I recently visited the Glore Psychiatric Museum in St. Joeseph, MO… this was a highlight of my trip.

The contents of a patient who suffered from “Pica” (an imaginative arrangement of 1,446 items swallowed by a patient and removed from her intestines and stomach. She died during surgery from bleeding caused by 453 nails, 42 screws, safety pins, spoon tops, and salt and pepper shaker tops).

Pica is characterized by an appetite for substances largely non-nutritive, such as clay, chalk, dirt, or sand.^[1] For these actions to be considered pica, they must persist for more than one month at an age where eating such objects is considered developmentally inappropriate. There are different variations of pica, as it can be from a cultural tradition, acquired taste or a neurological mechanism such as an iron deficiency, or chemical imbalance. It can lead to intoxication in children which can result in an impairment in both physical and mental development.^[2] In addition, it can also lead to surgical emergencies due to an intestinal obstruction as well as more subtle symptoms such as nutritional deficiencies and parasitosis.^[2] Pica has been linked to mental disability and they often have psychotic comorbidity. Stressors such as maternal deprivation, family issues, parental neglect, pregnancy, poverty, and a disorganized family structure are strongly linked to pica.