The morning finally ended and Mark hurried out. He winced as he got into his car and sat down and drove the quick ten minutes to the back of the medical school campus where the medical center ER and urgent care entrances were located.

He got in and was relieved that the waiting room had just two other people in it. He checked in at the desk and was given a clipboard with a form to fill out. He was glad to have the privacy of being able to explain things in writing as he had anticipated an embarrassing exchange at the desk with the receptionist when asked to explain his problem.

He was still finishing the form when a young nurse came out and called his name. She gave him a perfunctory smile when he stood up and she introduced herself, “I’m Lisa! Nice to meet you Mark.”

She brought him into an exam room. He followed her and watched her auburn pony tail swing back and forth across her upper back as she led him down the hall. They entered the exam room and she had him sit in the corner chair as she card swiped the computer to get started.

She asked him questions about his symptoms which were embarrassing for him to answer and he struggled awkwardly to communicate the desired information in the least embarrassing way possible. She got a puzzled look on her face and asked for clarification, “So the pain is behind your scrotum. Do you mean your perineum or your anus?”

He didn’t know what the first word meant and she realized this from his silence, “That’s the area between your scrotum and your anus,” she explained.

“Yes, that’s where it is,” he confirmed. “Also the head.”

She needed clarification again, “You mean you have a headache, or do you mean pain in the head of your penis?”

Was she deliberately trying to embarrass him, or was she just making sure she got accurate information?

“My penis.” He said softly. He became a bit unhappy as he considered his transformation in minutes from a confident outspoken young guy to an embarrassed meek boy slumped in a chair giving one word answers to this nurse as she explained anatomy to him like he was a kid.

She typed in some notes and then began to take his vital signs. The familiar sounds of the process were a bit reassuring — the beep of the electronic thermometer under his tongue, the puffs and then the hiss as his blood pressure was taken and the pleasant firm embrace of the cuff around his upper arm. Finally, the rip of the Velcro as she removed it.

She entered the data into the computer, but as she tried to enter his temperature, it would not accept the reading, rejecting it each time with three rapid beeps. She tried again twice, but the same thing happened. She stopped and turned to him, “It won’t accept your temperature because it is too low to possibly be accurate. There is a hard stop in the system for any temperature under 95F. I need to take it rectally. Sorry, but I will be in big trouble if I don’t follow the protocol. Especially since you might have an infection.”

Mark looked at her puzzled and was thinking he misunderstood, “Huh?”

“I need to take it in your butt.” she told him bluntly.

He was still a bit incredulous, “Really?”

“Really!” She said it with an emphasis and tone that, combined with a tilt of her head and an exaggerated wide eye look, communicated she was losing her patience a bit. “Deal with it” was the unspoken gist of it.

There is always a bit of a mismatch with patient communication due in part to the naïveté and modesty of a typical patient and the familiarity and ease with which nurses and physicians discuss sensitive topics. That Mark had up until now enjoyed generally good health made him more ignorant and uncomfortable with these things and that increased this discrepancy. He being a young man with a young female nurse created more tension still.

She put a folded gown on the exam table and then handed him a plastic cup with a blue screw cap and a small foil packet and said, “Since you’re having symptoms when you pee, I need a urine sample. The bathroom is across the hall. First pee into the toilet a bit and then stop midway before you empty your bladder. Use the swab in the packet to clean the end of your penis around the urethra — the opening. Then pee into the container, close it up and bring it to the my desk in the hallway. When you get back here, take off your clothes and put the gown on and I’ll be back in to check your temperature.”

Mark went off to the restroom and did as instructed. The burning when he urinated was worse. When he came out into the hall, Lisa looked up at him from her desk and then at the plastic cup with the amber liquid in it. She quickly put on a blue glove and reached out to take it from him. He was a bit embarrassed as he considered how she would feel the heat of his fresh urine when she closed her fingers around it. “I will be in with you in just a minute,” she said.

He got back to his exam room and got undressed, leaving his boxers on. The blue exam gown was not comfortable, but coarse and stiff. Do they starch these dam things? he wondered to himself.

He sat back on the chair in the corner dreading her return somewhat, but his worry about his problem helped him overcome his reluctance and he was eager to get things worked out. He heard her knock on the door and she came in after a brief courtesy pause and put down her thermometer and small foil packet of lubricant on the counter right next to him.

“Hop up on the table. Do you still have your underwear on?” she asked.

“Um, Yeah.”

“Take them off first, that’ll make it easier.”

Mark stood facing Lisa and slid off his boxers and put them on the chair. Lisa pointed towards the exam table directing him to it. He walked past her to the foot step at the bottom of it and as he stepped up on it, he immediately wished he had put more effort in trying to tie the cloth strings of the gown behind his back. He became acutely aware of his bottom being clearly in her view and that she could be staring right at it as he climbed up. He felt his withering embarrassment build. He thought about how he and his girlfriend, Tess, had been together for two years and he still tried not to show her his butt if he could help it. Tess thought his shyness about this was cute and would often tease him if she caught glimpse of his bottom,—“Peekaboo!” — he could hear her gently teasing him. He thought how he liked to have her see his dick. He thought it was big and every time he could have it on display for her, he liked that. But his ass, that was different. It made him feel uneasy having her see him from behind. “Don’t be such a baby!” Tess would say if she come in on him when he was naked in the bathroom, causing him to spin around to face her.

Lisa interrupted his thoughts, “Ok, turn on your left side facing away from me, bend your knees, and bring you legs up with your right leg a bit more forward than your left.” She made sure to make eye contact with him as she issued her instructions.

As he did this, he quickly realized the logic of her instructions as his bottom stuck out more towards her and with the final step, his buttocks parted slightly. He wasn’t just bare now, he was positioned in a way to give her a close up view of his butt and to get access to between his buttocks. He could hear her putting on gloves and then a click and a beep and she popped on a plastic sheath and switched the unit on.

“Okay, relax here comes the probe.” He felt her spread him open a bit and then a sharpish poke that seemed to miss and he jumped a bit and felt his anus tighten.

“Sorry! Hold still and relax again.” This time there was a painless slippery tickle and it was in him. She let go of his upper cheek, allowing them to come back together a bit. He could feel the shaft of the cool plastic probe sandwiched between his buttocks.

Time seemed to stop during the awkward silence as they waited for the beep. Mark thought, bad as this is, at least she isn’t trying to make small talk with me.

Finally the beep came and she quickly withdrew the probe.

“99.5F. The computer will accept that,” she pronounced with satisfaction.

Mark wondered aloud, “Is that high?”

Lisa seemed unconcerned, “Maybe a little, but your rectum is always going to be warmer than your mouth.”

He was relieved, but somewhat regretted asking, embarrassed to hear her describe his rectum as being warm.

She flipped up the trash bin lid with her foot and ejected the plastic cover of the thermometer probe. It hit the top part of the plastic bag and the sticky lube caused it to stay stuck there and not fall down inside. She saw this and pondered it for a second and then let the trash bin cover flop back down. She finished entering the info as Mark sat up to a more dignified position and he made a point of trying to tie the strings on the back of the gown as if this might protect him from future unwelcome intrusions.

Lisa got up to leave, but before she did, she asked him, “We have some interns rotating through our unit, ok if one comes in first to see you before the attending?”

He wasn’t quite sure what this meant and asked for clarification, “A medical student?”

“No, a doctor, but one who is still in their training years.”

Hoping that being cooperative would expedite him getting through all this, Mark agreed, “Yeah sure.”

Lisa left and he then got down to take a more comfortable position in the corner chair. In the few steps it took him to get there, he felt the slickness between his cheeks as a memento of what she had just done to him. He looked for a box of tissues, but could not find any, so he wrapped the back of the gown under him before he sat so he would not leave a smudge on the plastic seat of the chair.