Although my ultimate fantasy could involve a male or a female patient, I will use a male patient.
My patient arrives at the outpatient center for several tests, including a cystoscopy and a barium enema.
He is extremely nervous, shaking visibly, and having difficulty holding his hand steady enough to sign in at the desk.
He sits down in the waiting room, and a few minutes later a nurse opens the waiting room door, and calls his name. He half-heartedly gets to his feet and follows her into one of the many exam rooms.
When he enters this room, the first thing he sees is the exam table, which is rather large, and has leg supports on either side. He is told to undress from the waist down, and get up onto the table, lie down and place his legs onto the knee rests. He is completely embarrassed as the nurse helps him lift his legs up. Now he is completely exposed, penis, testicles, anus, perianal area.
The nurse then takes hold of his penis, and swabs it very thoroughly with betadyne. He is not exactly sure what she is doing, or what is about to happen. The doctor comes in, gives him a few words of reassurance, then proceeds to wheel a stool to the end of the table, between the patient's legs.
The nurse walks up to the head of the table, and puts her hand on his arm to comfort him. She knows it will be very uncomfortable for him, and she doesn't want him to make any sudden moves that could injure him.
The doctor starts to feed the cystoscope into his penis. The man starts to stiffen up, and holding his breath. The nurse tells him to try to relax, and breathe through his mouth. He is too traumatized to do either. He starts to moan, and then tell the nurse that he has to pee, really bad. The nurse tells him that it just feels that way to him. He will be fine. It does no good. The young patient is now starting to realize that if he had known the exam would be like this, he would not have kept the appointment. He is starting to panic. He wants to be let off the table. He starts to beg to take it out. He thinks he is going to pee on the table. Tears are forming in his eyes. The nurse feels very badly for the young man, but knows the exam has to be completed.
Finally the cystoscope is withdrawn slowly. The young man moans loudly as it comes out. After helping him off the table, the nurse realizes that he is not ready to go to his next exam, the barium enema.
She suggests to the doctor that she takes him to another exam room, and let him lie down for half an hour or so until he can deal with the next exam.
Half an hour later, the nurse goes to get him. He is very reluctant to come with her. He doesn't think he can go through another exam. The nurse tries to reassure him that this test won't be as bad.
She leads him into the radiographic suite, and he is faced with more intimidating equipment. There is no adjustable table, but there is a solid stainless steel table in the center of the room, with a very large x-ray machine over it.
She once again instructs him to undress from the waist down, this time removing his shoes and socks also, in case any fluid leaks onto him. He is helped onto the stainless steel table, told to lie on his back, and several x-rays are taken of his bowel.
The nurse then steps out of the room, and returns with a stand on wheels that has a large clear plastic bag hanging on it. It has a white liquid in it that the patient thinks is milk. He now sees also that there is about 9 feet of tubing coming off the bag. His mind is racing. He doesn't want to believe that this is some sort of enema.
Before he can say anything, the nurse asks him to roll over onto his left side. He resists momentarily, but she sort of pushes him into position. Then she tells him that she is going to have to make him uncomfortable for a little while. He asks what she means. She tells him that she is going to be giving him an enema, only with a barium mixture instead of water. He will be given quite a large amount, but he should be able to hold it. He immediately panics and asks her what if he can't. She tells him it shouldn't happen.
Then she inserts the enema tip into him. He tries to push it back out. She then tells him she wants him to bear down. It will make insertion easier. He tries to, and then he lets a very loud fart. He is mortified. He is completely beyond himself. He tells her "I can't do this. Just let me up." She manages to convince him that he needs to have this test completed. She once again starts to insert the tube, and is successful. She starts to let the barium flow into him. From the initial filling of his bowel, he pleads with her to stop. "I have to go". She reassures him that he will be fine. "I have to go bad -- I can't hold it". After a few more minutes and more barium, the nurse starts to see barium leaking out of his anus, and onto the table. He obviously feels it, too, on his leg. He starts to get hysterical. "Take it out. I can't hold it. Oh God, NOOOOOO!
Then with the pressure built up inside him, the enema tube is forced out of his anus, and barium shoots all over the table and floor. He is beyond consoling, and just wants off the table, and wants to go home. The nurse tries to convince him to get cleaned up and continue with the test. He says absolutely not. He just wants to get out of there.
I have actually done the enema part on many patients, and I deliberately make so that they CANNOT hold the enema. There is nothing so humiliating as losing control of your bowels in front of another person.
In reality, it is the embarrassment and humiliation part of an exam that is my fantasy. My ultimate fantasy is having a patient who is arrogant and possibly a bully whom I can control completely to the point of making them lose control of their bodily functions. They usually end up being traumatized for a very long time.