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The case of a fish hook in the eye

Triage Note: Fish hook in eye. No bleeding. Tetanus up to date.

It’s a sunny weekend during cottage season. A young woman is rushed into the ER as she cups both hands over her left eye. She’s in shorts, and flip-flops, and she’s hyperventilating. Her friends follow, hands similarly cupped over their mouths. I read the triage note. I’ve never seen this before. I’ve removed dozens of fish hooks — it’s one of my favorite things to do — sometimes challenging, and instantly satisfying. I’ve removed many fish hooks around the eye, but a puncture of the globe itself would need exploration in the operating room.

A fish cannot lie on its back. Well, maybe a shark can lie on its back, if you tuck the famous fin to one side. But the pancake-flat fish one usually catches with a line and lure cannot lie on its back. After having fished — once — I now know this to be an evolutionary trait. It was several years ago, at a lakeside resort north of the city. I was given a fishing rod, a small tin, and a life jacket. When I realized that the tin was packed with live worms that I’d have to murder via penetrating trauma, I did what any self-respecting physician would do: I asked my mother-in-law to impale the tiny serpents. After the line was cast, and the critically-injured invertebrates had drowned, I took control of the fishing rod. I didn’t have much hope, but my four-year-old was confident: If we waited long enough, we’d catch something. Sadly, he was right.

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