The day had finally arrived and I sent Les a text asking her if she was ready. She replied that she was as ready as possible. Told her I was leaving and would see her in an hour and a half. Okay was her reply. I knocked on her door, black bag in one hand and brief case in the other. She opened the door and said ’wow; look at you’, black bag and all. I set my bag and case on the table and turned to give her a hug. She wrapped her arms around me very tightly like she was holding on for dear life, and I could feel her heart pounding. I ask her if she was okay and she replied, ‘kind of’. What’s wrong I ask her. She said she was really nervous. I ask her if she still wanted to proceed and she said, yes. I opened my brief case and took out a chilled bottle of Asti and told her maybe this will help to relax her. She agreed and went & got a couple glasses. We sat at the dining room table and sipped the Asti and made small talk for a little while. She thanked me for the Asti and said it and our small talk helped to calm her nerves. I suggested she put the rest of the Asti in the fridge for later and she agreed. As she left to put the Asti in the fridge, I moved our chairs to the end of the table, across from each other. I also moved another chair next to mine and set my open bag of instruments on it. When she returned, I ask her if she was ready and she said, yes. I handed her the exam cape and told her while I finished setting up, I wanted her to undress, everything off but her panties, put on the cape, opening in the front and have a seat on the chair. She took the cape and excused herself to use the bathroom. When she returned, she had the cape on and quickly sat down in the chair across from me, hands folded in her lap covering her panties.

I reached into my bag and got my penlight and tongue depressor. I told her to open wide and say ‘ah’ as I pressed down her tongue and looked at her throat. Next I got the otoscope and moved to her side, pulled her hair back, and looked into her ear. I told her all looked good, and then proceeded to lightly breathe into her ear. She shivered as I did so, which was the intended reaction. I moved around to her other ear and repeated the process. I took a gallon food storage bag out and placed the otoscope in it. All instruments that are inserted are kept separate after they are used. I got the BP cuff out and placed it on her arm and put the stethoscope in my ears and inflated the cuff. When I had a good reading, I ask her what her BP normally was. She replied about 135/80, as she was on BP medicine. I informed her that her BP was 145/85; a little high, which was most likely a result of her nervousness; to which she agreed. I put the cuff away and sat down across from her. I reached over and palpated her neck and felt the glands and had her swallow; no issues. Next I told her I was going to listen to her lungs and heart. I put the steth back in my ears and moved behind her and ask her to lean forward a little. As I placed the bell on her back, outside of the cape, I told her to take deep breaths. After listening to her lungs in about 6 places, I told her that they sounded clear. Next I placed the bell inside the cape on top of her right breast and ask her to take deep breaths again. I listened all around her right breast before moving the bell to her left breast, As I moved to her left breast, my hand caused the cape to come open and expose most of her left breast. When I finished listening to her lungs, I told her I was now going to listen to her heart. Once I opened the cape fully and exposed her left breast, I told her to lift her breast so I could listen under it; to which she complied. After several minutes listening all around, I ask her if she had a murmur. She said yes, closed the cape, and returned her hands to her lap, thanked me, and said she would have it checked further. I put the steth away and sat down across from her.