Play Exam Script 3
Background: This is recreation of a physical I had by my pediatrician when I was 13. The reason for the exam was for sports participation. The doctor's office was in a modern medical office building adjacent to a hospital. The exam room was small, had vinyl tile floor, white walls, and had a typical metal exam table with drawers along the sides, an upholstered top with a pull-out foot extension, a paper roll to cover the top, and a pull out step at the foot. There was a straight chair, a small writing desk, and a rolling exam stool. On the wall were sphygmomanometer, otoscope, and opthalmoscope. The pediatrician was in his fifties, short and thin, and wore dress shirt and slacks, tie, and white coat.
You say "go ahead and strip down to your underwear including your socks." (I will strip to my briefs.)
Say "sit up on the table." (I will sit on the side of the exam table facing you while you stand in front of me.)
Take the blood pressure cuff and wrap it around my upper right arm. Position my right hand on the table next to my right thigh. Put the stethoscope on and inflate the cuff while you listen over the inside of my right elbow. Deflate the cuff while you listen. When it deflates, inflate it again and repeat the process. Take the blood pressure cuff off of me.
Take the stethoscope earpieces out of your ears and let them hang around your neck.
Get the otoscope and look in my right ear and then tell me "turn your head" and look in my left ear.
Get the tongue depressor and say "open wide and stick your tongue out." Put the tongue depressor on my tongue and shine the light in the back of my throat. Tell me "say ahhh." I will do it and then you remove the tongue depressor.Put the otoscope down.
Get the ophthalmoscope and say "look straight ahead." Shine the light in one eye and then go to the other side and shine it in the other eye. Put the opthalmoscope down.
Get the reflex hammer. Stand to my right, hold the reflex hammer in your left hand, hold my right wrist with your right hand and tap the hammer on my right elbow and then right wrist. Move to my left side, hold the hammer in your right hand, take my left wrist in your left hand and tap the hammer on my left elbow hand wrist. Take the hammer in your right hand and tap on each of my knees. Then hold the hammer in your right hand, hold one foot in your left hand and tap on my Achilles tendon on each ankle. Put the hammer down.
Put the stethoscope earpieces in, stand to my right, put your left hand on my right shoulder, put the bell of the stethoscope over the right side of my chest and listen. Move the bell around the right side of my chest several times. Then say " deep breath in and blow it out." Move the bell over both sides of my chest and repeat " deep breath in and blow it out" each time you reposition the bell. Continue doing the same thin over the back of my chest.
Say "lie back flat on your back." I will lie supine and you listen with the stethoscope over my abdomen in four or five locations.
Take the stethoscope earpieces out of your ears and take it off completely.
Use your hands to feel over my entire abdomen pushing down hard. Feel all the way down to the waistband of my briefs but not inside.
Step back one step from the table, look directly at me, and say "stand up here next to the table facing toward me." (I will stand up and face you.)
Say "let's go ahed and slip your britches down." (I will drop my briefs to my upper thighs.)
Start on the right side of my scrotum and feel the testicle .Then push your right index finger into the upper part of my scrotum on the right pushing toward my right shoulder. Say "turn your head and cough." (I will cough.) Say "again." (I will cough.)
Go to the left side of my scrotum and feel the left testicle. Then push your right index finger into the left side of the scrotum and say "turn your head and cough." (I will cough.) Say "again." (I will cough.)
Pick up my penis by the head and spread the meatus with one thumb on each side of the meatus. Drop my penis and say "we're done. You can get dressed."
Comment: There is nothing unusual about this exam, but it is the exact exam I received annually from the ages of 13 through 18 (when he did my college physical). I started seeing this pediatrician when I was 11. For the first two years, he did the genital exam with me lying on my back and he just pulled down the front of my briefs himself. At 13, he started having me stand and drop the briefs myself and added the hernia exam.