This follows on directly from 'Kate's follow-up exam III,' so if you want the complete picture, you may want to read that first. You can get the gist by just reading this, though. Anyway, I hope you enjoy reading it as much as I enjoyed writing it.

Several months had elapsed since I thought I had detected a heart murmur during my first play exam with Kate. After a bit of a nervous beginning, we had settled into a semi-serious relationship which, needless to say, involved regular medical play. After a long week at work, we both looked forward to nothing more than a good session of cold steel, latex gloves, and deep probing examinations.

So it came as a bit of a surprise when Kate received a letter from the local hospital with an appointment for an ECG. "Oh," said Kate as she opened the letter. "I had totally forgotten about this," she added, biting her lower lip.

As it turns out, Kate had got understandably freaked about the murmur issue and gone straight to her GP the following week. Not wanting to give away the details of how the issue had came about, she just told him she was suffering from chest pain. Her doctor, a real old-school West Indian guy and a real stickler for detail, had examined her thoroughly and could find no trace of any condition but wanted to be certain and processed a request for a series of cardiac tests at the hospital.

"Ummmm," said Kate, "I don't think I really need it, but could be interesting."

"If your GP has requested it, I think you should go," I added, pausing for thought.

"Do you want to come with me and watch?" Kate chirped with a laugh before I could finish. Needless to say, the answer was yes.

So a few weeks later I parked outside the drab grey hospital building. It was mid October and winter was starting to set in with the bleak constant drizzle which characterizes a London winter.

The receptionist took Kate's details, and we sat in the bright, modern waiting room. The walls were covered in health education posters, and it was beginning to feel a little too real when the nurse brought over a form for Kate to sign.

"Is it okay if my partner comes in with me?" asked Kate in a businesslike tone.

"Depends on the doctor," shrugged the nurse, without even looking at me. "I'll mention it when I take your notes through," she added before busily marching off through a door marked "Private."

Kate slipped me a smile and a wink and handed me a brown leather sports holdall. The letter had instructed that she wear loose clothing, but Kate had been to work in the morning so she was wearing a skirt and boots with a tight grey sweater. The bag contained her gym kit in the assumption she would have to get changed.

I was about to bring the issue up with Kate when the door sprang open and the nurse beckoned Kate in. Paranoid and fumbling, I tapped my chest with a finger to which the nurse nodded her head in a slightly agitated manner.

The room was obviously a state-of-the-art cardiac suite, bright and airy with a range of machines and monitors with a crisp white examination couch in the center of the room and a treadmill in the corner. A couple of chairs were lining the wall at the near side of the room. The doctor, who was wearing a white lab coat, had his back to us but beckoned us in with a waved hand.

Kate proceeded towards the couch in the center of the room whilst I quietly took a seat alongside the near wall.

The doctor turned around abruptly and introduced himself to Kate as Mr. Hassan, eyeing me suspiciously over her shoulder.

"Oh, that's just my boyfriend, Doctor. Do you mind if he stays, please? For moral support. I'm very worried."

Dr. Hassan just grunted as he flipped open Kate's notes. He was clearly a bright young man with sharp Asian good looks, but he wasn't going to tolerate any nonsense.

"So you have chest pain?" he quizzed Kate. "Exactly where? Tell me, please."

Kate rubbed the center of her chest, just under the line of her breasts in the tight grey sweater to which he gesticulated impatiently for her to remove, patting the crisp white cotton on the examination couch with the other hand.

The nurse handed him a big cardiac stethoscope, which appeared to be gold plated. I had seen gold plated audio leads before and assumed this to be because of the superior sonic qualities.

Kate slipped her sweater off and hopped-up onto the couch. As Dr. Hassan began to listen to her chest. I could clearly see, even from where I was sitting, that the big metal bell was pressed firmly and deeply into her warm skin. He listened for a while at the apex of her chest before moving the stethoscope around, listening with focused intensity at the four main valves, slipping it inside Kate's bra when he got to the bottom before placing it on her back and listening to her lungs. When he had finished, he asked her to lay flat, and repeated the process, bending over Kate's prostrate form as he moved the cold metal instrument over every inch of her chest.

Standing upright again and removing the stethoscope from his ears, Dr. Hassan beckoned to the nurse to bring some equipment over. Two portable high-tech machines with flat-screen computer monitors where wheeled over to the examination couch where Kate was laying flat in her skirt, boots and lacy black bra.

"Remove your brassiere and boots, please," instructed the doctor in a curt, efficient tone.

Kate complied and unzipped her winter boots, dropping them onto the floor with a thud as they hit the white tiled flooring before unclasping her bra and returning to the flat, horizontal position on the couch. Dr. Hassan removed a small metal stick from his top pocket and used it to stroke the sole of Kate's stockinged foot. Twice on the left and twice on the right, obviously checking her neurological reactions, before repeating the process on her hands.

The machine to the right looked like a sonograph, and I was proved correct as the doctor unhooked a Doppler-like instrument and the nurse applied a clear gel to Kate's chest, smack in between her naked breasts. I could see Kate flinch slightly as the liquid was applied. It must have been very cold. The doctor then moved the instrument around the center of Kate's chest as the cone-shaped form, familiar to anyone who has been for a pregnancy scan, appeared on the screen with a picture of Kate's beating heart.

I could see the doctor maneuvering the instrument under her left breast to get a better view, the clear sound of her thumping heart perfectly audible from the speakers.

The doctor appeared satisfied and instructed the nurse to clean her up. Kate cut a quick look to me with a warm smile. She was obviously enjoying every minute of this.

The machine to the left was obviously the cardiograph, although it looked more like a graphics station. It was only when the nurse began to plug the leads into the sides that it started to look familiar. Happy that they were all in the correct positions, she leaned over Kate and began to attach the white and blue sticky circles to Kate's bare chest. After a couple of minutes they were all in place and the nurse flicked the machine on, booting it up like an office computer. As the screen buzzed into life, four traces appeared on the screen: one white, one red, one blue and one green; as it began to trace the rhythm of Kate's resting heart in a series of spikey asymmetric patterns.

Dr. Hassan studied the patterns for a couple of minutes, scanning up and down and comparing the information before gesticulating to a treadmill in the corner of the room.

Kate carefully climbed off the couch and moved slowly across the room as the nurse pushed the mass of bleeps and wires along beside her, stopping at the side of the treadmill and switching it on with a mechanical whirring sound. Kate grabbed the metal rail and climbed on at a slow walking pace as the nurse wrapped a BP cuff around her arm. After a short time you could hear the speed of the treadmill increase along with the bleep of Kate's heart monitor. From where I was sitting, the colored lines were now moving too fast for me to read, but the doctor studied them with the same focused intensity with which he had listened to her heart earlier, studying each reading and comparing the results.

By now Kate was moving at a very fast walking pace, her naked breasts jiggling slightly with each step. My mind wondered as to why she had bothered to bring her gym kit, as it was clearly not being used as Dr. Hassan unhooked his stethoscope again and listened intently to her accelerated heartbeat. My first thought was: I hope Kate's okay, but I did have to concede a degree of envy.

After about 10 minutes I could hear the treadmill slowing to a stop, which must have indicated the ECG exam was over. The nurse hurried over and removed the leads and handed Kate a glass of water whilst the doctor barked notes into a dictaphone. When he had finished, he asked Kate to return to the examination couch. As Kate lay prone again he began to explain that there was nothing wrong with her heart and that he suspected the pain was digestive. Again he quizzed her about the pain, to which Kate again had to lie.

The doctor frowned and narrowed his eyes, putting on his stethoscope yet again to listen to Kate's flat and toned abdomen before firmly palpitating the area with his hands.

The doctor muttered something to the nurse before confidently requesting: "Can you remove your skirt and underwear now, please," to Kate's (and my) utter surprise. The nurse quickly appeared with a tray of apparatus, which at a glance included some latex gloves, lubricating gel and a long metal tube.

Kate cut me a look of horror, but i just nodded back suggesting it was okay. Kate complied and slid her black skirt and knickers off, leaving her naked on the couch in only a pair of tan hold-up stockings.

The nurse held Kate's arm and helped her flip over onto her front and applied the gel to her rectum as the doctor pulled on the gloves. He wasted no time getting down to business and slid an extended finger into her rectum as the nurse put pressure on her buttocks. I couldn't believe what was happening, and by Kate's expression, neither could she. This was, after all, a cardiac examination and the doctor was performing a full rectal. Maybe he was just being thorough, maybe he had tumbled us and was teaching us a lesson, or maybe he was enjoying it as much as me. Who knows? Who could really say, apart from him? One thing's for sure, though, the instrument the nurse was quietly lubricating was a proctoscope.

I lent over to make eyes with Kate, but her eyes were shut tight and she was biting her lip as the doctor slid his finger out and removed his gloves. Her eyes remained shut, but I could see her her tense as his finger was replaced by the cold metal proctoscope. The doctor bent down to peer into the end whilst he shouted notes to the nurse, pushing the instrument deeper and deeper into Kate's rectum.

I could see Kate's nails digging into the couch and tearing the crisp white paper cover and her toes curling in her stockings. This was obviously an experience she wasn't going to forget.

The doctor barked one more instruction to the nurse, then slid the device out, leaving the nurse to clean Kate up and help her get dressed. The doctor had confirmed that there was no detectable cardiac problem, but she should be careful as to what she eats and cut out cigarettes, alcohol and coffee. At no point did he attempt to explain the need for the procedures and, with a humorless smile, bid us good-bye. After what seemed like a lifetime, Kate was finally dressed and we were both on our own again in the examination room collecting our thoughts.

"You okay?" I asked rather gingerly. "At least there's no problem with your heart."

"Phew," said Kate, puffing out her cheeks, clearly still a million miles away. "What the fuck did he put up my arse at the end? It was bloody huge."

"I think it was a proctoscope," I added sheepishly.

"Oh, yeah?" Kate added with a huge smile. "Do you know where we can buy one?"

😉