Quote · Armchair Expert with Dax Shepard
Armchair Anonymous: Foreign Object in Butt III
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Josie the Post-Op Nurse: Razor Blades, Super Glue & Munchausen's
At 49:46 · chapter starts 49:20
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 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
Josie's patient arrived with multiple razor blades inserted vaginally and her labia super-glued shut — unable to urinate. She needed emergency OR surgery under general anesthesia. Then, minutes before discharge, she revealed she'd hidden more razor blades inside a binder cover and swallowed one. She had Munchausen's syndrome.
Josie described the episode's first female foreign-object patient: a young woman with Munchausen's who inserted multiple razor blades into her vagina and super-glued her labia shut.
Munchausen's patients aren't treated like typical self-harm cases. The psychiatrist's protocol: no inpatient psych, minimal interaction, don't get emotional, don't help with daily living, and don't even tell her she's on a camera. Every instinct a nurse has is the wrong move. The goal is to make hospital care as unrewarding as possible.
Minutes before discharge, the Munchausen's patient revealed she had hidden razor blades inside the cardboard cover of a 3-ring binder and swallowed one, requiring an esophageal scope procedure.
Dax noted that healthcare workers, particularly nurses, have the highest rates of Munchausen's syndrome because they are skilled at navigating hospital systems.
