Tale of the Rambutan

Scary how this sweet, round ,slippery delight of a fruit could put you on the ventilating machine. On my last duty, we had this patient who was rushed to the ER cyanotic and gasping for air after eating rambutan (Nephelium lappaceum). My co-resident immediately intubated him, finding a big piece of the fruit stuck in his trachea. Good thing it wasn’t deep enough so the intubation blade was able to dislodge the fruit, enabling air to pass through once again. But it was too late. His brain has suffered a few minutes of hypoxia (lack of oxygen delivery), hence causing a part of it permanently damaged. It could have been avoided had someone perform the Heimlich’s maneuver at home.

See, the patient was recently discharged from another hospital weeks ago, treated for stroke. He was confined at the ICU that time, narrowly escaping death. However, luck wasn't on his side when the perils of the normally harmless rambutan caught him. His recent stroke had something to do with his inability to swallow properly. Usually, post-stroke patients are advised soft diet or nasogastric feeding until their swallowing function improves.For some reason, he enjoyed eating the fruit too much that he accidentally swallowed it whole.

A few hours after admission, the ICU nurse referred the patient to us for seizures, a manifestation of the hypoxic injury to his brain. With that, we knew his chances of survival were slim. The next day when I was logging out from my 24 hrs duty, he was still holding on to his dear life. If he does survive, he’s a vegetable, that’s for sure. (digression: odd how a fruit can turn you into a vegetable). I haven’t gone back to duty and I’m not sure whatever happened to him, most likely, he’s dead. It got me thinking how in a snap of a finger, practically anything you do, even something as trivial as eating, can bring you face to face with the angel of death. Life, indeed is short.