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The reason I love working in the casualty or emergency medicine department is the sheer unpredictability of what will walk through the door. Between skin rashes at 3am and a screwdriver through a hand, you just never know. It just keeps getting better as South Africans keep getting more creative.

I came to this conclusion during a still Sunday morning just before noon. I had just finished mopping up the drunken assaults , the superficial toe laceration while walking home from the pub, and the piece of garlic a 3 year old decided to shove up her left nostril. All was well. No pending discussions, no blood results to follow up and no xrays to review.

I sat down and admired our domain. Often i found myself so busy attending to patients, I missed so many of the finer details of a place i had worked in for months. The glazed green door with the emergency sign. The way the IV trolley was always so chaotic yet so accessible. The makeshift tape dispenser someone had so cleverly created with an ice cream stick. The way the floors would shine after being mopped by the cheerful gogo. I sensed an inkling of pride.

“Is there a doctor here?” I heard a young gentleman enquire. I peered up and ushered him into the empty casualty. “How can I help you sir?

He looked surprised. A look I am all too familiar with.

“Yes its me. I am on duty today. My name is Dr Moosa. You may call me Sabeeha if you wish. I know I look young as I am 155cm’s tall but i can assure you i did go to medical school and I have a copy of my qualifications on my cellphone should you wish to view”

And as expected he looked shocked and confused. I chuckled inside. He then proceded to look extremely uncomfortable and asked if he could be seen by a male doctor. I explained that he would have to wait as I was the only one on duty. I guess patience wasn’t his forté.

Pretty soon he was explaining in explicit detail, how he accidentally wound up in a situation whereby the cap of a coke bottle had made its way up his butthole. For once in a very long while, I was speechless.

So many questions. What possesses a man to allow himself to get into such a situation? I thought of what the don once told me “Always respect the rectum, it can give you a whole lot of crap!”

Yet I felt it safer not to probe. Maybe it was better not to know. The chap seemed well educated and not prone to placing objects where it didnt belongs so I gave him the benefit of the doubt and decided to venture into the rear portal. As usual, I triple gloved.

With the aid of a speculum and lubricant, i was able to visualise the rear. To avoid keeping the gentleman in such discomfort I tried my best to be quick. The cap was lodged deep in the walls of the rear just peeping behind a flap of mucosa. Hidden like a gem. Unwilling to be found. I grabbed the red cap as fast as i could and apologised for the pain.

The sight of the cap allowed him to heave a sigh of relief. He assured me this was a freak accident and he would never be found in such a situation again. On his way he went.

After a few weeks I happened to see him again whilst I was exiting the hospital during my post call period. He waved violently “dr moosa hi hi hi” i waved. Wondering what brought him back this time.

I then met a colleague who was also on his way out and he noticed the greetings we exchanged. “Have you seen this patient before?” He asked. “Yes. Weeks back. Foreign body in a strange place”

He looked amused. “He came back this morning with a piece of cardboard up his crack”

I was too tired to laugh.

He grinned. “In my professional opinion using utmost discretion I can scientifically conclude that we can’t cure stupid”.