Such was the case recently at a military hospital in Bagram Air Base in Afghanistan. Lieutenant Colonel Anthony Terreri was checking a patient's CAT scan when something caught his eye.
"I sat down and started to adjust the contrast on the CT scan, and I noticed that the inside of this device was not solid metal at all," said Lt. Col. Terreri.
It wasn't shrapnel at all. It was part of a bomb. Five grams of a live explosive round were lodged in a bone just under the patient's scalp.
"It essentially looks like a large bullet," said Major John Bini, 455th Expeditionary Medical Group.
The trauma team's director evacuated the operating room and turned off all electronic devices that could set off the explosive. Just two doctors and a specialist from the bomb squad remained in the room.
"The operating room usually has its natural sounds that go along with it," said Major Jeffrey Rengel, 455th Expeditionary Medical Group. "With everything unplugged, my monitors were turned off, so I didn't have the constant beeping of the patient's heart rate. There was an uneasy quiet. I would lie if I said I wasn't nervous. I certainly thought about my wife and kids and said a quick prayer."
Without electronics, he resorted to counting the drips through the IV to gauge when the patient was ready for surgery.
"When it was time to actually go into the operating room, I did have kind of a little nervous moment, and was about ready to tell somebody to tell my wife and kids that I love them, but surgeons are kind of a superstitious lot, so I thought it was better to keep my mouth shut," said Maj. Bini.
Ten minutes later, the explosive was handed off to a member of the bomb disposal team.
"Their advice to me was 'Just don't drop it,'" said Maj. Bini.
"When I talked to my wife about it, I made light of the situation," said Maj. Rengel. "I knew this was very unique and hopefully, not likely to encounter this again. They worry enough about us over here, the less we can add to that the better."
"I try not to let them know about stuff like this," said Maj. Rengel. "I did actually mention this to my wife and her reaction was, 'Don't tell me stuff like that.' She says, 'I'm worried enough about you being over there.'"