Cocaine Bear

We watched this movie on Peacock streaming last night. Its plot is pretty spare. A drug smuggler bringing some 70 pounds of cocaine bricks into the US from Colombia, bails out of a plane over a Georgia national forest. The smuggler falls to his death in a suburban driveway after his parachute fails to open and his emergency chute does little to slow his fall. Adios, MoFo.

A black mama bear finds the smuggler’s duffle bag full of cocaine and proceeds to consume a brick of it. Mayhem and hilarity ensue as the bear, high on coke, comes into contact with various feckless humans including a couple of forest service employees, three teen delinquents, a couple of thugs trying to recover the drugs, a detective and police officer investigating the smuggler, a mom, and a couple of tweens pushing the limits of adolescent independence.

I have to say at this point that I have only used cocaine once in my life. No wait, not like that! I mean that I used medicinal cocaine only once. Shit, that doesn’t sound much better. Okay, here’s the story. When I was a first-year medical resident, my team was called to the emergency room late one evening. One of the Emergency Physicians working that night directed us to an ER bed where a 50-something, white male sat with his head bent over a blood-soaked towel. A Foley catheter dangled from his right nostril, and that nasal passage was stuffed with a tampon. The tampon was still drip, drip, dripping blood.

The ER physician had already tried all the conservative measures to stem the flow of blood with only partial success. The patient’s bloodwork showed a normal blood count and normal platelet count and clotting parameters. What to do?

Epistaxis, nasal hemorrhage, is common in young children and in middle-aged males. I know, there really isn’t that much difference between these two groups. Epistaxis most commonly occurs as a consequence of facial trauma, penetrating injury such as occurs with piercings that penetrate the nasal septum (the midline of the nose between the nostrils), and nose picking. Didn’t I just say that middle aged guys are not so different from children?

Nasal hemorrhage typically comes from injuries to the lining of the nasal septum rather than the fleshy outer portion of the nose (the nasal ala, aka the nasal wing). Injury to the anterior nasal septum (within easy reach of a fingernail) can result in significant bleeding, that is most often controlled by placing an improvised Kleenex tampon in the nasal passage and compressing that nasal ala against the septum. Bleeding from the far posterior part of the septum often goes undetected because the blood drains into the throat. Fatal epistaxis does occur, but it is relatively rare. I have never seen a case.

Our patient sat there, dripping blood, and we gave him a new towel as his had become soaked. What to do? I suggested to my supervising resident that we try nasally administered 4% cocaine solution. This was a maneuver that I had read about but never actually used. My second-year resident agreed that it was worth a try, and we called the hospital pharmacy requesting that they send some cocaine solution to the ER.

Cocaine is a powerful vasoconstrictor – a compound that causes arteries to contract and impede blood flow. Oxymetazoline (Afrin) and phenylephrine sprays work as nasal decongestants in the same fashion. 4% cocaine solution is stronger than the former and comparable to the latter in the concentrations that are used for nasal surgery. The cocaine solution arrived a few minutes later. We removed the tampon, soaked a gauze in cocaine solution, wadded it up, and stuffed it into the bleeding nasal passage. A couple of minutes later, the bleeding stopped, and we removed the Foley catheter. After a period of observation, we discharged the patient with the admonition that if he put anything in that nostril, even a finger, he would likely bleed like a stuck pig. We never saw him again. I want to believe that he did well rather than return home to exsanguinate in his bed. Sigh.

Back to the bear. Cocaine Bear is a creature feature in the spirit of movies like Eight-Legged Freaks and Roland Emmerich’s 1998 Godzilla. It has a high body count with grizzly (pun intended) bear on man violence and more than a few comedic scenes. It is clearly meant as a horror comedy, and it actually works.

I’m sure that if you read my posts, you realize that I have a special place in my heart for gallows humor. This movie really hit the spot. Recommended.