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A Day In The Life Of A Small Town Doctor.

Chapter 2

The morning had turned out to be interesting and even a little entertaining considering the way it had started off.

It was going on twelve thirty my receptionist had just reminded me there was a one o'clock appointment for a physical.

I asked her what information she had on patient that was coming in? She said all she knew was that the patient was a female and she didn't know anything else? If she had to guess she would guess she was fairly young considering it was a new hire physical for the manufacturing plant and they hired a few college students this time of year.

I asked if she had the paperwork already or the person coming in was bringing it?She said she didn't have it, and then asked me why? I told her I was just wondering how much of a physical was required for a female employee? She was pretty sure that they will require a complete physical. More than likely including a pelvic but no pap smear.

I told her thanks. And that I would be in the first exam room getting things ready.Then I asked my receptionist if she would mind helping me out with this. She turned her head to look at me and said she would be glad to help. I then told her for one I will need a chaperone, and also it might make the patient feel a little more at ease if she were to explain everything that was going to happen during the exam before I was in the room. And also to collect the urine sample, and take the vitals, and help to make sure the patient is fully naked and gowned. I apologized for all the extra work and thanked her.

I then headed back to the exam room and began getting things layed out. I took a cart and a stainless steel tray and placed a couple of different sized speculums, a few pairs of gloves and occult blood test card a tube of lube. I didn't need a spatula or a brush or slides. I covered everything with a white towel and rolled the cart into the corner of the room.

I then went back out to the reception area and told my receptionist it might be a good idea once the patient was in the exam room. If we were to hang the office is closed sign on the door. There are only two of us here and we will both be with the patient. We don't need somebody walking in off the street. It has a emergency phone number on it if someone needs to get a hold of me. That I will hang it out but where is it? She reached in a drawer and pulled it out and layed it on her desk.

By now it was almost one o'clock I was back to my office and that's when I heard the door open and my receptionist greeting whoever it was that had just walked in. I could hear the person saying hello and giving my receptionist her name and that she was there for a physical. I heard my receptionist say that we were expecting her and that if she would follow her back that we could get started.

Then I could hear my receptionist tell my patient that first she needed to weigh her then have her pee in a cup for a urinalysis. Then check her vision and hearing. The patient told her sure she thought she would be able to pee. I sat at my desk and listened to what was being said. Now they were at the restroom and I could her the patient being told that when she was done peeing in the cup that she should go ahead and make sure she fully emptys her bladder for the exam. I thought to myself that I had gotten lucky hiring this gal for my receptionist that she was really good at her job.

Finally I could hear them head back down the hallway and enter the exam room. This is when I went to put the sign out and lock the front door. Once this was done I walked back to the exam room and waited outside the door listening and waiting to enter. I could my receptionist taking her vitals and making small talk. And asking if she had brought any kind of forms to be filled out and the patient replying oh yeah I forgot to give them to you.

My receptionist told her that was fine and laughed. Then it was quite for a few seconds and I figured that my receptionist was writing down the numbers from the vitals. Then I could hear the reception start talking, as if she was reading off the forms telling the patient that she was going to receive a full physical including a pelvic and rectal exam that this is part of the requirements for the company. And then if she would to please remove her clothes and put on this gown with the opening in the back. Then I heard you mean everything? and then I could hear yes everything. Then I heard Oh! ok.I gave them a couple of more minutes and then knocked on the door. Then entered slowly and introduced myself. My patient was very healthy looking young lady I asked why she was here and she told me for a physical for my new job. I asked her age and she said twenty three. I then asked if my receptionist, who also helps out as my nurse had explained everything to her. She told she had, I then asked if she understood everything and was she okay with this. She told me she was, but didn't understand why she needed to have such a through physical. I told her it was the companys policy and it was mainly to protect the company from work comp claims. She said she was fine with this if it had to be. I smiled and asked if she was ready to get started.

I told her first I would check her eyes, then her ears, then I would check her throat and neck. I asked my nurse to get the ophthamaloscope and began checking her eyes then handing it back to my nurse and asking for the otoscope and began checking her ears. Then I grabbed a tongue depressor and checked her throat before feeling her neck for swelling or lumps.

I then explained I needed to listen to her heart and lungs I would listen to her heart by just reaching in the front of the gown and would listen to her lungs by opening the back of the gown she shook her head yes. I looked at my nurse who handed me my stethoscope and smiled at me with approval. I took the stethoscope and asked my patient if she was ready, she looked at me and shook her head yes I gently reached in the front of her gown and began listening to her heart. When I was done with her heart I asked my nurse if she would please untie the back of the gown and placed the stethoscope on my patients back and told her to take a few deep breaths and hold them and then let them out slowly with this done I told her so far everything sounds and looks healthy.

I told her next I needed to exam her abdomen, that I needed her to lower her gown to her waist and to lay down my nurse would get a sheet and cover her breasts. She lowered the gown and layed back. I began palpating her abdomen working my down to her waist line just above her pubis.With this I told her next I was going to examine her breasts and asked if my nurse had explained self exams, she answered yes she had. So far this young lady was handling everything very well. I asked my nurse to please remove the sheet. She looked at me and said she would. She gently removed the sheet. I glanced at my nurse who was very enthusiasticly looking at my patients breasts with a small smile on her face. Now that my patient was laying down and her breasts exposed I noticed that she was starting to act self conscious about what was happening. My nurse was talking to her trying to keep her calm her down. I told her I was going to examine her breasts while she was laying down and try to relax this won't take to long. She was looking at my nurse I think for approval my nurse just looked at her and shook her head yes. Then looked at me and said it was ok go ahead. I noted the patient had medium sized breasts and they were firm the patient herself was in very good physical condition her thighs were some what large but very muscular her stomach was tight and firm. Her buttocks was not small but by no means fat very tight and firm .

I then announced I was going to begin and reached down and began examining her left breast squeezing gently feeling for lumps and abnormalities. When I began squeezing my patient let out a small moan and I saw her eyes flicker, I asked if I was hurting her she said no it didn't hurt. So I finished the left breast then continued with the right breast the same thing happened she moaned quietly and was looking at my nurse. Who was standing at the side of the exam table holding my patients hand trying to comfort her. With the breast exam done I stood back and told my nurse she could cover the patient again, before she had her covered I noticed how hard the patients nipples had become. When she was situated, I announced it was time for the pelvic exam and asked if she had ever been examined before she replied only looked at. I asked if she was sexually active and she replied she had, had sex only twice with a guy. I then asked so you have had your hymen broken? My patient said yes she had bled the first time. I asked if she was on birth control she said no. I asked her if she practiced safe sex she replied yes, but she doesn't really have sex with guys. I noticed my nurse who was standing off to side of the room was smiling.

I told her I needed to do a pelvic exam. I didn't need to do a pap smear I just needed to look. She asked me if I had too? I told her I did if she wanted me to complete the physical. She reluctantly agreed. Now she had become very anxious and nervous my nurse was standing back at the side of the table rubbing the patients arm telling her she would be fine. I pulled the stirrups out and locked them in place. While my nurse helped the patient place her feet up and her legs in the stirrups and then told her to scoot her bottom all the down so that her butt was just hanging off the edge of the table. With this done I raised the rests a little higher this caused the patient to be fully spread open and exposed. By now the nurse had wheeled the cart with the tray on it over and was raising the patients gown and exposing her vagina telling her she was going to be okay. I sat down on my stool and put on a pair of gloves. When I had my gloves on and looked at my patient she was fully spread open and on display with her vagina and anus completely exposed. I started by telling the patient first I was just going to touch her leg then her labia. I layed the back of my hand on her thigh this caused her to flinch. My nurse patted the patients arm and look at me like go ahead. This is when I took my other hand and touched her labia gently pinching the left side between my fingers first, and then the right side. With this done I gently spread them apart letting me see the opening of her vagina. It was very pink and healthy looking also very moist. I gradually worked my way down towards her perineum inspecting the perineum and then spreading her cheeks and inspecting her anus. When I spread her cheeks open I could hear her gasp and suck air through her teeth. I held her cheeks open for a couple of seconds inspecting her anus. It was surrounded by dark skin but the opening was pink and healthy looking. I noticed that she had become a little more moist. I was beginning to wonder if this was arousing her. With the external inspection done I announced now I was going to insert the speculum. I asked my nurse to run warm water over the small speculum to warm it up, and she knew enough to also know that would help to lubricate it. When she was done warming it. I gently took the thumb and forefinger of my left hand and gently spread the labia of my patients vagina opening it enough to inspect the opening of her urethra.

And also opening her vagina enough to start inserting the speculum. My nurse was telling the patient that this was going to be very uncomfortable and try to relax. My nurse was now standing back far enough she was able to witness what was happening. As soon as the speculum touched my patient she gasped and began to to squirm away from the invading metal blades, my nurse grabbed her hand and told her to try to be still it will be over quick! The patient layed still breathing fairly heavy looking at my nurse who just kept telling her to relax. Finally I had the speculum fully inserted and open. The nurse took and placed the lamp where I could see into the patients vagina her vagina looked healthy no abnormalities the opening to her cervix also looked healthy.I noticed that now she had calmed down and was just laying still and breathing slow but with deep heavy breaths. I also noticed my nurse was staring directly at the patients open vagina and that her breathing had become heavy. I was starting to wonder if my nurse was starting to get aroused by this. I was now done with the speculum exam.

I now informed my patient I was going to do the bimanual exam and we were getting close to being done. She just looked at me and smiled a weak smile. I held my hand out and my nurse took the tube of lubricant and squirted a glob on my two fingers I was holding out. I gently placed my two fingers at the opening of the patient vagina and gently pushed in. This caused the patient to moan loudly and twist her bottom on the table. I watched her face and saw her eyes open wide and look directly at my nurse. Who was standing slightly behind me watching my fingers disappear into the patients vagina. I took my left hand and palpated her lower abdomen feeling for her ovaries.

With this completed I took my middle finger and let it slip down between her buttcheeks, rubbing my finger up and down feeling for her anus. When my finger touch her anus she flinched my nurse told her to relax the doctor is going to insert his finger in your rectum. When my finger entered her anus I just pushed in this caused her to to squirm even harder trying to get away from my finger. I noticed now she had started becoming visibly wet her vagina was self lubricating. My patient was becoming sexually aroused, having her anus penetrated was arousing her. I noticed my nurse was starting to breathe heavyer. I was wondering if this was also arousing her. I slowly pulled my fingers from the patients vagina and then from her rectum.

She let out a big sigh of relief thinking she was done. I told my nurse we needed to do a rectal exam to collect a stool sample my nurse looked me in my eyes and smiled, my patient looked confused.

I changed gloves and my nurse lubed my index finger. I reached back down between my patients legs and let my hand drop down by her bottom. I reached out with my finger and rubbed the lubricant onto her anus. I was noticing how wet my patients vagina had become. My nurse was telling her to relax she was asking my nurse if I really had to do this? My nurse told her it was necessary, it needed to be done to check her stool for blood. Hearing this she got even more of a confused look on her face. I don't think she comprehended what collecting a stool sample with my finger actually consisted of, that I was about to bury my finger in her rectum to collect some of her feces on my finger. The nurse told the patient to relax, she told her you just had the doctors finger in your bottom you know it won't hurt. My nurse gave me a look like hurry up, just go.

So I did, with no warning I pushed my finger all the way up her rectum not stopping to let her sphincter open. I was wiggling my finger around feeling for stool. She stiffened her legs and raised her bottom up off the table. Letting out big gutteral grunt. I just kept applying pressure working my finger deeper. By now l could feel soft stool. My patients bottom was back down on the table and she had began moaning and withering on my finger, her anus was clenching my finger, she was having a orgasm right on the table with my finger buried in her rectum.

Finally she calmed down and I slowly pulled my finger out of her rectum. My nurse stood staring at my dirty finger before grabbing the occult blood test card and handing it to me to wipe my finger on.

My patient just layed on the table in a daze. My nurse was also in a daze but was a little more coherent than the patient. Finally everybody had gathered there sense's. I thanked the patient and told her the nurse would help her get cleaned up and dressed. I asked my nurse to help her and I would go get her paperwork ready. I left the exam room and went and opened the office up and then got everything in order for the patient.

I was sitting at the desk in the waiting room when they came out. I thanked my patient again and handed her, her paperwork she thanked me and said good bye her face was flushed and her eyes a little glazed. My nurse thanked her also, and told her she was glad to meet her. She thanked my nurse and told her she was glad to meet her as well and left.

My nurse who was now back to being my receptionist again. Her face was flushed and she looked a little anxious and acted a little nervous. She asked me if I would be okay watching the office for a few minutes. She needed to use the bathroom. She really needed to relieve herself. I told her sure she better go take care of herself. She turned around and gave me a big smile and hurried off.