Sean had grown up in San Francisco but was anxious to move to the US East Coast to attend a private school he had been thinking about for years. After a long application process, Sean received the great news that he had been accepted for study. He read the information packet with excitement but when he neared the end of the paperwork, he discovered that he was required to undergo a comprehensive physical exam. His face turned red as he read the form. There were standard things he was expecting - age, height, weight, blood pressure, eyes, throat, abdominal area, but he saw that he was required to undergo a genital/rectal exam. At 21, he had never undergone such an examination and though he had been told by a few of his friends what it was like, he never anticipated he would have to submit to such a procedure.
His voice was nervous when he called Dr Nash to schedule a comprehensive physical. I asked if he had the required forms from the new school and he said yes. I made an early evening appointment for him, knowing that it would be important to take my time with this young man and his anxiety. Since I was familiar with the school he was about to attend, I knew the exam components and imagined that this nervous young man had never undergone an adult physical. Sean arrived on time, slightly sweaty from his anxiety and he was clearly unsure what the procedures would require of him.
As I went through his pre-physical questionnaire, I saw that Sean was nervously eyeing the exam area. He saw the gloves, the gown lying on the exam table, and the medical instruments I would be using. I suspect he saw the tube of lubricant on the stand next to a specimen plate. He answered my questions with a simple yes or no, and addressed me as Dr, Nash or, on occasion, Sir - which I though charming, respectful, and likely obedient. AS he sat in the chair next to my desk, I asked Sean to remove his shirt so that I could take his blood pressure. He did so quickly and placed his arm on my desk without hesitation. I could see that Sean had taken care of himself. A little muscle on his arms and long fingers were balanced by the light hair on his chest. He was lean and I could see a little bit of his boxer shorts above his belt. His BP was normal and I ask Sean if he was ready for his exam. Yes, Dr, Sean said. I pointed to the gown on the table and told him to change into the exam gown and leave all of his clothes on the chair he had been sitting on.
Sean's face turned bright red - "I have to take off all my clothes?" he said almost apologetically. Sean, this is a comprehensive physical exam and I will be having a good look at you from head to toe. Your exam gown opens to the back and you need to remove your clothes. Sean gulped and stood slowly and removed his shoes and socks. He slowly walked towards the exam table. He picked up the gown and unfolded it to see how it was thin and the ties worn. He unbuckled his belt and unbuttoned his jeans. As he lowered his zipper, the room was so quiet it seemed to magnify the sounds. He removed his jeans, folded them and placed them on the exam table. I began to notate my observations and Sean glanced over at me writing on his forms. He put the gown on and tied it. It seemed as though Sean thought he had done the right thing, but I saw his red boxers were still on. Sean, I said directly, please remove your boxers and place them with your other clothes. Yes Sir, Sean said and he returned to my desk area and with shyness, this soon to be college boy dropped his boxers and placed them haphazardly on top of his remaining clothes. Good I said, breaking the quiet room. Now let's take your height and weight. Please stand here on the scale.
As Sean walked his bare bottom exposed he tried to place his hands behind him as if to cover himself. I guided him onto the scale, facing the wall, and told him to bring his hands to his sides. He did and through the exam gown, I could see his naked body and then I noticed that he was shaking slightly. I asked if he was cold and he said no, just nervous because he had not had a physical since he was a kid. I told him that this was a common situation and that it was normal for him to feel a little nervous. Sean, I have examined many males your age - you have nothing to worry about. I will guide you and just follow my directions and you will be just fine. Yes, Sir, Sean said as I finally saw the was going to be a wonderfully compliant patient.
After his height and weight, I asked him to sit on the exam table and proceeded to examine his eyes, ears, throat, next, and scalp. I handled Sean with a firm and strong hands hoping it would help him feel more assured that he was in good hands. I had him stand for the eye chart and as he did, the gown stuck to the table. Sean was exposed for a few seconds and he was quick to grab the gown and cover himself. I asked him to read the chart, first with the right eye covered, then the left. Sean, I said directly, I need you to lie on the exam table on your stomach. Sean did so with no hesitation. He turned his head towards the stand where I had the instruments and he saw that I was putting on two gloves. I picked up the thermometer and said: "Sean, I need to take your temperature." Sean opened his mouth and I said, Oh, sorry Sean, in this office temperatures are taken rectally. He rolled his eyes and I took that moment to spread his buttocks open with my left hand. I told Sean to spread his legs slightly and he did, but not enough. I took my right hand and guided Sean's legs to open a bit more. Sean realized that his scrotum was in full view and I told him I would lubricate his rectal area and insert the thermometer. Sean said, "Aren't I a little old for that?" It's not a matter of age Sean, I said to him. This is how the procedure is done in this office. I understand Dr Nash - and with that, I took the lubricant and placed it directly on his rectum. He gasped a little and I said "Sorry, I know it's a little cold Sean - but it will warm to your body temperature soon. Now just relax, I need to lubricate you just past your sphincter muscle" And as I said that to Sean, I slid my gloved finger just past his muscle. At first, Sean was relaxed, but as soon as he felt my finger inside of him, he tightened his muscle. I took my time and circled around his sphincter as Sean said that it felt weird to him. I removed my finger and slide the fat thermometer inside of him. I will observe your temperature Sean, I sad, as I continued to hold his buttocks open with my left hand.
The room fell silent again. The tension was strong as I held Sean's buttocks open and the thermometer was sticking out. Occasionally, I twisted the instrument and moved it deeper inside of him. He made little sounds - and it was clear that Sean was very sensitive to being so submissive.