The word sloth comes to mind, whenever I think about this next job. It is often one of my favourite stories to tell whilst I’m teaching first aid to my students, and it’s funny to see the facial expressions that the story can generate in people.

In many of the cases of choking that we are called to, the patient usually manages to clear the obstruction before we get there. This time however, the patient still had the obstruction present.

The job was over in Toongabbie, in an area where there was a high density of housing commission occupancy. The house we were responding to, was one of those number. The large percentage of home occupants, keep a very orderly, and a well maintained house, and this is represented by maintained lawns, and neat appearance of the house. This particular address, was not one of those.

The yard was overgrown with long grass, with it growing up through the wire mesh fence, almost like a hedge. There were remnants of bicycles in amongst the grass, and an old car body taking pride of place up near the front of the house. The car in the driveway had multi coloured panels, a peeling vinyl roof and at least 2 bald tyres on the drivers’ side as we walked past it. This was looking good. These things we notice, can often give us an indication of what you are going to get on the inside, and in this case, we were spot on.

The front screen door had the wire hanging off it from the bottom half, and the front door was wide open. I knocked on the door jamb, and was rewarded with a partially shouting voice, “he’s in here”.

We stepped on through into the gloom, and were met with a sight that completely strips you of any hope for the human race in general.

Mum was a grossly overweight woman, probably in her late thirties, and sitting next to her was a young boy who was following in her deep footsteps towards obesity. Both had TV dinner trays on their lap, with what looked like takeaway chicken dinners being consumed. In the corner opposite the door, there was a male, I’m assuming the partner and father, obviously choking. His face was becoming cyanosed (blue colour tinge to the skin), there was saliva dripping down his chin, onto his dinner tray, and he had eyes on him like a scared cat, wide open and pleading for help. He was not a small man by any standards, but when he tried to breath, there was a peculiar, faint gurgle sound. He had about four empty beer cans on the table next to him.

I immediately asked the wife what he was eating, and she said, “just his bloody food, he never chews his bloody food”. By this time, he was becoming very fatigued, which in a way was better for us, as he wouldn’t be as combative when I started to investigate his airway.

I got a Guedels airway (commonly known as an Oro-Pharyngeal Airway) and placed it sideways between his teeth to stop him biting, as I shone a torch into his. I could see, what I could only guess, was a piece of meat at the back of his throat, and made my mind up that this was his problem. It was then that I realised that he only had a couple of complete teeth in his mouth, as the rest were either missing or decayed. The stench from his mouth was something to write home about.

I had a couple of attempts to get the meat out, but it seemed wedged fairly hard. I still don’t know to this day, how he remained conscious as long as he did. Maybe his brain was used to working with little oxygen, or just maybe it was used to not working. You choose. My partner had gotten the Soft Bag Resuscitator out of the oxygen equipment, and applied it to his face, and tried to assist with a couple of ventilations to oxygenated him a bit. While they met some resistance from his airway, we believe we may have gotten a bit of oxygen in. I knew he was in a bad way, as he didn’t even fight the mask on his face. I didn’t really want to resuscitate him, as he was a big boy, and would be exceptionally heavy, and very difficult to manage.

To get a proper grasp on the obstruction, I needed to grab the meat firmly, further down, so I took hold of it as far down as I could, squeezed the Magills Forceps as firmly as I could, and tried to pull. I succeeded in budging it, then suddenly, it started to come up. There was quite a lot of movement of the throat muscles as I tried my best to move it. Yes! As I pulled it, it kept coming out, and out, and out. You are kidding me! I pulled a full piece of steak from his throat, the only things missing were the tail and the horns. At that, he took a couple of gasping breaths, and vomited all over himself. There was a torrent of mashed up potato chips, some of them still whole where he had apparently wolfed them down before his steak, and it seemed to be mixed in with beer. A lovely mixture.

My partner was trying to assist the guy by placing the oxygen mask over his face, as he was no doubt hypoxic from the partially blocked airway, but he simply batted it away from his face, saying “f##k off with that thing”. I just realised what I still had in my hand, half a cow, and became so sickened by what I had just seen, that I just let it drop onto the floor. The patients wife immediately asked why I just dropped it on the floor, because how can he finish his dinner now?

My partner and I just looked at each other in amazement, and I asked the patient if he wanted to go to the hospital. He replied that he was just going to finish his dinner, as he sat there in all of his own vomit. We took that opportunity to quickly gather our gear together, and gave the advice to call if anything changes, and we got out of there as quickly as we could. We walked out to the ambulance, and instead of cleaning and restocking all of the gear, we placed it in a blanket on the floor, and radioed the Coordination centre that we needed to return to station to clean and replace gear. We were given the all clear to return thankfully, as the least time we spent at that address, the better off we’d be. As we drove back to the station, my partner asked if I noticed the woman and the child, to which I said no, as I was concentrating on the guy, and that was when he told me that they didn’t even bother to look in our direction once while we were there. They just watched the TV, the whole time.

The return trip only took about fifteen minutes, and we pulled into the station. I started the paperwork, as my partner started on the clean up. Normally I would do my paperwork in the ambulance, but this time I needed to get away from the mess, so I went into the meal room, to sit down at the table. Whilst I was in there, I casually mentioned to the other officers there about the job we had just done, and that was when one of them asked if it was a blue fibro house with a car body near the front of the house. I stopped what I was doing, and just looked at him. That was when the bomb came down. He said he’d been there before for the guy choking on food. He doesn’t chew anything, and just swallows it whole, but he gets too drunk on beer, and can’t swallow and chokes. Again, getting in the way of natural selection. It is so sad to think that that poor, overweight child, will not grow up knowing anything different, and is probably the butt of a lot of ridicule at school because of his size. The parents never seem to give much thought as to what goes on outside their habitat.