I recently saw a website that reported, “A 36-year-old California man recently coughed up part of his lung after being hospitalized for heart palpitations. During the first week in the intensive care unit, he coughed up blood and sputum frequently, but one cough was worse than the other. He coughed up an intact piece of the right bronchial tree, an intact piece of the bronchial tree that has some ducts that carry air to the lungs. Yes, he coughed up part of his lung.” The summary at the front of the report reads, “It turns out you really can cough up a lung, or at least part of a lung.” In fact, this patient report is from the New England Journal of Medicine [1]. The story is about a 36-year-old male California patient who was admitted to the intensive care unit with an acute exacerbation of chronic heart failure. The patient had a history of mitral valve replacement, intra-aortic stent implantation and a permanent pacemaker. He was treated with a ventricular assist device for severe heart failure and required systemic anticoagulation therapy. In the following week, the patient developed small amounts of hemoptysis and progressively worsened dyspnea, and in a fit of violent coughing, the patient coughs up a clot like a right bronchial tree. The human lung is like an inverted tree, with the trunk to the branches being the bronchi and the alveoli being the leaves of the tree. The bronchial tree is wrapped in connective tissue, which holds the bronchial tubes in place like armor. Therefore, it is impossible to cough out part of the bronchi or lungs even with a violent cough. However, if the bronchial tree is filled with blood clots or sticky sputum, these clots or sputum will form a bronchial tree-like shape, and when you cough vigorously, you may cough up a bronchial-like blood clot or sputum plug.