When I was about seventeen I told my parents that I wasn't going to go back to the pediatrician for my yearly physical examination. It was just too humiliating to be in that office, decorated for kiddies, and for the kind of procedures that have been described here -- like having to go out into the hall dressed only in your jockey shorts to be weighed and measured. I insisted that it was time to find an adult doctor, and to my surprise, they agreed.
I was driving a car by this time, so they let me make the appointment, drive myself across town there, and go in completely on my own. The doctor had been my parents' doctor for a number of years, but he was part of a big practice, and I wasn't too concerned that he would relay anything too personal back to them after the exam, unless there was something seriously wrong.
I remember walking into the large waiting room, letting the receptionist know that I was there, and then finding a seat to wait for a few minutes until the nurse called me back into the examination suite. I had only met the doctor once, when one of my grandparents was in the hospital (he also took care of them, come to think about it). He was slight in stature, and mature, but very kind and thorough -- a specialist in Internal Medicine rather than Family Practice.
His nurse asked me some basic questions about my medical history. I suspect my pediatrician had sent over records to this new office, so most of the data was there already. She checked my temperature (orally) and blood pressure, weighed me and checked my height (fully clothed except for my shoes) and then told me to undress to my briefs, and that the doctor would be with me shortly. I stripped, and folded my clothes on a chair, and then sat up on the examination bench (much more modern and mysterious than in the previous office). The doctor bustled in, all business, shook my hand, and sat down on a stool to go over the records the nurse had placed in my chart. I was nervous, but began to relax as he asked me simple questions, and read the chart. Then he stood up, and reached for an otoscope and began his top to bottom examination: eyes, ears, nose, and throat. He made me gag with his tongue depressor, and explained that this was a good way of testing the central nervous system. (I had told him I was interested in a career in medicine -- so he was particularly generous in explaining what he was doing as we went along.) Then he put the otoscope away, and fastened his stethoscope in his ears and listened to my chest, ordering me to breathe deeply as he moved the bell of the instrument all over my chest and back. The he had me relax, and spent a good deal of time listening to my heart. I didn't know it at the time, but he told me later that he thought he heard an irregularity in the heart rhythm, and he was very concerned to check it out completely.
After listening so thoroughly to my chest, he had me lie down on the bench and pressed on my belly, all over. He felt my flanks on both sides for the kidneys, and tapped with his fingers all over my chest and belly. He checked my pulses in my ankles and knees, and then kind of shoved the legs of my jockey shorts up to feel for the femoral pulses in my groin. When he was done, he made some notes in my chart, and asked me to jump down from the bench and stand in front of him. I knew what was coming next.
I watched him as he pulled on a pair of rubber examination gloves for this part of the exam. He told me to lower my underwear, and to step out of them. I did as he requested, and he examined my penis and testicles, squeezing my scrotum all over and ending with the familiar "turn your head and cough" examination for hernias on both sides. The he surprised me by telling me to turn around and bend down to the floor, touching my toes. I received my first rectal examination in that position, and I could feel my penis getting harder and harder, until his finger was withdrawn. By now I was very embarrassed, but also highly aroused. He put his hands on my hips and turned me back around to face him, noticing my erection. "Don't worry about that, son," he commented, increasing my shame. "It just tells me everything is working down there as it is supposed to."
I started to reach for my underwear, but he stopped me. "There's a little something off in your heart rhythm," he observed. "I'd like you to do some jumping jacks here for me, and I'll take another listen to your heart after a few minutes of exercise."
I was too young and inexperienced to ask him why I had to do this nude, instead of wearing my tighty-whities, so I just began to jump and exercise as he sat quietly watching. I was acutely aware of my rapidly deflating penis bouncing all over the place, but I kept it up for a good five minutes, and then he refastened his stethoscope and listened intently to my heartbeat for a number of minutes. He made some notes in my chart, and then told me he was going to order some bloodwork and a urinalysis (which I had expected), a chest X-ray and an EKG (which I had not.) I would have to go downstairs for the laboratory and the X-ray, but he would have a technician from his office come in and do the EKG right here. "Why don't you slip your shorts back on" he asked, "and lie back on the couch? I'll have the EKG tech step in in a minute and get you all fixed up."
A few minutes later a young woman stepped into the room wheeling the EKG machine in front of her. She was very businesslike as she went about fastening the electrode leads all over my chest and ankles and spent a few minutes more quietly getting her reading. When she was done she pulled the sticky pads off my body, and gave me a tissue to wipe the conductive jelly off my body. "I'll give this to the doctor right away," she offered, "and I'm sure he'll be back in to give you the results."
I waited for about ten minutes more, still in my underwear, and then there was a knock at the door, and the doctor stepped back into the room. He had the EKG strip in his hands, and told me that everything on the strip looked normal. He took his stethoscope out again, and listened to my heart once more, and then shrugged his shoulders and said he guessed we would just have to keep an eye on things -- depending on the results of the lab work and X-rays of course.
Then he told me I was free to dress and go downstairs for the rest of my tests. He handed me the lab requisition form which told the technicians there what tests to do, and the slip for the chest X-ray. I followed the signs downstairs, waited a little more and then offered my veins to the phlebotomist, and stripped off my shirt a second time, this time for the X-ray technician.
There was nothing more that showed up on the test results -- and the old doctor retired soon after this visit, so I never got to follow up with him. I have wondered since if I was just experiencing a little medical fetish excitement during his examination, causing my heart to "skip a beat" in the presence of this kind old man. No other doctor has ever found any coronary irregularity in me since (thank God). But I have never forgotten his very complete examination so many years ago. I got everything I bargained for, and then some! It was a great experience, looking back on it, and one I often try to replicate with my patients in a play scene -- taking my time, and being thorough and careful -- explaining what I am about to do as I go.
I just regret that I wasn't due for any immunizations at that visit. That would have made a great experience even better for me!