Alexandra stepped out of the elevator on the third floor of the Women’s Health Pavilion feeling the same low hum of dread she always did before her annual exam. Twenty-four today, actually; her birthday had been yesterday, celebrated quietly with brunch and mimosas. Nothing wild. She liked her life predictable, pleasant, and above all, private, especially when it came to anything below the waist and behind the waistband.

She signed in at the desk, smiled the polite smile she’d perfected over the years, and took a seat among the pastel chairs and old magazines. The receptionist called her name sooner than she expected.

“Alexandra? Dr. Endicott is ready.”

Dr. Endicott was new. Her usual doctor had retired last spring, and the practice had reassigned her without much ceremony. Alex had met Dr. Endicott once before, briefly, when she’d come in for a quick prescription refill. Mid-thirties, calm voice, dark hair pulled back neatly. Professional. Nothing alarming.

The nurse weighed her, took her blood pressure, asked the usual questions. Alex answered everything cheerfully until the nurse got to the phrase “any rectal bleeding?”

Alex froze mid-sentence. “Um… no?” It came out higher than she meant it to.

The nurse gave her a neutral little smile and typed something anyway.

In the exam room, Alex changed into the paper gown, the one that never quite closes in the back. She sat on the table, knees together, and tried to think about anything except what was coming: the speculum, the cold gel, the stirrups. She could handle that now. She’d trained herself. Front stuff was clinical. Manageable.

Back stuff was another universe entirely.

There was a soft knock. Dr. Endicott stepped in, chart in hand, and closed the door.

“Happy belated birthday, Alexandra,” she said warmly, scanning the screen. “Everything looking good up here… but I do see you circled ‘occasional bright red blood’ on the questionnaire and then told the nurse no. Want to tell me which one is the truth?”

Alex felt her face go hot. “It’s… it’s barely anything. Like one streak. Once in a while. I figured it was nothing.”

Dr. Endicott's expression didn’t change, but her voice softened. “Bright red usually means it’s from the very end of the line. Could be a little fissure, could be a hemorrhoid. Either way, I need to check. It’ll just take an extra minute.”

Alex’s stomach flipped. “Check… how?”

“A quick visual and digital exam. I’ll be gentle, I promise. You can stay lying on your left side, knees up. Most patients say it’s less awkward than they expect.”

Most patients are liars, Alex thought.

She opened her mouth to protest, to say she’d come back another day, to ask if they could just pretend this conversation never happened, but the words wouldn’t come. Dr. Endicott was already pulling on gloves, calm and unhurried, the way people move when they know you’re going to give in eventually.

Alex slid off the table, legs shaky, and repositioned herself on her side as instructed. The paper crackled under her. She stared hard at the wall, at a cheerful poster about breast self-exams, and tried to disappear into it.

Cool air brushed her skin as the gown lifted. She squeezed her eyes shut.

“Breathe for me, Alex,” Dr. Endicott said quietly. “Just relax everything you can.”

There was the snap of a lubricant tube. A gloved finger rested lightly against her anus, not pushing yet, just waiting.

Alex’s entire body went rigid.

And then, very gently, the finger pressed forward.

The intrusion was immediate, unmistakable, and mortifying. She felt herself clench involuntarily, heard the softest chuckle from the doctor—not mocking, just acknowledging the reflex.

“Easy. You’re doing fine.”

It slid deeper. Alex bit the inside of her cheek so hard she tasted blood. There was pressure, a strange probing sweep, and then a pause.

“Ah. There we are,” Dr. Endicott murmured. “External one’s tiny, barely a skin tag. But you’ve got a nice little internal one too—grade two, I’d say. Swollen, but not thrombosed. That’s why you’re seeing the bright streaks.”

Alex wanted to die. She wanted the floor to open and swallow her whole. Someone was talking about her asshole like it was the weather.

The finger rotated slightly, exploring, and Alex let out the tiniest whimper before she could stop herself.

“Sensitive,” Dr. Endicott noted, clinical and kind at the same time. “You’ve been straining a lot, haven’t you? Trying to hold things in?”

Alex couldn’t answer. She just nodded against the pillow, cheeks burning hotter than she thought humanly possible.

The finger withdrew, slow and careful. Alex exhaled shakily.

“We’re all done with that part,” Dr. Endicott said, stripping off the glove. “But we do need to talk about fixing this properly. Because if we don’t, sweetheart, it’s only going to get louder back there.”

Alex pulled the gown down and sat up, clutching it closed, feeling strangely small.

Dr. Endicott washed her hands, then turned back with a look that was almost sympathetic.

“First things first,” she said, pulling a small carton from the cabinet. “Suppositories. Twice a day for a week. Then we’ll schedule you for a proper anorectal exam under sedation—scope the whole area, make sure there’s nothing else hiding. Sound like a plan?”

Alex stared at the box in the doctor’s hand like it might bite her.

Her bottom—her secret, silent, never-discussed bottom—was about to become the main character of her life for the foreseeable future.

And something told her the story was only just getting started.