John sat in the chair of the exam room as the doctor tapped on the keyboard, entering his notes and sending off the e-prescription for his patient’s allergy medicine. John had just moved to the area for work and was fortunate to find this doctor not far from either his office or condo. He was glad to be able to get a quick appointment to get his allergy prescription refilled as the pollen and dust in the area were really bothering him recently. It was a solo practice office, which the older doctor had occupied for what seemed to be many years: kind of a “Marcus Welby MD” style older office with nice, albeit dated, pictures and furniture. It even had a nicely weathered wood sign hanging above the front door that read: “James Anderson, MD. Family Practice” The only thing that seemed modern about the office was the electronic medical record.

In a way, the more old fashioned practice helped to calm John’s nerves a bit. He was super anxious—maybe even a little scared—of the doctor. John was a handsome, young man and definitely had nothing about his body to be ashamed of however being the “center of attention” in an examination had always been super stressful for him. A nice, fatherly-like doctor made it a little easier for him to get the nerve up to make the appointment. John had gotten the recommendation from a friend after he had moved to the area. “He’s a super nice guy. Careful and really smart, I never feel rushed. Easy to get appointments there,” his friend said. John did his normal, thorough due diligence that he applied to any decision in his life. He looked up Dr. Anderson’s medical licensing information on the state medical board website, checked out online reviews, and went over his profile on the county medical board website. Valid license, no disciplinary actions, very nice reviews with comments about his bedside manner and attention to detail. He went to a good medical school and did his residency in Connecticut. Seeing his date of graduation and medical board photo, John estimated Dr. Anderson was in his early to mid-60s.

“OK,” Dr. Anderson said “you should be all set. This will get sent to the pharmacy electronically.” John was relieved. He was glad to get out of there with very little additional fuss.

John grabbed his bag and started to get ready to go when the doctor stopped him. “John, since you’re a new patient, we need to get you in for a complete physical.” John got a knot in his belly. Yeeesh, he thought…a physical…not what I was hoping to hear. “OK, I’ll set something up on the way out,” John replied.

“My next patient cancelled,” the doctor continued, “so we can do the history and get your blood drawn today. That will save a little time when you come back for the physical. Do you have availability to come in next week?”

“Next week?” John asked, a bit confused.

“Yes, to come back for your physical,” the doctor continued as he got some forms out of his desk. “We will get started today then do your examination next week.” He handed the forms to John then started looking at his schedule on the computer. “Thursday the 11th at 8AM work for you?”

John knew he wasn’t going to get out of this. He looked at his schedule on his phone. “Yeah, that will work,” he replied curtly as he blocked out his calendar.

“Very good,” the doctor said as he handed John a clipboard with a form: “Review of Systems (Male)”. “Fill this out and I will go talk to my assistant about getting your labs drawn. We will go over it when I get back,” he said as he left the room. John heard the doctor chatting with the assistant out in the hallway then heard the receptionist saying he had a phone call on line 1.

John focused on the form, which had easy demographic information to start. Date of last physical? John drew a blank. Probably back when he started college. That would have been ten years ago, when he was 18. He estimated the date the best he could. “Date of last rectal and prostate exam? Date of last colon exam?” John left those blank. Lots of questions about eating habits, exercise, amount of sleep then questions grouped in sections for each body area: Hair/Skin, Eyes/Vision, Ears/Hearing, Cardiovascular, and more. John slogged through the questions. He gulped a little when he turned the form over and got to the section on “Male Genitourinary” and “Sexual Health”. Yikes, super detailed, John thought. Of course, the gentlemanly Dr. Anderson breezed back into the room right as John was answering those sensitive questions. “Almost done, son?” “Uh, yeah,” John replied, focusing on the form as he felt his face flush.

51. Do you have any sores on or discharge from your penis? YES / NO

52. How often are you performing testicular self-examinations? ___________

“Just take your time, John” Dr Anderson said, “I’ll go and gather everything for your blood draw.”

Dr. Anderson left and John finished the forms. Ever diligent, John scanned the forms one last time to make sure he didn’t miss anything or answer incorrectly.

Dr. Anderson came back with a little tray filled with blood collection supplies. John was a bit surprised that the doctor was going to take the blood himself. Dr. Anderson set the tray down and took the forms from John.

“Let’s go over these then I’ll draw your blood,” the doctor said as he sat down at the desk.

Dr. Anderson sat and reviewed the forms. “So, you’re 28. No other medicines besides the allergy meds I prescribed.”

“No, sir,” John replied.

“Seems that it has been a while since your last complete physical,” Dr. Anderson commented. John winced a little at the tone he used with the word ‘complete’.

“Yeah, well you know, I was in different jobs, getting moved from city to city,” John replied.

“You left the parts about rectal and colon exams blank, don’t remember the dates?” Dr. Anderson asked.

Yeeesh, John thought…colon and rectal exams. Nothing unclear about that. “Uh, well, heh, I’ve, uh, never actually had them,” John stammered.

“No problem. We’ll take care of that and get you on track,” the good doctor calmly replied as he continued reviewing John’s responses on the rest of the form. While Dr. Anderson was calm and collected on the outside, his pulse quickened as he thought about how fortunate he was to be able to put John through his first in depth exam.

“So, are you sexually active with women, men or both?”, Dr. Anderson asked in a quiet, gentle tone.

John felt his face redden as he replied. “Uh, both, sir.”

“And I see you left the section about last STI screening blank. Didn’t remember or haven’t had that done?” Dr. Anderson said as he began making notes on a sheet that was labeled “TREATMENT PLAN”.

“Well, I don’t remember ever getting tested for that,” John replied as he became conscious of how wet the armpits of his undershirt had become.

“Ok, John, roll up your sleeve on your right arm and let’s get some blood out of you, sport” Dr. Anderson said as he grabbed some gloves and the phlebotomy supplies. John watched him put the gloves onto his large hands and gather the supplies. Dr. Anderson made small talk with John as he expertly drew four tubes of blood from his arm.

“Now, I am a strong believer in getting a good baseline set of data on you. So, these tests and this physical will help do that. You’ll be here for about two hours next week then you’ll be all set,” the doctor said as he finished labeling the tubes.

Dr. Anderson went over to a cabinet and got out a brown paper bag which he handed to John with an instruction sheet.

“Here is a pre-exam prep kit with instructions inside. There are containers in there as I’ll need samples of urine and stool that morning,” Dr. Anderson continued, “And there is also an enema kit with instructions on the side of the box in there, you’ll need to use that about 2 hours before your appointment.”

Yikes! An enema, John thought. That’s a first as well as the stool sample. Jeez.

“Uh, ok, looks like it’s going to be an early day for me next Thursday,” John replied with a weak chuckle as he took the bag.

Dr. Anderson washed his hands. “Ok buddy, I’ll see you next Thursday. Have a good weekend!”

John put the brown paper bag into his backpack and grabbed his coat. He left the office, kind of in shock about what he had gotten himself into. He really thought he was just going to get his allergy prescription.