At a time in everyone’s life, we come to find ourselves in a situation where the music stops, and we must go on.  The unfortunate truth about life is that the unexpected will happen. Some of us learn from it, some of us change because of it and some of us find our life’s calling because of it. The latter was the case for me.  After our dad picked us up from middle school, we spent that afternoon like we had every afternoon that month. We went to the oncology unit at the hospital, where my brother was admitted.



I remember him. I remember the man in the dark blue sarong the same way I remember the lines on back of my own hand. He was hunched over next to a column on a dirty platform at a railway station in Calcutta, India in the middle of the harsh summer sun. His hands were withered, his fingers and toes looked like tiny nubs, and he was completely malnourished and alone. He had opaque blue eyes, as if fog had taken place of his irises and pupils.



I studied insects in college; my favorite insects were the bees (I found them diligent and so helpful to humankind).  One of my favorite classes was about medical diseases caused by insects. My professors noticed my interest in the medical side of things and connected me with a professor who did clinical research. Our work focused on a clinical trial for children with intractable epilepsy and exposed me early on to patient care and patients.


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 It was anterior and mobile, the two criteria that made me confident it could be taken out then and there.

I asked the child if he wanted the fist back. This was met with an emphatic, "Yes!", as he raised the action figure. His mom came over and slid her hand gently up and down his back. His dad congratulated his son on his bravery, telling him Iron Man would be proud. The child agreed to close his eyes and began singing his favorite song at my instruction. I gently slid a curette behind the object and with one swift motion popped it onto his lap. He screamed and pulled away from me but the deed was done. I picked up the fist, washed it off in the sink and placed it back in its rightful place. The child shook off his shock from the removal and slowly placed his arms around my neck, bracing me in a hug for saving Iron Man. I glanced over to his parents who were equally appreciative. Their 12-hour ordeal was finally over.

Removing a nasal foreign body is not curing cancer. While I am confident he will not place Iron Man's fist anywhere near his nose ever again, this experience will play a very small part in a long and healthy childhood. In a few months his visit to the emergency room will be a small afterthought in the entire family’s mind. However, that day I got to be a superhero. The immediate impact on a child and the family at large is one of the reasons I became a surgeon. In the simplest terms a surgeon assesses a problem and then does something to fix it. The act of "doing something" and the effects of those actions are what I truly love above medicine. This one small act allowed me bridge the gap between the child I used to be and the surgeon I have grown into. I won’t soon forget it.  

It is not often you get the chance to meet a celebrity in the emergency department, especially at 2 a.m., and when that opportunity arises you must seize it. When Iron Man strolls through the door notice is taken. As a child I was fascinated by superheroes. Superman, Batman, Iron Man, Wonder Woman; my appetite was insatiable. I felt a connection to these figures, wishing I was only a radioactive spider bite away from saving the world.

That sense of wonderment and enthusiasm was what I saw when I first walked into emergency examination room 14. A five-year-old child clutching an Iron Man action figure. Moving his arms and legs up and down the bed, fighting invisible foes. He barely noticed me as I strolled into the room and began my usual questioning of the parents. He had been transferred to the University of Kentucky for a nasal foreign body. My curiosity could not be contained and I asked the parents what I would be looking for in the child's nose. He sprung to life, waving Iron man in my direction, and yelled, "Iron Man's fist!"

This was not the first attempt at removal and the child was understandably wary of anyone who remotely resembled a healthcare worker. His parents relayed the harrowing story of an attempted flushing out of the foreign body in Hazard, Kentucky. From their description the child was nearly tortured to no avail. They then traveled to London, Kentucky for another attempted removal. This time he was held down forcibly and multiple attempts were made to slide a foley balloon past the object and drag it out.


This was successful in creating a nosebleed, but unfortunately the object remained.

I have taken multiple strange and wonderful objects out of children’s nasal passages. Beads, buttons, magic grow super snakes; anything imaginable and can remotely fit. However, this young child yearned to make his superhero whole again. He glanced my way and calmly stated, "Mister, can you give me his missing hand?" Upon glancing back at Iron Man he began crying.

Five-year-old children can be challenging patients. They are too strong to be forcefully held down and too aware to be tricked. They have a heightened sense of adventure that is only matched by their sense of fear. As with all my patients, I had to earn his trust before attempting to restore his toy to its original glory. I needed to visualize the foreign body and that required placing a small scope in the child's nose. I allowed the child to look through the scope, feel the tip, understand that this piece of equipment he had never seen posed no real threat. Once he understood he allowed me to insert the scope gently into the left nasal passage. Nothing was seen. I then inserted the scope into the right nasal passage. A red, fist-like object was well visualized. I touched it with the scope.


Michael Kaufman, M.D., attended Emory University for his undergraduate education where he majored in neuroscience and behavioral biology and played on the varsity tennis team for four years. I completed my medical degree at Wayne State University in Detroit, Michigan. He is currently an Otolaryngology Head and Neck Surgery resident at University of Kentucky Medical Center.