Weird/Horrifying Science Friday: Choking on Toilet Paper

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I sincerely hope that none of you out there have ever had thoughts of suicide or death. Suicide is never funny, please don’t do it, and if you ever do have thoughts of suicide or death, please talk to a professional about it. Do not suffer in silence.
This Weird Science is mostly just…weird. I was looking through some of the articles from A Good Poop, and I saw this and went…no WAY.
I’d like you to take a minute, look around, and think of what things around your home could be used to kill someone/yourself/cause severe trauma. Say your home is being invaded by flesh eating zombies and you have to defend yourself. The things most people hit on would be:
1) The knives in the kitchen. Sharp, you always see people trying to defend themselves with them in horror movies. But no good against zombies.
2) Rope or a belt. Everyone’s seen someone hang themselves with a belt in the movies, or heard about it. And you could whip the zombies bloody, or tie them up, or something.
3) Chemicals under the sink, medicine in the cabinet. Bleach is deadly to zombies. Also anything to make them clean. Have YOU ever seen a zombie wash his hands before eating?
4) A gun (if you own one). Completely ineffective against the zombies.
So how many of you looked and thought….the toilet paper!


Sauvageau, A, Yesovitch, R “Choking on toilet paper: an unusual case of suicide and a review of the literature on suicide by smothering, strangulation, and choking” the American Journal of Forensic Medicine and Pathology, 27(2), 2006.
So suicide by asphyxia, cutting off air, is pretty rare, though you see it in movies a lot. Some guy in the movie is desperate and in jail, hangs himself by his own shoelaces, etc. Strangulation by hanging, or more rarely by ligature (something you would wrap and tighten), which was the lengendary method of murder used by thugees in Imperial India.
Smothering is a bit more rare than strangling. Most commonly, air is witheld from the outside, like smothering in a plastic bag (which always reminds me of that movie, Igby Goes Down, and gives me the shivers). The authors cite case studies of a man who wrapped his head in tape, several former Israeli armed servicemen who smothered themselves with Israeli gas masks, and a psychiatric patient who apparently smothered himself in his own pillow entirely without outside assitance.
Obviously, this isn’t something that everyone does, and I really hope that people never ever do this again. Every case mentioned in the case report is someone who was diagnosed with severe schizophrenia, and usually someone who’d had at least one previous suicide attempt. And with a lot of these, whether or not it is suicide is very up in the air. One man who choked with tissue paper in his mouth had been killed by his roommate at the psychiatric institution. It’s something that is so difficult to do by yourself that very very few people do it.
The current case was no exception. Diagnosed with schizophrenia and medicated for half his life, he was found in the bathroom, with a mouth full of toilet paper. He had stuffed it entirely down his throat and completely blocked off the airway. The oddest thing about it is that the patient had a pocket full of expired psychiatric medications, many of which were barbiturates, and which could have taken him out fairly quickly. Autopsy revealed that he had taken none of them. Apparently he had attempted something similar before, but how can you keep someone away from toilet paper? Or any paper? Or cloth?
So next time you’re in the bathroom (perhaps taking a good poop) treat the toilet paper with respect. It could kill. Now I’m thinking up ways to use it against flesh eating zombies. Stuff it in their mouth? Wrap them up in it mummy-style? Zombies shamble a lot, so maybe use it as a tripwire…
Anny Sauvageau, Rose Yesovitch (2006). Choking on Toilet Paper The American Journal of Forensic Medicine and Pathology, 27 (2), 173-174 DOI: 10.1097/01.paf.0000203269.97907.a7

5 Responses

  1. When I was an undergraduate, a fellow student took his own life by taking a sizeable dose of a sleeping medication, then putting a large plastic bag over his head. That particular combination- where the sleeping drug prevents you from waking when carbon dioxide levels rise – is apparently unusual but not unheard of. Not sure if that counts as smothering or not, though.

  2. Suicide is not always unwarranted, and for those times we really need a medically sure, safe and painless mechanism. Unfortunately our society’s unwillingness to deal with this means that people try some pretty disastrous technique.

  3. j-t: I would never, ever encourage suicide. And it’s very obvious that, in these particular cases, there were severe psychiatric problems, and the patients were not in their right minds. There may be some times when suicide is warranted, but those situations could only occur is a patients is sound of mind.
    Janne: Yikes. I’ve heard of that combination. I’m so sorry.

  4. Never having felt in the least suicidal, suicide stories, except in cases of extremes like horribly painful terminal illnesses or immanent more-hideous-than-suicide death, have always made me feel exceedingly squeamish.
    Suffocation by any means seems just so dreadful, but there always seems to be some poor individual who one-ups the worst you can think of. I haven’t been able to forget an incident I read about sometime in the past couple of years, of a person who committed suicide with yet another household item. He used superglue to glue his lips together, then similarly blocked his nostrils.

  5. Think outside the roll – remember those commercials with the puppy slipping going around the corner and hitting the bumper of toilet paper? It’s soft, squishy zombie repellent. Add it to the outside of a shield and your battering ram is good to go.
    I know this does not address the article in any thoughtful way, but given the previous comments I felt that I had to say something frivolous.

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