(The waiter returns briefly to clear away the empty glasses. The two women suddenly fall silent, exchanging knowing glances. As soon as the area is quiet again, Silvia leans forward once more, driven by palpable excitement.)

Silvia: Oh my goodness, Elena... This is all extraordinary. But once you have her there, immobilized, unable to escape, and completely yours, what else does this strict protocol entail?

Elena: Hydrotherapy has many variations, as you well know. I range from the classic gravity-fed enema to hydrocolon therapy, where, however, I manually block the flow of water and force her to retain it to the absolute limit of her physical capacity. And then there are the injections. I deliberately choose thick needles. It’s a deep intramuscular injection, straight into the upper-outer quadrant of the gluteus, administered while she’s immobilized face-down on the standard treatment table. The viscous liquid is injected with exasperating slowness, seeping into the muscle for days. Every time she sits in her executive chair, that dull pain reminds her exactly who controls her will. (Elena said in a sadistic tone)

Silvia: (She bites her lower lip) Oh my God, it’s as if I’m controlling her from a distance… But I imagine that gynecological exam table isn’t just for needles and enemas. Physical pleasure has something to do with it, too, somehow, or am I wrong?

Elena: (She sets down her glass of water with a decisive gesture, smiling mischievously) Hey, slow down a second, Silvia. You’re definitely getting ahead of yourself. Your eyes are shining in a peculiar way—you know that? You seem a little too eager to reach the conclusion of pleasure…

Silvia: (Suddenly blushes, lowering her gaze) Me? No… it’s just that your narrative is incredibly intense. I was simply putting myself in the clinical dynamic—that’s all. It’s a fascinating psychological conditioning. And let’s face it, you handle this protocol with surgical precision, Elena… but where does all this awareness of control come from? Have you never been through it yourself?

Elena: (Her gaze grows distant) Of course I have, Silvia. During my first year of residency at the hospital, I made a serious mistake with a medical record. The head of the department—a cold woman with unquestionable authority—took me into her private office. She locked the door and inflicted an exemplary punishment on me: she forced me to bend over her desk, and I received a memorable spanking.

Silvia: (Holding her breath, leaning forward) She punished you… your department head?

Elena: (Nods) Yes. A woman. I still remember the burning sensation on my skin and my tears. Many would have come out of it traumatized; I, on the other hand, just as I was undergoing that total deprivation of my will, had a moment of crystal-clear insight. I realized the enormous, devastating psychological power of the person who decides the punishment. Enduring that physical submission at the hands of another woman made me realize, by contrast, that my true nature wasn’t to be subjugated… but to be the one orchestrating the control.

Silvia: So that’s where it all began.

Elena: Exactly. Except that over time, I realized I wasn’t interested in replicating those dynamics in a traditional way. I replaced emotionality and impulsivity with the rigor, discipline, and ritual of medicine. That’s where I began to develop my method.

Silvia: And was Clara the first person to try it out?

Elena: No, not the first to try it… but the first to truly understand it. She immediately recognized what I was offering: a space where she could let go of the weight of the responsibilities she carries every day.

Silvia: (Looking at her intently) And does it really work?

Elena: (Looking at Silvia with a mischievous smile) I’d say so. But the interesting part is something else.

Silvia: What is it?

Elena: I’ve been watching you for half an hour. Every time I describe my method, you’re not thinking like a colleague. You’re putting yourself in my shoes.

Silvia: (Completely flustered) Um… Maybe because you’re telling the story as if you were still right there.

Elena: Or maybe because you’re imagining Clara in that room. And, who knows, maybe you’re wondering what it would be like to be in her shoes.

Silvia: (Trying to quickly change the subject) Maybe. But we were talking about her, weren’t we? Tell me something: once all this discipline is in place, what does she get in return? What does she find in these sessions that makes her come back every month?

Elena: It depends on the moment and what she needs. Everything is precisely planned. Some sessions are dedicated exclusively to monitoring, others to discipline and observing her progress. Between visits, I assign her tasks, rules, and notes to report back on. When she returns, the first thing I do is check how she handled that period. That’s when I understand her mental state and decide how to proceed.

Silvia: (Almost in shock from the story) What kind of rules? Are we talking about simple behavioral guidelines or something more strict?

Elena: Much stricter. She has to do a maintenance enema once a week, and since you’re so interested, the first rule above all is that she’s forbidden from touching herself when she’s alone.

Silvia: (Now completely stunned by the story) She can’t touch herself… That’s total biological submission. A woman of that caliber having to ignore her own impulses until you order her to. And how do you make sure she does everything as she’s supposed to?

Elena: (Pleased with Silvia’s curiosity) Simple. As soon as the procedure is finished, she has to send me a message with the amount of fluid used and a photo of the fluid expelled into a graduated container. Everything has to be recorded in her file. If she skips the procedure or makes mistakes, she knows her next visit will be much more corrective.

Silvia: (She remains silent for a few moments, trying to process what she’s just heard) That’s incredible—I can’t imagine how embarrassing that must be. So the supervision isn’t limited to the hours she spends with you in the office. In a way, it continues even when she’s at home, at work, during her normal life. It almost seems t , as if the session begins long before she walks through that door.

Elena: Exactly, dear. When you restrict her body in her private life, my consultation becomes the only safe space where she’s allowed to let off steam. It all begins in the changing room, the room just before the examination room. I instruct her to undress completely and enter fully naked. When she arrives in the examination room, she’s barefoot, stripped of the makeup she uses as a social shield, without even her jewelry. I have her step on the scale, then I take her blood pressure. Every piece of data is recorded in her chart.

Silvia: And what about the transition to more invasive procedures? How do you proceed?

Elena: At first, I have her lie down on the classic examination table—the original one from my father’s practice. The first standard procedure is the classic rectal temperature measurement. I use an old glass thermometer. I instruct her to lie on her side and bend her knees. I apply a thin layer of lubricant and insert it slowly but deeply. Clara must remain motionless, in total silence, for exactly five minutes while I prepare what’s needed for the rest of the exam. Other times, to prepare the mucous membranes, I insert a therapeutic suppository—inserted deeply, of course—and then have her contract her muscles to hold it in until it’s completely absorbed.

Silvia: (Listening with visibly labored breathing) It’s incredible how you use the solemnity of medicine to completely disarm her… And as for the body positions, does she accept them all?

Elena: The position is determined solely by the requirements of the procedure. If the session involves hydrotherapy or a deep vaginal examination, the position is the classic gynecological one: the pelvis positioned at the very edge of the examination table, with the legs raised, spread apart, and securely fastened in the metal stirrups with the black leg straps. It’s the position that offers the greatest possible exposure, as you know. If, on the other hand, the protocol calls for injections or certain types of rectal examinations, I instruct her to lie prone, on her stomach, placing a firm pillow under her pelvis to lift and spread her buttocks. She has no choice but to accept the position I’ve determined for her.

Silvia: You essentially nullify all her motor functions… She remains there, a motionless body at your complete mercy. But after undergoing such invasive and painful procedures, how do you end the session? How do you grant her release?

Elena: It ends only when my mental timer decides it does, and not always in the same way. Many people make the mistake of thinking that pleasure is the final reward of the protocol. That’s not the case. I don’t hand out rewards. Every procedure I perform has a specific purpose, and release—when it occurs—is simply one of the possible stages of the treatment.

Silvia: (Completely captivated by Elena’s words) So it’s not something Clara automatically expects every time.

Elena: Absolutely not. There are sessions that end without any release. Other times, however, I realize she’s built up so much tension that a controlled release is necessary. In that case, I consider it an integral part of the visit, just like any other procedure outlined in the protocol. It’s not a reward for her obedience, and it’s not a personal favor. It’s a clinical decision I make when I believe she truly needs it.

Silvia: So it’s always and only your choice.

Elena: Exactly. Clara doesn’t ask for it, she doesn’t demand it, and she never takes it for granted. She knows that everything depends on the assessment I make at the end of the session. Only then do I decide how to conclude the protocol.

Silvia: And when you feel that release is necessary, how do you proceed?

Elena: It depends on the person and the moment. There are different approaches. Some are more impersonal— r almost mechanical—and maintain a total distance between me and the patient. Others, on the other hand, require my more direct involvement and a continuous assessment of her reactions. I choose the method based on her emotional state and the goals of the session.

Silvia: So you don’t always follow the same pattern?