One Less Nut in LALA Land

The day after Jane Brody’s article in the New York Times came out, describing how surprisingly common it is for children to choke on objects, be they toys or food, I’m in the operating room with a toddler’s who’s choked on a cashew. Wait, he’s not even a toddler. He’s a BABY. By some arbitrary definition, toddlers are 18-months to 3 years. This boy was 16 months old. His mother had given him ‘cut up’ cashews six weeks ago, when he was 15 MONTHS OLD! He had a coughing episode, and has been wheezing ever since. At the persuasion of his pediatrician, he finally had a chest X-ray, which showed that one lung was blocked. The most likely cause was a nut sitting in his airway, blocking off air from getting to his lung.

His parents agreed to bring him in for surgery to check his airway and remove the nut. I told them that the surgery would be performed through telescopes, so he wouldn’t have any scars or stitches. They were good with that.

I cannot describe the feeling of having a healthy boy’s lips turn blue in front of my eyes, listening to his oxygen monitor drift from the brisk, beautiful high-pitched tone of 100% to the dreaded baritone of 80% or below. I cannot describe the feeling of looking down a perfectly healthy child’s airway and seeing fleshy tissue, blood, and pus, caused by the nut’s oils and chemicals eroding his airway. I cannot describe the feeling of grabbing the rotting nut, only to have it break in half in that eroded airway. I cannot describe the feeling of getting half of the nut out, only to have to go back in to get the rest of it, amidst the blood, fleshy tissue, and pus. I cannot describe the feeling of finally getting the whole thing out, where the entire operating room team breathes a sigh of relief, and the oxygen monitor gently creeps back up to the beautiful trilly soprano of 100%. I also cannot describe the feeling I have when I strongly, yet kindly, tell his parents that all is well, but he should not eat nuts until he’s five, nor should his three-year-old brother, and his father proceeds to try to convince me that his brother is picky, and nuts are healthy.