Enjoy your Steak

Since the beginning of time man has procured food through hunting and gathering. Whether they were taking down a wooly mammoth, cultivating a vegetable garden, or shopping at a mega warehouse store with millions of products people find a way to feed themselves. Sadly, for a significant part of the population hunting and gathering involves panhandling food on streets, visiting soup kitchens, and, when everything is closed and people are off the streets, scouring alleys behind restaurants to locate discarded tidbits.
A year ago I had a 50-ish year-old homeless person arrive in the ER in acute respiratory distress. She was quite anxious, frothing at the mouth, turning blue, and really working hard to breath. All she could say was that she had got “a piece of steak stuck in my throat”. After I alerted the pulmonary specialist that we may need to scope this patient, I prepared my crash cart, gave the patient some sedatives, and went hunting for the offending piece of food with my laryngoscope. I didn’t have to look far; I discovered something lodged in her esophagus partially obscuring her windpipe. I quickly grasped it with some forceps and, to my amazement and the entertainment of all the staff that were present, I proceeded to withdraw an enormous chunk of slimy, grisly, fatty meat that did not in any way resemble a steak. The patient immediately felt better and her respiratory status improved. She was able to describe that she found this hunk of discarded meat while “dumpster diving” behind a restaurant. Since it was too gristly to chew with her 4 remaining teeth she had attempted to swallow the 5 inch piece of meat whole thinking it would be digested in her GI tract. It was an interesting theory but a dangerous practice. On more the one occasion I have had to code a patient who turned purple, passed out, and arrested at restaurants or in their home. I have attempted to put breathing tubes down patients’ windpipes to ventilate them during the code only to find large hunks of poorly chewed food, often steak, clogging their airways. After removal and ventilation their color would improve, but typically after suffering prolonged periods with no oxygen they would not regain cardiac function and I would have to pronounce them dead. Point is if you’re gonna enjoy a steak then do it slowly by chewing well before swallowing, and, just in case your enthusiasm overcomes your common sense, have your family trained to perform the potentially life-saving Heimlich maneuver. Oh yeah- if you only have 4 teeth then stick with soft food!