Patient demeanor?

I know there's not going to be one single answer to this question as it will be highly situational, however:

If one is being given a "realistic" exam by a play doc, then how are you supposed to respond to various stimuli? For example, if I was being given a prostate massage in a doctor's office the most I might do is a grunt or something as they went in. If it felt good I would try to give no outward indication. But in the play exam situation is it expected that I might at some point express pleasure? Nothing like a porno soundtrack, but the occasional semi-involuntary moan, etc. Even when you're going for realism it's also a sexual scene.

I discuss it with my partner ahead of time. Are we roleplaying or is he just giving me an exam? If we're roleplaying and he's planning on going beyond the clinical, how does he want me reacting? Trying to pretend I don't know what he's doing? Does he want me to question or protest?

I guess its all about personal preference. For me I like to combine elements of BDSM slavery with my medfet. Aware not everyone is into that, but it sure scratches my itch. For that to work its best if the patient is shy and reluctant so that the doctor can more agressively dominate them. I enjoy when patients me included feel humilated and vulnrable. Obviously in play consent is required always in fiction its fun to tease out the humilating aspects.