Doctor Sticks His Finger Where the Sun Doesn't Shine and What Happened to the Patient's Heart Left Everyone Stunned

It sounds like something from Grey's Anatomy, but it happened in real life.

In 2010, Dr Cheng-Huai Ryu, then an internal medicine intern in Queens, New York, published an unusual medical case after a 29-year-old patient's atrial fibrillation (AFib) unexpectedly resolved during a routine hospital examination.

More than 15 years later, Ryu, now Chief Executive Officer of the Texas Center for Lifestyle Medicine, has shared the story behind the now-viral case, explaining what happened and why it continues to fascinate both doctors and social media users.

A Routine Hospital Assessment Took an Unexpected Turn

The case began when a 29-year-old man arrived at hospital after developing persistent heart palpitations while walking home.

Doctors recorded a heart rate of about 140 beats per minute, well above the normal resting range. An electrocardiogram (ECG) confirmed atrial fibrillation, a condition in which the heart beats irregularly and often rapidly. Although AFib is common, it is relatively uncommon in an otherwise healthy 29-year-old.

Because the cause of the arrhythmia was initially unclear, doctors began preparing for cardioversion, a procedure that restores a normal heart rhythm using a controlled electrical shock if required.

The Examination That Changed Everything

Speaking in a recent Instagram video, Ryu recalled that he was assigned to perform a rectal examination after jokingly losing a game of rock-paper-scissors to another intern.

According to Ryu, the examination was performed to check for hidden blood in the stool before the patient received anticoagulant medication, which can increase the risk of bleeding.

At the same time, the patient performed a Valsalva manoeuvre, a breathing technique in which a person bears down while exhaling against a closed airway.

Moments later, the charge nurse noticed something unusual.

The patient's heart rhythm had spontaneously converted from atrial fibrillation back to a normal sinus rhythm. His heart rate fell from roughly 140 beats per minute to around 80, and follow-up monitoring confirmed the normal rhythm remained stable, eliminating the immediate need for cardioversion.

Encouraged by senior cardiologists and department heads, Ryu later published the unusual case in a peer-reviewed medical journal in 2010.

Why Doctors Think It Happened

Doctors believe the most likely explanation is stimulation of the vagus nerve, which helps regulate heart rate through the autonomic nervous system.

Activating the vagus nerve can slow electrical conduction in the heart and, in some cases, terminate certain abnormal heart rhythms. The Valsalva manoeuvre is already used clinically to produce this effect in selected patients with rapid heart rhythms.

In the published case, Ryu concluded that the combination of the rectal examination and the Valsalva manoeuvre most likely produced sufficient vagal stimulation to restore the patient's normal heart rhythm.

However, he stressed that this represented an unusual clinical observation rather than a recognised treatment for atrial fibrillation.

Cardiologist Questions One Part of the Story

As the story resurfaced online, it also prompted discussion among heart specialists.

Responding to Ryu's Instagram video, cardiologist Dr Joel Beachey wrote: 'As a cardiologist who regularly performs cardioversions, I can tell you that a digital rectal exam is not routine before anticoagulating patients for cardioversion — especially not in a 29-year-old with presumably no signs of GI bleeding.'

He added: 'I've never heard of someone doing this, sounds like someone was messing with the intern 😂. Super crazy story and case report though, I've definitely sent this to several colleagues in the past.'

The comment highlights that while the published case itself is genuine, aspects of the patient's management may not reflect standard cardioversion practice today.

A Rare Medical Curiosity

More than 15 years later, Ryu's case remains one of medicine's most unusual published anecdotes.

While spontaneous conversion of atrial fibrillation can occur, doctors emphasise that a digital rectal examination is not a recognised treatment for AFib and should never replace evidence-based medical care. Instead, the case serves as a rare reminder that the heart and nervous system are closely connected, and that medicine can still produce unexpected moments even during routine clinical assessments.