It was, we can safely assume, a rude awakening for Alexander P Broughton, when he eventually regained consciousness on the morning of Sunday, 23 September. The 20-year-old student must have been bleary-eyed, sore of head, and highly confused: his normal bed-sheets had been replaced with the crisp linen of the University of Tennessee Medical Centre's emergency ward.
At some point, as Broughton pieced together the events of the previous night, some more pressing problems will have emerged. Firstly, he was now the subject of a police investigation. Secondly, he was about to gain viral media notoriety. And thirdly: what was that stabbing pain in his backside?
Later that day, local newspaper reporters learned that Broughton had been rushed to hospital shortly after midnight with a blood alcohol level of 0.448 per cent, more than six times the state's legal drink-driving limit. Injuries to his rectum led doctors to believe he'd been forcibly sodomised.
Police said they'd raided the Pi Kappa Alpha fraternity house where Broughton lived. They found dozens of empty boxes of wine, several lengths of rubber tubing, and some extremely intoxicated young men who were under the legal US drinking age of 21.
After interviewing witnesses, detectives concluded that the fraternity had been staging what is known as a "hazing" ritual. Participants, they believe, were required to consume large quantities of wine through a home-made enema constructed by placing a rubber tube in their anus. The process is known as "butt chugging."
Reports of the incident spread like wildfire across the internet. And this being America, a lawsuit wasn't far behind. In a bizarre press conference this week, Broughton announced that he was considering legal action against his university, the hospital, and local police, for (allegedly) leaking what should be private medical information.
Though memories of the night remain hazy, Broughton also denied "butt-chugging." He said: "I would never do such a thing. I am a Christian who would never desecrate my body in that manner. To do so would be against God's law." He added that media reports had implied he was gay, a charge he vigorously denies.
This amusing (if probably inconsequential) case sheds light on a famous and sometimes tragic American social phenomenon. It's widely known as "hazing," and involves would-be members of university sports teams, social organisations, or the independent "fraternity" or "sorority" houses where many male or female students live, taking part in highly-unpleasant formal initiation procedures.
Hazing is intrinsic to the undergraduate social culture celebrated by such films as the 1990s comedy Frat House, and Will Ferrell's Old School in 2003. Participants, known as "pledges," are typically required to drink to hideous excess, while being publicly humiliated. For men the process usually involves bodily fluids, and heavy physical activity. For women, the bullying tends to be more psychological.
"There's one well-known ritual where new members of a sorority are required to stand in their underwear," says Stephanie Kaplan, of the student website HerCampus. "Older members will then draw with marker pens on parts of their bodies that they think are too fat."
All of which may sound like playground stuff. But hazing can have tragic consequences. Hank Nuwer, a Franklin College academic who is perhaps the world's leading authority on the subject, says there have been 106 recorded deaths from the practice, including at least one a year from 1970 to the present day.
"Students seem to want a rite of passage, even if it is bizarre or stupid. We all want to belong as humans, particularly if we are young or insecure," says Nuwer, the author of four books on hazing. A recent University of Maine study found that 54 per cent of the nation's young people had taken part in hazing. "Even after a tragedy, they tell themselves that they went through something noble, worthy, or exclusive."
Recent months have seen high-profile casualties from the practice. In a case now wending its way through the court system, Robert Champion, a 26-year-old member of the Florida A&M University's marching band, was killed during a hazing ritual that required him to crawl through a packed bus, while being attacked by colleagues wielding fists, feet, and drumsticks.
An autopsy showed he was beaten to death. Fourteen people have been arrested and face criminal charges in relation to the incident. And a wrongful death lawsuit has been filed by Champion's parents.
This week saw a legal action filed by the parents of Victoria Carter, a student at East Carolina University who died in a car accident in 2010. Her parents allege that she was killed because the driver of the vehicle had been deprived of sleep for days during the Delta Sigma Theta sorority's "Hell Week" of hazing.
Carter and another victim in the accident were physically exhausted. All week, they'd been forced to wear "Delta Lipstick," or Tabasco sauce rubbed on their lips, the lawsuit alleges. They had also been required to exist on a diet of "Delta Apples," or large raw onions, and cottage cheese.
To proponents, the stomach-wrenching rituals are harmless fun. In the rare cases where tragedy ensues, victims are adults who took part willingly, they say. Many supporters will also claim that hazing forms part of a grand human tradition, stretching back to ancient Carthage and perhaps perfected in British public schools of the Victorian era, where the system of "fagging" was best chronicled in Tom Brown's Schooldays by Thomas Hughes.
The first recorded US case was in 1657, when one Joseph Webb was expelled from Harvard for an unspecified hazing practice. The first known death in the US came in 1877, when a Cornell undergraduate called Mortimer Leggett, the son of a Civil War hero, fell down a ravine in upstate New York, after being made to walk the region while blindfolded.
To this day, it endures at many Ivy League universities. This year a Dartmouth student, Andrew Lohse, found himself suspended from both his university and his fraternity house after writing a detailed screed against the practice in an editorial for the college newspaper. "I was a member of a fraternity that asked pledges... to: swim in a kiddie pool of vomit, urine, faecal matter, semen and rotten food products; eat omelettes made of vomit; chug cups of vinegar, which in one case caused a pledge to vomit blood; [and] drink beer poured down fellow pledges' ass cracks," he said.
There is, however, growing public disquiet about the tradition. Over the years, high-profile deaths have seen laws passed that now forbid hazing in 44 states. On paper, hazing is also banned by almost every university, although many are accused of turning a blind eye to it.
David Stollman, the founder of hazingprevention.org, has been touring campuses since 1994 attempting to persuade students to forego the practice. "I've spoken at over 500 universities," he says. "Tolerance is declining. And the seriousness is declining. But there's still a death somewhere every single year."
Ultimately, it may fall to the nation's political leaders to stamp out the practice. Moved by the death of Robert Champion, Florida Congresswoman Frederica Wilson is introducing a bill to remove Federal funding from students who take part in hazing. "When did it become a tradition to beat each other and torture each other?" she asked, when unveiling it last week. "Hazing is dangerous. Hazing is deadly."
Case studies: Student deaths
Matthew Carrington (2005)
A student at Chico State University in California, Matthew Carrington was frogmarched into a cellar and told to perform press-ups in raw sewage while drinking excessive amounts of iced water. After several hours, he began urinating and vomiting. Eventually, he died. A post-mortem revealed he had suffered swelling to the brain, seizures, and a heart attack. But members of his fraternity failed to call emergency services for more than an hour.
Gordie Bailey (2004)
Bailey was 18 when he was blindfolded by senior members of the University of Colorado's Chi Psi fraternity and driven into the mountains. He and 26 fellow "hazees" were given 30 minutes to drink seven litres of whisky and nine litres of wine. After returning home, Bailey fell unconscious. Homophobic slogans were then scrawled on his body in marker pen. The next morning, he was found dead, from alcohol poisoning.
Kenitha Saafir and Kristin High (2002)
After spending hours, after dark, doing callisthenics on a Los Angeles beach, in their underwear, the two members of a Cal State University sorority were told to walk backwards towards the sea. They were knocked over by a wave and – being physically exhausted – both drowned.