, non-commercial objects — has involved a patient over 65. Lucy attributes it partly to a lack of sex-positive education and embarrassment about visiting an adult store, and partly to the psychology of suppressed curiosity finally boiling over. Dax speculates many of these men have been ruminating on the idea for years and simply reach a tipping point. Monica floats the darker possibility: maybe their wives were partners in this for years and now they're alone. ^{[1] — Lucy "Every story in the episode converges on the same demographic: older men, often with wives away or deceased, finally acting on long-suppress…" 44:59 Play} The conversation is equal parts analytical and darkly comedic, with Dax wondering aloud whether George personally turned a banister piece on a lathe as a gift for himself.

Josie receives handoff report on a young adult female in the emergency department: multiple razor blades inserted vaginally, labia super-glued shut, now unable to urinate. The bladder scan confirms severe retention. The OR team puts her under general anesthesia to safely separate the glued tissue (solvents would have burned the mucous membranes), remove the blades, and insert a catheter — no lasting wound, no required stitches. Josie takes over care on the post-op floor. ^{[1] — Josie "Josie's patient arrived with multiple razor blades inserted vaginally and her labia super-glued shut — unable to urinate. She needed emerge…" 50:45 Play} The patient's chart flags Munchausen's syndrome, and a psychiatrist has left a specific treatment protocol: no inpatient psych (would reinforce behavior), minimal interaction, no emotional engagement, no ADL assistance, camera room but don't tell her, and no one-on-one staff. Josie struggles against every caregiving instinct she has. Then, minutes before discharge, the patient calmly tells Josie she swallowed a razor blade — and shows her exactly where she'd hidden it: behind the thin plastic lining of a 3-ring binder that passed Josie's thorough inspection. Chest X-ray is unambiguous: blade in the esophagus. Discharge canceled; an EGD removes it. Josie and Dax reflect on how Munchausen's patients — especially those with healthcare backgrounds — are the most sophisticated operators in the system. ^{[2] — Josie "Munchausen's patients aren't treated like typical self-harm cases. The psychiatrist's protocol: no inpatient psych, minimal interaction, do…" 54:50 Play}

With the final caller signed off, Dax circles back to the moment he correctly identified John as being in Ohio from almost no visual information — a green wall, a ceiling, and John's face. Monica teases that she 'gave it' to him, but Dax insists something clicked intuitively. He attributes it to years of traveling for the Car Show and various film shoots, hypothesizing that unconscious regional pattern-matching is now a skill. Monica plans to run a formal test on the next fact-check episode, though Dax half-jokes he'd rather not risk his one confirmed superpower on a test he might fail.

Dax closes out with an Allstate ad that uses the universal humiliation of locking your keys in your car as the hook: if checking first is a good habit, so is checking Allstate for an auto insurance quote that could save hundreds. Listeners are encouraged to add an Allstate Roadside Plan, with insurance provided by Allstate North American Insurance Company and roadside assistance by Allstate Motor Club Incorporated.