Sandy brings Billy Cranston back to one of the "fun" exam rooms in the middle wing. Sandy is not much older than Billy. At 21, she is only 3 years older than his 18 years. She is not a nurse yet. She had worked as an aid at an old folks home for a couple of years after high school to earn money to go to nursing school. As part of her second year, she has been shadowing a nurse here at Valley Care two mornings a week. She is not allowed to do things like give shots, but they have been letting do things like taking vitals, getting patients ready, helping to hold kids down when they resit a shot. She jumped at the chance to help out with the emergency.

Mostly she has been working with the little kids. This will be the first time she has worked with an older teen. Taking a temperature on an 8 year old was one thing; taking a rectal temperature on an 18 year old was quite another thing. She had been taking vitals on the 7 to 12 year olds for couple of weeks now, mostly on her own. However, she had not taken a rectal temperature on a teen yet, although she had observed it a few times.

Taking Billy back into exam room 5 and making sure that the curtain in front of the door was drawn, she starts with the easy bit. Taking the sampling swab in hand she says, "The first thing that I need to do is get a sample to test for mumps. Can you open your mouth real wide for me?"

"Everyone will tell you that I can open my mouth. Usually they are complaining about it. " Billy jokes before opening his mouth wide. Sandy carefully swabs his mouth and the back of his throat as she has been taught, only making him gag a little.

She gives him a little "Sorry about that" as she packs the swab in the vial of media and seals it carefully. "OK Billy. Dr. Jan is going to have to look at you all over, so I need you to get undressed. Take off everything except your underwear and socks."

Billy is a little nervous to get undressed in front a girl not too much older than he is. Especially one as pretty as Sandy. Spotting the rectal thermometer in it's cylinder, he realizes that it will get even more embarrassing. But he decides to get it over with and quickly undresses down to his tightly whities and socks. "Knew I should have chosen boxers today." he thought as he put his pants on the chair.

"Let's get your weight now." Sandra says as she guides Billy towards the scale with a hand in the small of his back. It takes her a few tries to get the scale to balance and she directs Billy to get up on the table as she records his weight.

She then takes the rectal thermometer from it's case and concentrates on preparing it to calm her nerves. She shakes it down and checks the level. After rinsing it off, she puts some surgilube on a tissue and carefully lubricates the bottom two inches.

Finally, she grabs some extra tissues, takes a deep breath, and turns to Billy who is sitting on the table. "I have to take your temperature Billy. I'm going to put the thermometer in your bottom, so I need you to pull your underwear all the way down and turn over. Can you do that for me?"

Billy is about to crack a joke about knowing where rectal thermometers go, but he can tell that Sandy is nervous. From her words, he figures that she is new and used to working with the little kids, so he spares her his wit and follows her directions. He slides his underwear down past his knees and rolls over on his side, knees bent and facing away from her.

Sandy blushes a little as she sees Billy's adult size penis as he pulls his underwear down before turning on his left side. She is used to taking temperatures with her patients in the prone position, but remembers from her training that the side lying position was more common for adults and adolescents.

She approaches Billy and uses her left hand to lift his left buttock so that she can see his anus. "Billy, you are going feel me put the thermometer in. It might be a little cold." she says. "You can do this. It's just like with the younger kids." she thinks to herself as she bends over to get a better angle.

Billy feels Sandy's breath on his bottom as she slides the thermometer two inches into his rectum. As she releases his buttock, he feels one warm hand up against his bottom holding the thermometer in place. He then feels her other hand settle on his hip with her finger tips not to far from his penis.

Billy has never been one to make a fuss about rectal temperatures. It was the only way that he had had his temperature taken and it was no different to him than getting weighed or having his abdomen felt. This was different. Sandy was only a few years older and he started to feel a bit of a tingle. He worked hard to distract himself from .... getting hard.

After a couple of minutes, Dr. Jan knocked and came in. She wanted to make sure that Sandy was doing OK with her first big kid temperature. "How is it going with our Mr. Cranston, Sandy? You doing OK with a more adult patient." She asked.

"Billy has been a good patient Dr. Jan. It's nice to not have to worry about a squirmer. I put his weight is on the form and I will have his temperature in a minute." Sandy said. "This is the first time I had done a temp in the side lying position though. It’s easier in some ways, but …. things are a bit more visible."

"Times up. Let's see what your temperature is Billy." She lifts his buttock and pulls the thermometer out slowly with a bit of a twisting sensation. She gives Billy a little wipe with a tissue and then wipes the thermometer and squints at it. "99.2. You can pull up now Billy." Sandy says, turning her back to give Billy a little privacy while cleaning and replacing the thermometer.

"Thank you Sandy. You can get Tina's roommate Jill Smith ready. Use room 6. Get her undressed, weighed, and get a swab and a temperature like you did for Billy."

"So Billy, you were Jack's roommate. How are you feeling? Any pain in your jaw? Any trouble swallowing?"

"No Dr. Jan. I feel fine. Just a little hungry."

"Well let's get you examined so we can get you out of here. Open up wide." Dr. Jan uses the light from her otoscope and tongue depressor to look at Billy's throat. She then goes about examining his ears and nose.

Not finding anything out of place she proceeds to feel his jaw and neck while watching for any signs of pain. Taking out her stethoscope she gives his heart and lungs a quick listen. She finishes up by feeling the lymph nodes in his neck and armpits.

"OK Billy, I just need to do a quick genital exam. Go a head and slip out of your shorts and lie back." Dr. Kate said as she put on gloves.

Billy is a little nervous. He has only had physicals from Dr. Kate and Dr. Sarah. Dr. Kate was his main doctor until he was 11 or 12. She would usually just take a "quick peak bellow". When he graduated to Dr. Sarah, he started to get more involved exams with him standing while she felt _everything_ and did the whole "turn your head and cough" thing. He had even hear from an older friend that his 18 year old exam would include a finger in his butt. He was not sure what to expect.

Dr. Jan looks at the naked Billy and notices that his penis appears to be normal sized for his age and his pubic hair distribution looks normal. Spreading his legs a bit, she feels the lymph nodes in one of his groin and then the other side.

Gently moving Billy's penis out of the way, she holds his testicles in her hand and judges them to be of normal and equal size. She then isolates his left testicle in with her left hand and gently palpates it with her right, watching Billy for signs of pain. Seeing no more than the normal tenderness, she repeats this for the right testicle. Out of habit, she quickly palpates his penis from base to glans.

"All done. You can put your underwear back on for the moment and sit up." Dr. Jan says as she turns to make notes in his form.

"I don't see any signs of mumps yet, so we are going to stick with the smaller preventative dose for you Billy. However, since you were Jack's room mate, you are still at increased risk. If you start running a fever or having other symptoms in the next few days, have your folks contact the office and one of us will come out to re-check you. OK?"

"Yes, ma'am. I will do that."

"Good. One of the nurses will be in a few minutes with your shot." She adds a note on his aftercare form asking his parents to check his temperature for the next few days and hands it to Billy before leaving.

A few minutes later, there is a knock at the door and Nurse Amy comes in, trailed by Sandy. Amy is carrying a syringe with a large needle.

“Hey Billy. I have your shot ready. The good news is that you get the smaller dose. The bad news is that it is still kind of a big shot. Sorry about that.”

“You’ve always taken shots better than your classmates. We are hoping that you can take this shot without too much fuss to show them that it’s not too bad. Some of your classmates are a little scared and we hoped you could help them by being brave. Can you do that?”

Billy thinks for a second. He thought about Tommy and Phil and Sally and Mary-Sue and some of the other kids that he knew didn’t take shots well. He decided that he would try to be a calming example, the same way he was for his little sister. “Sure. I’ll try not to scream loud enough to be heard in the lobby.” He says with a smile.

“I assume that is heading for my butt, like a penicillin shot? And that it will hurt like one?”

“I’m afraid so.” Amy says. “You know the drill. I need you pull your underwear all the way down and lie on your tummy for me.”

Billy pulls his briefs down bellow his knees and rolls over on to his belly, giving Amy and Sandy a view of all he has. Sandy takes up a position on the opposite side of the table. She puts hands on Billy’s thighs in case she has to help restrain him, the way she has with some of the kids. Billy is 18, but Sandy knows that this is a tough shot to take.

Amy cleans a section of Billy’s right buttock and uncaps the large bore needle while waiting for the alcohol to dry. “Point your toes in and relax the best you can. The more your relax the less it will hurt. I know you can take this. Big stick on the count of three. 1, 2, 3”

On three, Billy feels a sharp pain as Amy swiftly pushes the needle deep into his glute. He gives a little gasp, but remains still as he focuses on his breathing. He then starts to feel a burning spread through his butt as Sandy pushes the medicine in. This keeps spreading like an antibiotic shot, but he remains silent like he did when showing his little sister that shots weren’t too bad.

Then after an agonizing eternity (20 seconds), the fire stops spreading and he hears, “All done. You took that very well Billy.” and feels Sandy bandaging and gently rubbing his abused buttock.

“Yeah, that one is pretty bad. About like a penicillin shot. But don’t worry, I won’t scare anyone. In fact, I know a couple of people that I will try to reassure.” Billy says as he carefully sits up, not caring about what Amy and Sandy are seeing.

“Thanks Billy, believe it or not, that helps.” Amy says as Sandy helps pull up Billy’s briefs.

After carefully dressing, Billy heads out to talk with Tommy and a couple of others that he thinks will need encouragement while Sandy starts resetting the room.