Ever since childhood, I have dreaded auscultation. It’s like … the most intimate part of me, raw and naked and bare, fully exposed to a complete stranger. The second that cold diaphragm lands on my body anxiety rips through me like a tornado, causing a noticeable change in my breathing pattern. And no matter how hard I try, there’s absolutely no way to hide it. Because he can hear everything.

“Okay Molly, I’m going to have you lean forward a little so I can listen to your lungs,” he says, unsnapping the back of my gown and preparing to place the earpieces snugly into his ears. “Just take a deep breath in and out each time you feel me move the stethoscope please.” Without further ado he nestles the stethoscope into his ears and begins his auscultation. “Go ahead, whenever you’re ready,” he says as the cold diaphragm makes its first contact with my warm skin.

The slow, methodical movement of his stethoscope on my body – the first time the sounds inside of me are made accessible to him – sends a chill through me. Nothing on Earth makes me feel quite as vulnerable and helpless as this. He responds with a quiet “mm hmm,” or “again,” here and there, moving down and across my back.

Next, he slips his hand further underneath the gown from behind to access my lateral lung fields. “Slow your breathing please, and take a nice, deep breath in and out with your mouth open …. that’s it,” he nods slightly, moving the diaphragm a fraction further inside the gown along my ribcage before shifting to the other side. “And .. again, with your mouth open ….”

From this side, the placement of his hand displaces the gown just enough to expose the outer curvature of my breast, and my body stiffens. “Just relax,” he adds as he lingers in the same spot for several seconds.

“Alright,” Dr. Goodman says finally. He takes the stethoscope from his ears and lets it hang from his neck. I’ve never quite understood it, the dip and swoop in my stomach at the sight of a stethoscope dangling from a doctor’s neck like that. It’s just always been that way. The auscultation is followed by percussion, after which he begins to slip the gown off of my shoulders.

“If you can slip your arms out of the gown now,” Dr. Goodman instructs, “I’ll have you lie back.” My body complies, if not against my will then certainly without its help. The back of the exam table hasn’t moved, so when I’m able to settle back, I am situated at an angle of maybe 50 degrees. Replacing the stethoscope into his ears and lifting the diaphragm to continue his auscultation he asks, “Ever had any trouble with your breathing, Molly?”

“No, not really,” I reply as I feel the cold metal disk land once again on the surface of my skin.

He nods. “Deep breath in and out please ….” He listens at my upper chest in two places, then two more below that, all just above my breasts. “Again, with your mouth open.”

He unplugs his stethoscope and, holding it in one hand, steps back to prop himself on the counter behind him, arms crossed.

“So … ‘not really.’ Can you be more specific? Have you been sick at all in the last few months? Bronchitis, maybe?”

“Actually, yes. I’d forgotten, but I did have bronchitis earlier this year,” I admit.

“Okay, that’s actually reassuring,” he nods, shifting a little. “I hear some wheezing when I listen to your lungs, which would concern me if you hadn’t recently been sick. But the effects of bronchitis can linger for quite a while. Perfectly normal,” he says, approaching the table again.

“Okay Molly, I’m going to examine your heart now,” he says, hanging the stethoscope from his neck. “Let’s have your hands by your sides here,” he adds, gently moving them from my stomach and placing them flat on either side of my body. A fluttering in my belly intensifies. I stare straight ahead. It’s either that, or close my eyes. I can’t look at him.

“Just breathe normally,” Dr. Goodman says, plugging the stethoscope into his ears and tapping the diaphragm to test the sound quality. “Cold touch here .…”

He plants the diaphragm at the aortic position and listens, left hand propped at the top of the exam table as his right moves the stethoscope across my chest. He shifts across to pulmonic, then to Erb’s, and I can feel my puffy nipples beginning to harden against the crinkly gown. Without warning, he folds the gown down underneath my breasts, exposing my now-hardening nipples to the coolness of the room, and plants the diaphragm purposefully at the tricuspid position. He drops his head and listens carefully. And I wonder: can he tell just by listening how nervous I am? Finally, he leans in more closely and listens under my left breast, displacing the pillowy flesh with his hand.

“Sit up for me please …” he says, placing a hand on my shoulder and helping me straighten from the reclined position I am in. When I am upright, he listens at Erb’s point again and then at tricuspid, before landing under my breast again at mitral and applying gentle pressure to my back. “Lean forward .…”

More listening. More incredibly uncomfortable silence.

“Hmmm.” He takes the earpieces from his ears and hangs the stethoscope from his neck. “Go ahead and lie back again please,” Dr. Goodman says, pulling the leg extensions out and lowering the back of the table until it’s flat.

“Have you ever been told that you have a heart murmur?” he asks, looking directly into my eyes as he lifts the gown back over my breasts.

“No, never. Why, do I?”

“You might,” he responds speculatively. “I’m going to have a listen again while …”

Just then there’s a quiet knock on the door and Sarah leans in quickly.

“Just wanted to let you know we reached Simmons and the last visit of record was 18 months ago.”

“Ah. Okay, thanks Sarah. I may call you back in a few minutes …”

I’ve already put the anxiety about the gyn out of my mind, but overhearing that interaction brings it all flooding back. Dear God. Now a well woman exam seems all but inevitable.

“Okay,” he says, moving to the head of the exam table such that I see him upside-down. “Relax and breathe nice and easy for me,” he says as he puts the stethoscope back into his ears. “Without moving if you can,” he adds before slipping an expert hand underneath the gown on my upper right chest. He listens intently. Lifting the gown slightly with his other hand, he continues to listen carefully on the left, at the pulmonic and Erb’s positions.

“Molly,” he says, letting the stethoscope hang from his neck. “I’m going to have you roll onto your left side …” And in an instant, I feel the cool rush of air moving unexpectedly across my skin once again as he exposes the entire left side of my body. “Slide your left arm under your head please, and … this arm can stay right here,” he says, positioning it flush with my body on my hip.

“That’s perfect.” Through my peripheral vision I see him replacing the earpieces of his stethoscope and my breathing becomes erratic again. “Okay Molly, you’re going to feel me reach over you to take another listen,” he says quietly.

His proximity makes me uneasy, as he is so close leaning over me from behind that I can feel his body heat warming my back. With his right hand pressing against the puffy flesh at the base of my breast, he asks me to breathe normally and I almost laugh.

Nothing about this feels normal. I’m sure my anxious heartbeat is pounding through his stethoscope. He shifts the diaphragm slightly, this time over tricuspid. “It’s okay, try and relax,” he says quietly. He finally straightens, guiding my right shoulder back onto the table so that I am once again flat on my back.

“I can hear an innocent murmur, likely benign,” he says as he shifts my now crumpled gown to cover me up. My attention is absorbed by my naked breasts, and I don’t process anything he’s saying. I’m just relieved to be covered again.

“We’ll just monitor that, keep an eye on it. No arrhythmias or anything else of concern,” he says, moving to the counter to complete some documentation. His words finally register in my mind. Wait, monitor what? “Which is good,” he adds with a smile, evidently seeing worry in my eyes.

“But what does that mean exactly? Having a heart murmur? Does it require treatment of some kind?”

He steps away to the sink, responding as he lathers up, rinses, and dries his hands. “Typically, no. Murmurs are pretty common and most are harmless. But we’ll keep an eye on it, not to worry,” he says reassuringly.

Sarah’s words rattle around in my head and I brace myself, not sure what will happen next. As if he’s reading my mind, Dr. Goodman returns to my side and announces that it’s time for the abdominal exam, to my relief. “Are you comfortable like this?” he asks, regarding me lying flat on the table.

“This is fine.”

“Okay, good. I’m going to bring this sheet up to cover your bottom half, and then lift the gown so I can examine your belly,” he explains. When he’s finished the sheet rests right below my panty line, and the gown is pushed up just below my breasts.

A thorough abdominal exam follows, beginning with auscultation of the four quadrants of my belly, and then a bit of percussing. He spends more time palpating my abdomen than I’ve ever experienced, but none of it is painful and I find I’ve fallen into a calmer state of mind. I even surprise myself by not startling when his fingers slide into my groin to feel my femoral pulses. What I’m not expecting is the auscultation that follows, or the feeling of his cold stethoscope – and thus his hand – nestled just inside my panties. I engage my kegels in an effort to keep myself from squirming, and he soon removes the disk from my groin and drapes the stethoscope back over his shoulders.

“Okay Molly, very good.” He reaches for a few pumps of hand sanitizer from a dispenser on the wall. “You can go ahead and sit up if you like,” he says, offering me his hand. “Any questions for me before we move on?” He sinks onto the stool by the counter and rolls over to the computer, waking the screen up.

“No,” I say cautiously, after some hesitation. “I don’t think so …”

“Okay …” he responds, documenting briefly before turning back to face me. “Then let’s take care of your well woman exam next,” he says, rolling over to the foot of the exam table. My heart starts pounding double-time against my chest wall.

“It looks like it’s been close to two years since you saw Dr. Simmons, so …”

“Oh wow.” The inside of my mouth is dry and chalky. “It doesn’t feel like it’s been that long,” I say quietly.

“It’s easy for this stuff to get away from us,” he says, rising from the stool. “We’re all busy, right? But given how long it’s been I’d like to do a pap today, along with a routine pelvic and breast exam, if that’s okay with you.”

I feel my head nod affirmatively, as though an external force has taken control of my body.