I escorted the twins upstairs to the back bedroom where I had prepared a make shift exam room the best I could with the little supplies that I had. Instead of an exam table with stirrups I had a regular bed with 2 kitchen chairs that had high backs on them. I planned to use the chair backs as foot rests. I also did not have a hospital gown but I did have a robe. I entered the room followed by the twins and instructed them to have a seat.

I took their clipboards from them and kept the clipboard from the twin on the right in my right hand (the one with the pony tail) and the one from the left side in my left hand (long hair pulled to the left side of her head). I quickly went over the top section and saw their names were Amy (pony tail) and Nichole. In the nickname section the girl called Nichole wrote down she is sometimes called or prefers to be called Nicky. I looked further down the list and saw that Nicky’s last menstrual cycle ended 5 days ago and Amy’s was a week ago. Under the section for pains both wrote the word none. I then told the girls that if it were alright with them that we would just sit and talk for a few moments. They shook their heads in agreement.

I placed the clipboard on my lap and introduced myself to them and told them that I understand from what their father told me that they were going to a real doctor the following day and that they always did a practice run through before anything new was tried. Then Amy spoke saying that it was usually their parents that ran them through the practice event and they did not really understand why I was there to run them through the practice exam. I asked them when was the last time they had seen a doctor. Nicky replied that they had group exams in school with the nurse but other than that they were babies last time they were in a doctor’s office and they do not remember much about it. I then told them that the reason I am here is to practice with them the exam they are going to be doing tomorrow as it is called a pelvic exam. I then went into details about the steps of the exam. I said first we will sit and discuss your current health and hygiene habits and discuss your past health history. I stressed to them that anything said or done in this exam remains in this exam and would not be talked about any other time unless they decided to discuss it. I told them to be open and honest with me as it was their health, not mine that would suffer if they were not honest. They agreed and were fine with it.

So after discussing their last menstrual cycles and present day hygiene habits we discussed their health history. They both started menstruating around age 12 and their breast started growing at about the same time. They admitted to not done self breast exams and I told them we could go over that and I could show them how to do it and what to look for. I reminded them that monthly self breast exams would be the best way to note any changes in the breast and to see a doctor if they do notice any changes. When I asked them if they were sexually active they both replied that they were daughters of extreme strict parents and were not even allowed to date and were still very much virgins. This answer seemed almost like a complaint than anything else. I then asked them about sun exposure. It was the middle of summer and I could tell they girls had spent some time outside in the sun. I asked if they used sun screen at all. They replied that they did wear sun screen when they were allowed to sun tan outside in the back yard, while the parents were at home, other than that they were to stay in the house. Then Amy said with a disdain in her voice that their swim suits were one piece and covered most of their body and wasn’t really worth it to sit out and get sun on their faces. I reminded them that sun screen on their faces was also very important.

I asked them if they had any questions or concerns they wished to speak to me about. They sat quiet for a second and I tried to gauge if one of them wanted to speak privately with me. I could not judge their body language as they told me that they did not have any questions yet. I stood up and proceeded to tell them that we will do the physical part of the exam one at a time. I pointed to the robe at the head of the bed and told them to choose one of them to go first in removing all of their clothing and put the robe on then sit on the side of the bed. I would be back in about 2 minutes. As I went to open the door Nicky asked to clarify the statement to remove all of their clothing. I stopped in my tracks, turned to them and Amy piped up saying that I had asked for one of them to remove all clothing till they were naked and then put on the robe. I bowed my head to her as appreciating her candor in explaining the details to her sister for me.

I left the room but stayed within ear shot of the door for a few seconds as I heard them loudly whispering to themselves what was about to go on in there. One of them said it was just a practice exam and not to be worried. The other one said she would not remove her dress, let alone her underwear. I walked downstairs, checked my answering machine and ice tray. Both did not need the attention I had given them. I walked around in the kitchen just under the room the twins were in. It seemed pretty quiet and motionless up there so I returned to the bedroom and knocked on the door. They both answered to come in.

Amy sat on the bed wrapped in the robe as if she were a nun out in the late, cold night air attending to some urgent catastrophe. I walked over to the side of the bed and told her I will begin the exam by looking in her eyes, ears, nose and throat then listen to her heart and lungs. She asked if it was the same as the group clinics they had sometimes attended in the school gymnasium. I replied they were one in the same. She looks over at her sister and says, see not much different than what we already had been through. I peered into her ears, then eyes, nose and then throat. The hand held flashlight only allowed me to pretend like I was looking. I am not a medically trained doctor and never really understood what they were looking at in there. Here is my chance and I have not a clue, other than knowing that doctors like to look in these places. I then placed a stethoscope in my ears and then placed it on her back. I asked her to breathe as I moved it around. Unfortunately for me I got an ear full of the sound the robe made as I moved it around. The robe being a winter thick fur robe the high fabric fur made loud by the stethoscope almost blew out my ear drums. Again, I have no idea what to listen for but I am protected by the fact that I am not a doctor and don’t really need to find anything or will not be charged for overlooking something. I just need to go through the motions and practice what the girls will go through tomorrow when they see a real doctor.

I switch to the front side and ask her to slightly open the robe so I can listen to her heart. This time I really do want to check out the beat of her heart to see if it is quick and fast or normal. She reaches up and grabs each lapel and opens them ever so slightly. I say that’s fine and stick my hand down inside as I look the other way. Her heart is not racing and seems to have a nice beat to it. I remove the stethoscope from my ears and then tell her it is time to examine the breast for lumps or abnormalities. I ask her to remove her left arm from the robe and allow that side of the robe to fall free and open. She tries her best to remove her arm without exposing her breast. I reach down and tap her hand to allow the robe to fall open on the one side. I pull her left hand up and over her head. There she sits with one breast exposed holding fast to the other side. I explain what I am doing as I palpate her arm pit down the side and over the left breast. I can see her areola are small and her nipple is soft. I move circles around as I close in on her nipple. One last deep circle then a gentle pinch of her nipple as I role it around once and let go. Her nipple responds as it becomes hard and firm. I tell her to switch sides and cover up her left breast and do the same with the right. We repeat the same process. This time I looked over at her sister who was on the edge of her seat looking at every move I made. I finished with the same results on the right side and instead of draping her back up I asked her to lie back down and put her feet up on the bed as well. I told her I would repeat the process while she was laying down. First the right side then the left side. Instead of putting her arm back into the robe sleeves I just covered her shoulders.

I then proceeded to tell her I would palpate her abdomen and feel for abnormalities. There may be some pressure when I do this I tell her but it should not hurt. I gentle tug open her robe some more all the way down towards her lower half. I place both hands on her belly and start to press here and there. This part of the exam, I was told by my previous nurse girlfriend, I was really good at and it always felt good to her when I did it. As my hands move closer down to her pelvic area the robe opens more and she is pretty much naked, without being naked, under my hands. Her pubic mound is exposed and the center line of her chest is exposed. Yet the robe covers her legs and breasts still. I remove my hands as she covers herself back up with the robe. I then tell her that she will have to move down the bed until her butt is on the edge of the bed. I reach over and grab the 2 empty kitchen chairs and place one on either side of the foot of the bed. I coach her to move further down the bed as her feet dangle off the bed and almost reach the carpet.