Diversity of Life

7. The Echocardiography

"Can I put my bra back on?" Amber asked in a low voice. "Yes of course. Now you can do it first. Please take your sneakers with you as well”, the doctor replied while walking from the desk to a connecting door in the examination room. Amber took the garment and quickly put it on. Then she got up, got her sneakers and went to the door that Dr. Winkelmann held it open to her invitingly. "Shall I leave the other things here?" "Yes, you can. We'll come back here later." Amber wasn't sure what to expect in the next examination room. Will there be other people here? she wondered. Finally she was half naked. A feeling of insecurity came over her, which added to the feeling of shame.

The doctor and Amber entered the next room. This one seemed slightly larger than the previous one. Lots of light came in through a large window. There was also a table in the room, which, like in the previous examination room, was covered with black artificial leather, which in turn was covered halfway from the head end with a crepe sheet. Almost in the middle of the room was a stationary bike that she knew from the fitness center. Amber immediately remembered Helen, whom she met in the waiting room. She spoke of such an ergometer, Amber recalled. A slight shudder ran down her bare back as she remembered the conversation and saw a black stethoscope hanging from the handles. Next to the table, Amber saw several white devices that were also on the white equipment trolley. One of the equipment carts was equipped with a larger swivel arm from which several bundled cables hung down. On the other equipment cart was a monitor with a control panel in front showing buttons and a gray embedded sphere. On the side of this control panel were pins that were connected to the device with cables at the ends. Amber suspected that the examinations would take much longer than expected. What's going to happen here, she thought, I'm totally at the mercy here too. The big room, everything white and bright - and will we stay here alone? The impressions left her no peace. Tense, rather tense, she stood and waited for the doctor's instructions.

“Please lie down on the table over there." Winkelmann pointed to the doctor's table. The crepe pad was unused and lay fresh on the table. Amber went there, sat on it and then lay on her back. The surface seemed cool to her. I'll just keep my bra on now, Amber thought to herself and hoped that it would stay that way. "Will you please turn on your left side?" she was instructed by Dr. Winkelmann, who began to push one of the equipment trolleys to the table. “On which side?” “On the left. So that you look at me, please. It's best to put your left arm under your head.” Amber obeyed and turned on her side. She bent her left arm and rested her head in the crook of her arm. The position also placed her left breast on the table, conforming to the shape of the surface. Then she looked tense and waited to see what would come next. Meanwhile, the doctor sat down on a stool next to Amber, took one of the pins that was clamped to a device on the trolley and moistened the tip with gel. "We're doing an echocardiography now. With this procedure I can look at your heart and its activity visually. Winkelmann pointed at the monitor while continuing to moisten the tip with gel. "This is about to get a little cold." He then placed the probe on Amber's body above the bra, just above the heart. She twitched a bit because it was actually quite chilly.

Through her attitude, Amber once again presented her heart open and vulnerable. She kind of felt that uncomfortable feeling again, to be at the mercy of Dr. Winkelmann. But the images on the screen distracted her. She saw moving, pulsing shades of gray on the screen. A quiet pumping noise became audible. "That's your heart!" said Dr. Winkelmann while gently pressing the probe to various points above the bra at heart level. "Here, you can see the heart valves," he added. Amber didn't understand how to find your way around on the screen. Looks very funny, but the doctor will know what he's doing, she thought. Hardly anything was left of the discomfort she had just felt. With the bra on, she didn't feel as naked as before, which gave her some confidence again. The doctor pressed a few buttons, causing the shades of gray to move in sync with the audible noise, and now colors of green, blue, yellow, and red were added. "Perfect," he said. "But so that I can also examine the aortic valve. Please take off your bra again." He took the probe from Amber’s body and clamped it back into the device. The pulsating noise stopped. Then he took a paper towel and gave it to Amber, who wiped the gel off her body. She looked at her body. Uncertain feelings came over her again. Now again? she thought and started wiping herself. She obviously took more time for this process and used every second to organize her thoughts. Emerging feelings of insecurity, however, could no longer be stopped - quite the opposite. What follows now? she thought while straightening up. She checked again for wet spots, made sure everything was dry, and then gave Dr. Winkelmann the cloth. The doctor took it and disposed of it in a wastebasket. In an upright position, Amber gathered her courage and grabbed her back with both hands to undo the clasp of her bra again. Then she took off the straps and then her bra. She could now feel her nipples contracting and hardening. How embarrassing, she thought. The initial feeling of shame seemed to have been overcome, but now it was there again. Visibly uncomfortable, she looked around for an open area to take off her bra.

"Put the bra down on the table," said Dr. Winkelmann watching Amber take off her bra. "Please lie on the table again in the left position." Amber kept the bra in her hand and lay back on the table with her left side as before. Her left breast adapted to the ground. She looked a little embarrassed at the ultrasound machine and the screen. After Dr. Winkelmann had flipped a few switches, he turned back to Amber. "I will now put additional electrodes on your body." The doctor took two electrodes and stuck them under the left and right collarbone, another electrode placed on the right side. He pressed then with his fingers. Amber felt how the doctor was now also pressing the cables to the electrodes. There was no longer a distance that she longed for. She was not left with the distance needed to assess a situation or evaluate a situation. The doctor was very close to her and touched her in places where she would never have allowed other men to touch her. But that day was different. She felt every touch very intensely. Kinda uncomfortable, Amber thought, looking down at her bare chest for a moment. Her heart started beating a little faster again, the excitement grew. The electrodes stuck firmly to her body, she was now connected to the device with cables. The cables tickled a bit. She now also saw a heart curve on the screen and had the feeling that this was certainly making her heart palpitations visible.

“What are you going to do now?" she asked in a thin voice, trying to distract from her excitement. Dr. Winkelmann looked at Amber. “I will now examine the function of the heart valves in detail. I do that by checking the flow speed and looking at the flow accelerations. Winkelmann pointed to the screen. “There are red and blue colors here, which make the direction of blood flow easier to see. The flow of blood towards the transducer is shown as a red cloud and away from the transducer as a blue cloud. This way I can estimate how tight the heart valves are. That helps me to investigate whether you have mitral valve insufficiency, for example.” Amber tried to listen carefully. She hadn't understood the last one, but she didn't ask either. Her heart was pounding again. Dr. Winkelmann now took another probe, put some gel on it and put it back on Amber's body. The loud roaring sounded again immediately. In fact, it was now a little faster than before. The doctor also guided the probe along the areas over the heart previously covered by the bra. Then he moved the probe under Amber's left breast. She felt the back of the doctor's hand very clearly on the underside of her breasts. It wasn't just the play of colors on the monitor that had become more intense.

Amber's excitement increased. Her breathing became shallow and her heart pounded wildly. Dr. Winkelmann registered this as a matter of course, but gave no sign of it. In order to relax the situation, he began to explain the play of colors. “Look here, this is the heart valve. This is an ultrasound picture. Here, for example, I see the structure of the heart. Here you can see the heart chamber, the size. And here's the heart valve again. You have a little palpitations, but it's all right! The colors show me the direction of flow of different blood streams and the pumping capacity of your heart!” Amber watched the spectacle on the monitor while the doctor moved the probe back and forth on her upper body. She looked at the monitor but couldn't really surrender. She felt every slight pressure of the probe on her chest very clearly. Although Winkelmann tried very hard and proceeded very carefully, it was unavoidable and he repeatedly touched Amber's left breast. From time to time Amber looked from the monitor to Dr. Winkelmann, who followed the play of colors on the monitor with great concentration.

Every movement left wet traces of the gel on Amber's upper body. "It all looks good," said Dr. Winkelmann, took the probe from Amber's body and put it back into the device. "Then we'll do an ECG." Even if Amber knew what to expect, she felt a shock go through her body. Didn't we just have the ECG, that's still not enough? she thought. And what's next if I already have these things stuck to my body? For a moment she was unsure again and watched Dr. Winkelman. He took some paper towels and gave them to her so she could wipe the gel off her body. She took the towels and straightened up a bit. However, the cables of the electrodes were a bit annoying. The doctor saw that Amber was struggling and said: "I'll take the cables off you once." He detached the cables from the snaps of the electrodes and put them off. Should the stickers remain on the body? Amber was unsure. The two under her collarbones didn't bother much, but rather electrodes on her side under the ribs. As she wiped herself, she saw them. They were quite tall and white. Dr. Winkelmann waited briefly to take the used towels from her and then threw them in the wastebasket under the table.