The Blue Christmas Case On '9-1-1' Actually Happened To A Woman Suffering Tooth Pain

A woman has a decidedly blue Christmas on the Season 3 holiday episode of “9-1-1” after suffering an alarming reaction to medication in yet another case pulled directly from real-life headlines. 

The episode, titled “Christmas Spirit,” sees the 118 in a decidedly not jolly mood given they have to work on Christmas Day. After all, emergencies don’t stop just because it’s a holiday. Still, things could definitely be worse, as proven by one Los Angeles resident who spends Christmas Eve lamenting to her mother that, not only does she have to work the next day, she’s also suffering from a doozy of a toothache. 

In a fit of desperation and pain, she takes what appears to be a baseball-sized amount of the numbing agent benzocaine. The drug has the desired effect and she’s able to relieve her pain enough to go to sleep. However, when she wakes on Christmas morning, she discovers her skin has turned what she describes as “Smurf blue” (doctors would call it cyanotic, though).

As with many cases on “9-1-1,” the bizarre medical mystery was too strange to come from anyone’s imagination. Instead, it’s based on something that actually happened to a woman in Rhode Island in 2019. 

A 25-year-old woman went to the emergency room presenting with blue skin and complaining of shortness of breath, according to The New England Journal of Medicine. The doctors’ first thought was that she wasn’t getting enough oxygen. However, initial tests showed that, although her levels were low, they weren’t low enough to cause skin discoloration. As if her situation weren't dire enough, when doctors drew her blood, it was a deep navy blue color rather than the usual bright red. 

On “9-1-1,” the members of the 118 arrived at the woman’s home and discovered she had blue blood as well. They also discovered several empty bottles of benzocaine. In real life, doctors realized the Rhode Island woman had taken a large amount of benzocaine to treat tooth pain as well. 

In both cases, the patients were quickly diagnosed with methemoglobinemia. The rare condition occurs when iron in one’s blood changes form and can no longer bind to oxygen and carry it through the body. As a result, the person may not be struggling to breathe, but the body can feel like it is, according to NBC News. On the show, Howie “Chimney” Han (Kenneth Choi) notes it causes the woman’s skin to only reflect blue light.

Although it presents in a silly way, methemoglobinemia can be life-threatening in some cases, prompting the FDA to issue warnings in recent years. Fortunately, there is an easy treatment in a medication that is ironically called “methylene blue.” On “9-1-1,” Chimeny and Henrietta “Hen” Wilson (Aisha Hinds) give the woman the drug and her skin returns to normal in mere seconds. In real life, it took several minutes, but the end result was the same — her skin went back to normal, her oxygen levels balanced out, her blood turned back to red, and she had a really weird story to tell for the rest of her life. 

On “9-1-1” the crew saved the woman’s life, which was enough to make them feel better about working on Christmas Day. However, their friends and family saw it differently. When they return to the station after the odd call, they’re surprised to see their loved ones have set up a festive Christmas dinner for them while they work.

Unfortunately, it’s not all fun and games. In a private moment, Michael Grant (Rockmond Dunbar) confesses to Bobby Nash (Peter Krause) that, after experiencing symptoms he chalked up to stress from his first holiday alone, doctors diagnosed him with a brain tumor. 

So, between a woman’s near-fatal methemoglobinemia, saving her life, a surprise Christmas party, and some bad health news in the family, the holidays at the 118 were a mixed bag at best. 

Rerun episodes of "9-1-1" air every Thursday on USA Network.