When You Mistake Your Pen for a Tongue Depressor… And Use It Anyway

It starts like this: You’re mid-examination. The clinic is overflowing. You’re two espressos in, running on an empty stomach, and three hours behind schedule. You ask the patient to open wide. Your hand, trained by routine and muscle memory, reaches for what should be a clean, sterile wooden tongue depressor. But no—it's your trusted black-ink pen. Before your prefrontal cortex can scream “No!”, your reflexes have already acted. The pen goes in. Too late.
Welcome to the unscripted, chaotic, and slightly comical world of clinical improvisation—where even the most meticulous physicians are occasionally forced to repurpose stationery. Where fatigue rewrites sterilization standards. And where resourcefulness sometimes borders on absurdity.

This isn’t negligence. It’s survival medicine. It’s real life.

Every clinician has a story like this. Maybe you wrote discharge notes on the back of an EKG strip. Maybe you used a tape roll as a temporary speculum (we’re not judging). Maybe you held open a wound using your own ID badge. Or maybe, just maybe—you used your pen to inspect someone’s throat.

Let’s unpack this moment that is equal parts embarrassing, hilarious, and 100% relatable for any medical professional.

1. The Pen That Became a Tongue Depressor

It’s not glamorous. It’s not hygienic. It’s not ideal.

But it was right there.

You didn’t set out to break the rules. You’ve seen and used tongue depressors so often you could probably draw one from memory. But in that particular exam room—no extra staff, no time, no backup—the drawer came up empty. Your hand reached for what it could rely on: your pen.

“Use the pen. It'll be fine. No one will notice.”

And you did. You used it with the confidence of someone performing a routine exam. Cool. Professional. As if this was exactly how you were trained to do it.

2. The Real Reason This Happens: Medical Madness

Let’s not pretend this is some kind of personal quirk. The culture of medicine teaches us to think on our feet:

Act fast.
Solve alone.
Adapt without delay.
Break a few rules—if it means helping the patient faster.

In this environment, we start using:

Tongue depressors as finger splints,
Suture scissors to cut hair (yes, it’s been done),
Pen caps for pupil reactivity,
Gauze for... absolutely everything.

Medicine turns you into an improvisational expert—whether you like it or not. It’s not just encouraged; it’s often demanded by the pace and pressure of practice.

3. Why You Didn’t Stop Yourself

It’s not that you didn’t care. It’s that your brain went into autopilot.

Checklist complete:
Gloves—on.
Light—working.
Pen—always handy.
Tongue depressor—MIA.

You reached for what was there. Not out of laziness, but out of cognitive efficiency. After all, you’ve used that pen more times than you’ve used a proper tongue depressor this week. It felt familiar. Reliable. Like an extension of your hand.

At that moment, the pen became a clinical instrument—questionable sanitation aside.

4. The Moment You Realize What You’ve Done

There’s always a pause. A few seconds. Then, reality dawns.

Maybe it’s the patient’s puzzled expression.
Maybe you catch yourself in the reflective glass of the otoscope.
Maybe you notice the ink on your glove.
Or worse—your nurse walks in and stares in disbelief.

“Wait… did you just use your pen?!”

You stop. Blink. And internally panic:

“Did I seriously just do that?”
“Is this malpractice?”
“Do I sanitize the pen or the patient—or both?”

Then, in true doctor fashion—you brush it off and continue. Because stopping is a luxury you don’t have.

5. The Doctor’s Toolkit: Controlled Chaos

In an ideal system, all the tools are exactly where they’re supposed to be.
In the real world?

The otoscope battery is dead.
The thermometer is missing.
The tongue depressors are “on backorder.”
And the supply drawer is full of latex gloves and regret.

So you make it work. You adapt. You create a makeshift solution from the random contents of your coat pocket. You discover your reflex hammer works well as a doorstop. You find expired saline makes a decent lens rinse. You find a pen… well, it’s not a tongue depressor, but it works.

The real tools of medicine aren’t just in the drawer. They’re in your brain—wired by years of repetition and stress.

6. Improvisation or Infection Risk? The Ethical Line

Let’s be honest—this is where it gets dicey.

Improvising in a tight spot is one thing. But cutting corners at the expense of hygiene or safety? That’s a problem.

Every doctor walks a tightrope between:

Practicality and protocol.
Speed and safety.
Innovation and recklessness.

But know this: no doctor does this because they want to. These slip-ups are symptoms of a system stretched too thin. A moment of fatigue. A lack of support. A broken chain in the supply cycle.

It’s not the habit—it’s the exception. But it shouldn’t be the norm.

7. The Patient’s Perspective: Did They Notice?

Chances are… yes.

Maybe they didn’t say anything. Maybe they didn’t want to know. Or maybe they genuinely believed:

“She’s a doctor. That must be a medical pen.”

Patients often extend us a level of blind trust that’s both touching and terrifying. They believe we know what we’re doing—even when we’re obviously winging it.

But that’s why it matters. These small moments, where professionalism teeters on the edge, shape the trust patients place in the entire medical profession.

Next time, if there’s any chance to grab the real tool—take it. Because while patients are forgiving, they’re also observant.

8. Other Objects Doctors Have Used Improvisationally (Real Confessions)

Coffee stirrers for throat swabs
Dental mirrors for eye retraction
Penlights as reflex hammers
Stethoscopes for scratching unreachable itches
Clipboard corners to test reflexes
Exam gloves to collect urine (you had to be there)
Old ID cards for splinter removal
Gauze wrapped into anything imaginable

You’re not alone. We’ve all done something. There’s a creativity in medicine that isn’t always applauded—but is undeniably present.

9. The Humor That Keeps Us Alive

These stories aren’t in peer-reviewed journals. But they’re in every resident’s group chat. Every coffee room confession. Every “You won’t believe what happened today…”

They’re a coping mechanism. A reminder that while we carry immense responsibility, we’re still fallible. Still human. Still capable of laughing at ourselves, even if it’s through a face mask and exhaustion.

The pen-as-depressor isn’t a scandal. It’s a symbol—of how hard we work, how tired we are, and how deeply imperfect this job can be.

But also, how resilient we remain.

10. Final Thoughts: Keep Your Pen. But Use the Real Tool Next Time.

You used a pen in place of a sterile tongue depressor.
Yes, it was an improvisation born of necessity.
Yes, you know better.
Yes, you’ll laugh about it later—hopefully in good company.

But here’s what really matters: You kept going. You didn’t freeze. You found a way to complete the exam.

Just don’t forget this moment. Let it be a funny memory—and a reminder to keep your supply drawers stocked.

Because medicine isn’t a tidy profession. It’s not always textbook. But it is about rising to the moment, even when the moment hands you a pen instead of a proper tool.