By four o'clock the exam room was cleaned up and everything was charted for the last patient. There was a half hour left before we closed the office. I went to my office and called my insurance company and asked if they could fax me the physical exam forms I was going to need for my nurses physical? The courier had stopped and picked up the samples that needed to be delivered to the lab. Everything was pretty much done for the day. The forms came through and I looked them over. It appeared my nurse was in for a little more of a thorough physical than she was anticipating. I looked at the clock and it was four thirty I walked up front and asked if my receptionist wanted me to hangout the office is closed sign and lock the front door? She bashfully looked up and said yes thank you.

I hung the sign up and walked up to her desk and asked if she was sure about this? She looked at me and told yes she was very sure and I should stop worrying. I told her ok I'll stop, and then I told her I had the forms for her physical faxed to me. And it appears they are requiring a very thorough physical. She looked at me and told me she trusts me and it will be fine. I told her ok and she can come back to the second exam room when she is ready, but she should stop and try to empty her bladder on the way.

I heard my receptionist stop at the restroom. Then about five minutes later she walked into the exam room. She asked me where I wanted her to sit. I told her to hop up on the exam table and take a seat. I went and grabbed the physical exam forms and walked around to the front of the exam table and stood in front of my receptionist. And started to go through the questions. Family medical history? Her medical history? Medications? I knew her age already, I told my receptionist I would check her blood pressure and then she could hop down and I would get her weight. I took her blood pressure and checked her pulse, she slid off the table and went and stood on the scale, I recorded her weight.

She went and started to hop back up on the exam table, I told her I needed to get her temperature, she looked at me and said ok, and continued to hop up on the table, I told her not yet, I need you to face the the table and lower your scrubs, she looked surprised and asked me really? I just nodded my head yes. She did as I asked and I went and grabbed the thermometer with the red plastic cap and some Vaseline, dipped the metal tip of the thermometer in the petroleum jelly and walked back over behind my receptionist. I asked her to lean forward and place her elbows on the table, I slightly spread her cheeks with my thumb and forefinger of my left hand and placed the tip of the thermometer against her anus using my right hand, and then asked if she was ready? she told me yes doctor, I gently pushed the glass rod into her rectum until the red plastic cap was visible between her cheeks, I then placed my hand across her bottom to keep her from pushing it out and watched the clock. She told me it felt cold and it had been a long time since someone had taken her temp like this. I told her it was on the form they require it this way. Five minutes went by and I removed the thermometer from her rectum. I checked her temperature and then looked at the thermometer the tip had a little brown glob on it. I wiped it clean with a alcohol wipe and layed it on the counter, I told my receptionist she could pull her scrubs back up. And then she could hop back up on the table and take a seat. I told her next I was going to check her eyes and ears.

I went and got the two scopes and layed Otoscope on the exam table. I took the ophthamaloscope and began checking my receptionist eyes, when I was done with her eyes. I switched scopes and took the Otoscope and checked her ears. With this done I ran my hands over her head and checked her scalp. The felt her neck and lymph nodes. I went and grabbed a tongue depressor and checked her throat. I put the two scopes back in the holder. And walked over to the counter.

I filled out this part of the exam form. I told her that they want her to have a dermatology exam to check her skin. I asked her how she would be comfortable doing this? She said she didn't care it was up to me, I told her no it was up to her, I would give her a gown or she could just remove what needed to be removed. Or she could take everything off it was her choice. She asked me if I wanted to do this exam now. I told her yes then we will do the breast exam then the abdominal exam. Then we'll do the lower portion.

My receptionist asked me if I wanted her standing for this? I said I did. She climbed down from the exam table and started removing the top of her scrubs,I watched without saying anything, when she had her top off she untied the bottoms and removed them and then her underwear and socks. She was standing in front of me completely naked, she had medium sized breasts and a flat stomach, her pubis had thick brown hair, the same color as the hair on her head , her labia were puffed out and visible, her thighs were muscular, her calf's were also very muscular, her feet were small and well formed no bunions or bone deformitys. I put a pair of gloves on and ran my hands over the front of her body feeling for moles or skin growths. When I was done examining the front of the patient I asked her to turn around and visually examined her backside, her back was smooth and slightly defined, her buttocks was taught and muscular, I ran my hands over her back and the back of her legs and buttocks, I asked her to bend over and place her hands on her knees I needed to examine the skin between her cheeks, she did as I asked, she told me this is a little embarrassing having you look at this part of me. I spread her cheeks and examined the skin on the inside of her cheeks, it was smooth, there was a little hair surrounding her anus, the skin between her cheeks and around her anus, was slightly slimy from the Vaseline that I had used for her rectal temperature, the skin between her cheeks and her anus was colored dark brown, I would examine her anus closer during the rectal exam. With this done I told her she could stand up and offered her a gown. She said it didn't matter I was going to see all of her anyway.

I told her to hop back up on the table and lay down. I was going to examine her breasts next, I asked if she has had a mammogram done lately? she told me during her last physical. I told her when it was time for her to get it done again I would refer her. She thanked me and layed down,I put on fresh gloves and then began palpating her left breast, her breasts were firm with pink areolas her nipples were pink and small they were ridged, when I was done with her left breast I repeated the whole thing over examining her right breast.

When I was done with her breasts I just moved my hands to her abdomen and began palpating her abdomen, while I asked about her bowel habits, if she had black or tarry stools? Chronic diarrhea? Any blood in the toilet or on her stool it's self? Or on the toilet paper when she wipes? She told me no to all of these questions, I asked if she gets constipated? she told me no not very often, I asked if she has regular bowel movements she said she usually moves her bowels twice a day once before she leaves for work and then in the afternoon when she gets home from work. I told her that was fine, and then for some unknown reason I thought well that's about this time of day. I finished palpating her abdomen working my way down towards her waist line feeling her liver, and then working my way down to her pelvic bone .

As I was finishing, she asked me doctor do you ask all your patients these same questions? I told her yes, and then I asked her why she was asking? She told me these questions are very embarrassing, and some what humiliating, asking about my bowel movements and how many times I move my bowels in a day, this is embarrassing. I told her it is important to know this information about the patients. Then I asked her how she was doing with this? She said she was doing fine, but she was just trying to learn what happens, and how the patients feel about what is happening to them during these physicals? I told her that was fine she can ask me anything she wants too, especially during her exam. She said she would, she wants to know what is going to happen to her? And she would like to see as much as possible. I told her that this would be fine, and if she wants too, and she is comfortable with it, she can tell me what her feeling are, and her thoughts on what is happening to her. And now I am going to do her pelvic exam, and if she wants to I will sit her up as far as I can so she can see. She told she would like that very much, and thanked me.

I pulled the stirrups out and locked them in place, and then asked her to place her legs in the stirrups. She did as I asked, I then told her I was going to sit her up, I raised the back of table up, until she was sitting up as far as she could and still remain comfortable. I then asked her to scoot her bottom down to the edge of table, so that her bottom was just hanging over the edge. She scooted herself down, by doing this it spread her legs farther apart fully exposing her vagina and her bottom. I told her that was good and that I had some questions I had to ask.

She looked at me and told that was fine if I needed to ask. I told her I know this is embarrassing but I have to ask. She nodded her head yes, I started out by asking if she was experiencing any unusual or smelly discharge? If she was still getting her period? She told she was but not as regularly and the blood flow was not as heavy as it used to be, I asked if she was sexually active and if she used birth control? She said she was sexually active but she didn't have to worry about birth control, I asked if her tubes were tied, She told me no, I asked if she practiced safe sex? She said she took precautions, I then told her I that I could assume that her hymen was no longer in tact. She looked at me and told me no, that she had lost her hymen when she was in college to a girlfriend, I told her I didn't need to no the details, that was her personal business. She told me that she wants me to know, that she doesn't want to keep stuff from me. I thanked her for this and asked if there was anything else she wants me to know. She told me not now but she will tell me when she thinks I should know something. I said that was good to know and I appreciate her trust.

I then asked if she was ready? and then reached in the drawer and pulled out the speculum. Her eyes widened when she saw the speculum and told me this is one thing she doesn't like. I told her I know, as walked over and ran it under warm water, I then went and sat on my stool and put on a pair of fresh gloves, I told her I was going to touch her iner thigh and look, I took my left hand and lightly touched the iner thigh of her left leg, I took my right hand and touched her vagina, I spread her labia and looked at the opening of her vagina, and her urethra and her clitoral hood and then the clitoris it's self, then her perineum, then I spread her cheeks and visually examined her anus, her anus still had the Vaseline smeared on it from her rectal temperature, I took my thumb and forefinger and spread her anus exposing the opening when I pulled it open it made a wet suction noise, hearing this made my receptionist say a embarrassed oh! , I didn't say anything, I took the speculum and placed the blades against her vagina, I took my left hand using my thumb and forefinger and spread her vagina open, and slowly started pushing the blades of the speculum into her vagina. She looked at me and told me this is very uncomfortable it kinda hurts. I told her I was sorry, and it was almost all the way in, she looked directly at me and told me good! Once the speculum was in place I screwed the blades open, exposing the inside of her vagina, I took a pen light and looked inside, I could see the walls of her vagina and the opening of her cervix, everything appeared healthy. She asked me how she looked? I told she looked healthy, she then went on and told this is the first time a man as ever touched, or seen her vagina, that she as always went to female doctor's and she has never been with a man before, I looked at my receptionist and told her thanks, for trusting me with her private business, And that I also appreciate her confidence in me. I then asked her if she wanted me to go ahead and do a pap smear as long as we were already this far into the exam? She said yes, then she will be good for awhile. I told her of course, I had already layed a brush and contaminat free vial out, I took the brush and swabbed the opening of her cervix and then placed the brush in the contaminat free vial and placed them on the counter for later. With this done I told her I was going to do the bimanual exam, and then do the rectovaginal immediately after the bimanual.

She looked at me with her eyes and told me to go ahead, she is doing fine, I told her that she is doing fine, and we're getting closer to being done. I changed gloves once again and lubricated my two fingers. She flinched a little when I touched her with my fingers, she told me they were slimy and cold, I asked her to relax and then pushed my two fingers into her vagina feeling the walls of the vagina while palpating her lower abdomen feeling her ovaries, I slipped my middle finger from her vagina placing it against her anus working that finger into her rectum, she looked at me and told me that this is making her feel like she might need to go to the bathroom, I said she won't need the bathroom, I'm almost done. I removed my fingers from her vagina and rectum, she looked at me and told me that that made her feel funny, not like ha, ha funny but kinda of different uncomfortable feeling. I looked at my receptionist and told her we're almost done, she asked me if I was going to give her a rectal exam?

I looked directly at my receptionist and told yes, I was going to examine her rectum with my finger to collect a stool sample and feel for abnormalities, and I also had to check her rectum with a proctoscope, that was part of the insurance exam. She looked at me with a surprised, shocked expression of OH MY GOD !!! I tried to reassure her she would be fine, first I would do the rectal exam, I reached in a drawer and pulled out a occult blood test card, she saw this and her face started turning red. I told that she has seen this done before, to other patients, she said yes, she has, and she sees how embarrassed and humiliated they are when they see my finger, after it has been in there rectum, I told her I understand how this can make you feel that way but it needs to be done. I put on new pair of gloves and lubricated my finger as my receptionist watched, she told she has never had her anus penetrated very many times and this is making her a little scared. I assured her she will be ok. I put my finger against her anus and told her I wanted her to bear down like she was really trying to go to the bathroom, I watched as she pushed really hard when she did I heard a PFFFT she passed some gas she felt it as well as heard it, I thought she was going to start crying out of embarrassment, before she could start crying, I pushed my finger into her rectum in one swift thrust, this took her mind off of her embarrassment and caused her to clench her anus and grind her hips back and forth squirming on my finger, I could hear her telling me my bottom oh doctor! my bottom hole oh doctor! as I twisted my finger examining her rectum, I could feel a fair amount of soft stool, and knew obtaining a stool sample wouldn't be a problem, when I pulled my finger from my receptionist's rectum she was watching closely to see my finger, I asked her if she wanted to see my finger before I smeared it on the card. She blushingly said yes she did, she wants to know how the other patients feel. I showed her my finger it was coated with her feces. She looked directly at me and told me this is making her feel very humiliated, and now she knows how the other patients feel when they see my finger after there rectal exams. I explained that is why I try to hide my finger from them. She told she knew that but she wanted to experience it for herself. Then she looked at me and grinned and told me by the way, your finger is disgusting and gross looking that I should hurry up and smear it on the card so I can take my gloves off. I smeared the card and smiled at her. And told her I was glad this was not offending her. She told me that it wasn't offending her, but parts of it were a little painful and very embarrassing for her. I told her to keep up her spirits because the next exam was going to be the worst. She looked back at me and frowned. I told her she could take her legs out of the stirrups she was done with them, she removed her her legs but remained sitting on the exam table.

I explained that the insurance physical requires a proctoscope exam, She asked me how I was going to examine her? She told she has never seen a proctoscope before she knew what it was but had never seen one before, I reached in a drawer and took out a six inch proctoscope. I explained I would insert this into her rectum and then remove the obturator and take a light and shine it inside the tube, in order to see the lining of her rectum. She looked nervous and scared, I assured she was going to be fine. But this would be uncomfortable, and a good time for her to go use the bathroom and try to empty her bowels, and if she can't or would rather I could give her a enema. She thought about this for a few minutes and told me she didn't know if she could go to the bathroom? I told her she needed to have her rectum clean so I could see. She asked me if I could just do it anyway, I told her not really it won't do any good if I can't see.

She looked at me and asked if I would give her a fleet enema? I told her gladly, if she thinks it will help, she looked at me and told me it would make her poop. I layed the exam table flat, and asked my receptionist to lay down and roll on to her left side and pull both her knees up to her chest. She did as I asked, by doing this her anus was exposed. I had already put two fleet enemas in the room and hid them under a towel, I picked one up and pulled the orange cover off the tip, l put on a pair of gloves and with one hand lifted her cheek and placed the tip of the bottle against her anus and gently pushed it into her rectum, and then squeezed the contents into her. She let out a little gasp when she felt the liquid shoot into her rectum. I asked her how she was doing? She said she was doing okay, I asked if she wanted to sit up? She said yes and then rolled on to her back and sat herself up. She sat and waited telling me that she has never had anything like this done to her before, I asked her how all this was making her feel? She told me this whole experience has caused her to feel a lot of different emotions, I told her I would like to hear all of this sometime. She said she would gladly tell me, she started to tell me and then grabbed her stomach and jumped down off the table and scurried across the hallway to the restroom. She didn't take the time to close the door, just hurriedly sat down on the toilet and then looked across the hallway at me. She shrugged her shoulders and shook her head as to say sorry. I made eye contact with my receptionist and returned the shoulder shrug and smiled. I stepped away from the door as not to watch her. I could hear her grunt and then a PFFFFTT and a squirt of water, followed by another low deep grunt and then what sounded like a long solid stream of wet thick liquid being expelled, as the stench slowly drifted across the hallway making it's way into the exam room, then I heard a small PFFT and a sigh of relief. About three minutes later my receptionist was back in the exam room avoiding eye contact with me. She shyly looked at me and told me she was sorry it smelled so bad. I put my finger to my lips to shush her, she looked at me with a embarrassed smile. I smile and laughed a small laugh and told her I was glad to see that she has become so comfortable around me. She grinned at me and told me she couldn't help it, it worked fast. She then looked at me with a serious look and asked me what I wanted her to do now.

I told her I was going to have get up on the exam table and then get on her hands and knees. She looked at me with a look of if I have to I will. I patted her arm and told her I would be careful and she will be alright she just nodded her head. She climbed up on to the exam table and got into position, I then asked her to lower her head and rest it on the pillow or her forearms which ever is the comfortablest. She lowered her head while looking over her shoulder at me. In this position her anus was fully exposed. I could see there was some fresh feces on her anus from when she had wiped herself after she expelled the enema. I went and got a tube of lubricant and put on a pair of gloves. I told my receptionist that I was going to squirt some lube directly on her bottom and then smear it on her anus. Then I was going to insert one finger and lubricate the inside of her anus, and when I had her anus lubricated I was going to insert two of my fingers to help loosen her anus . When she heard me tell her this she told me no! please doctor it will hurt. I told her that I wouldn't lie to her this is going to be uncomfortable but I will go slow.

I squirted some lubricating jelly on her bottom, then smeared it on her anus and worked one finger into her rectum she accepted my finger with no problem. I worked it in and out, then added another finger this caused her some discomfort, she groaned, and then squirmed against my fingers telling me it's too tight, I told her in a soothing voice to relax and try to push, I could feel her trying to push her anus open and I knew she was bearing down hard, I slowly worked my fingers into and through her anus, pushing them fully into my receptionists rectum this was making her moan, and flex her anus on my fingers all the while telling me it's too tight, I coaxed her telling her she was doing good, and I thought she was ready for the proctoscope? I could hear my receptionist telling me she hoped so her bottom was getting very sore , I told her once I had the scope in it wouldn't take long, she sighed a sigh of relief hearing this. When I removed my two fingers and went to pick up the scope. I noticed her labia had become swollen and her vagina was moist. I picked up the scope and heavily lubricated the tube. I asked my receptionist if she was ready? and when she felt the scope touch her anus to bear down. I placed the proctoscope against her anus I saw her anus push out and then slowly started to push the scope into her rectum, when the scope pushed against her sphincter she stiffened her back and tensed her thighs, and gasped loudly, I coaxed her and told her she was doing very good and to relax, it was almost in. She tried to look over her shoulder and started to tell me but doctor it hurts bad, and I feel like I need to go to the bathroom. I told her it was just the pressure from having the scope so far in her rectum. She groaned and told me she needs to go to the bathroom, it hurts, I told not yet, you can go in a few minutes. She grunted and told me she felt full. I told her to relax, she kept telling me she needs to go to the bathroom!! I told her she can't not yet. I finally had the scope in as far as I needed it. I told my receptionist I was going to remove the obturator and start looking, as I slowly started to pull the scope out, I could hear her telling me to hurry up. I could then hear telling me she needs to poop!! and if I don't hurry she is just going to do it. She was starting to get agitated with me. I asked her to please be patient with me, I had the obturator out and was looking, I had my pen light and was shining it down the tube as I slowly worked the scope back out of her rectum. I took my time I didn't want to miss anything. My receptionist was starting to calm down, she could feel the scope sliding out of her, and the pressure in her rectum subsiding. I was about three quarters of the way out and wasn't seeing anything. My receptionist was still grumbling telling me she was feeling better but I should still hurry up. I told her I didn't want to miss anything she groaned a little more, by now I was back as far as her anus, I slowly pulled the scope back through her anus trying to look for hemorrhoids. As soon as the scope popped out of her anus. I could hear a huge sigh of relief, I layed the scope on some paper towels that I had put on the counter. I told my receptionist not to move and I would wipe the lube off of her. I wiped her bottom and helped her down off the table. She looked at me. And I told her everything looked good.

And now she could get dressed, she put her underwear and socks on, then she started to apologize for how she had spoken to me. I stopped her in mid sentence and told her to stop it. There was no need to apologize for anything, I told her I was the one that should apologize. For causing her so much discomfort. By now she was fully dressed. She told she would help me clean the exam room. I told her no let's wait and do it in the morning it's late. She looked at me and said sure if this is what you want to do. She said she would like to help me lock up if that's ok. I grabbed the sample from her pap smear and we walked towards the back door. I told her we would do her labs first thing in the morning. We stopped to put the sample in the refrigerator. When we reached the back door my receptionist put her arms around me and hugged me, giving me a peck on my cheek. She then told me good night. I told her to have a good night and get some rest. She smiled as she left turning around to tell me she'll be in early.