“Joan, do you have any questions at this point?” he asked as he continued his digital examination, this time pressing his fingers on the bottom of her vagina and occasionally moving them up again to palpate the upper wall. This was one of the time-honored exam situations, that of the doctor with his fingers inside the patient while conversing as if across a dinner table. It was a staple of real exams and forced the patient to go outside herself and reply, while at the same time her body was being poked and prodded. “Any arousal or orgasmic difficulties?” he asked, taking his fingers out of her. “No, not particularly,” she answered. “I tend not to feel much inside my vagina,” she offered. “Well, at least now you know you have a G Spot; that’s something to consider for next time,” Dr. Welch offered agreeably. “Any problems with achieving orgasm?” he asked matter-of-factly, taking the opportunity to pick up his clipboard and glance over the notes. “We didn’t spend much time assessing your clitoral sensitivity before, but I want to go back to that after we finish this part of the exam,” he explained. “I think it’s a tremendously important element of a well-woman visit, and you’d be surprised how many women know almost nothing about the subject.” He looked up at Joan now. “All right?” he smiled. As a playdoctor, he was once again caught in the amazement of being fully present in this moment, with his patient spread open before him and both of them completely at ease.
“Yes, that sounds fine,” Joan agreed. She didn’t quite know what he had in mind, but this exam was agreed beforehand to be utterly clinical so she knew it would be within that parameter. “All right, then, I’m going to remove the speculum and we’ll finish up here,” Dr. Welch said as he turned the screw, releasing the pressure on the bills and slowly closing up the speculum. He went slowly, careful not to pinch her vaginal walls as it retracted, and when it was nearly completely closed he began to pull it out. Joan watched in the mirror as he did so, always marveling at the way the vaginal opening just closed back in on itself even after being assaulted with such a steel invader. Dr. Welch set the speculum back on the tray, and pulled his used gloves off with a flourish, then picked up and donned another pair.
“All right, Joan, the last thing we need to take care of is the rectal exam, which I know is difficult for some women but will be over very quickly.” He picked up a tube of lubricant from the tray and squeezed a generous amount out onto his right index finger. Joan wasn’t looking forward to this; rectal matters and procedures had no interest for her, but it was always an integral part of a playdoctor’s fantasy routine so it seemed the least she could do to go through with it. There was nothing unusual about it in medical terms; all thorough female exams were supposed to include it, but many didn’t, and the digital rectal exam seemed to have achieved a legendary unpopular status among most women. She didn’t even want to watch it in the mirror, but wanted rather to experience it as solely a physical sensation, as more a task to be mastered than a playexam treat. Dr. Welch stood up between her legs to perform this exam. “Joan, you’ll feel my finger pressing up against your rectum,” Dr. Welch explained as he gently pressed his index finger between her ass cheeks and slid his finger to her hole. “Just relax as I’m pushing inside your rectum,” he said soothingly, and she indeed did feel his finger ease past her sphincter and push slowly inward, the lubrication making the passage not uncomfortable, but the sensation was unusual. “You might feel as though you need to have a bowel movement, but you won’t,” he assured as his finger continued its journey inside her. Once it was inserted to its full length he moved it around slowly inside her; Joan tried to enjoy the sensations but mostly merely found them unusual, though not painful in anyway. To the playdoctor, the interesting part was the combination of the physical sensation of his finger inside the tight rectal passage, the slight patient unease, and the overall somewhat forbidden nature of all rectal contact. After a few moments of internal examination, Dr. Welch slowly pulled his finger back, and this surely was a weird feeling to Joan, but she said nothing. The doctor’s finger was now completely out, and Dr. Welch quickly pulled off the glove and threw it away. In a real exam, the doctor might have taken a sample of any stool present, but that wasn’t part of this scenario.
Stil standing, Dr. Welch re-gloved his right hand. “Joan, I’m going to do the recto-vaginal examination now, one finger in your vagina and one in your rectum at the same time, which allows me to feel the wall separating the two areas and get a better assessment.” After putting a small amount of lubrication on the third finger of his right hand, he pressed its fingertip against her rectum, and his index finger was poised at her vaginal entrance. “All right, just relax,” he said, as both fingers began to push inward, her ass and her vagina being penetrated simultaneously to the full length of Dr. Welch’s fingers, till his knuckles were pressed against her perineum. She could feel his fingers moving slightly inside her, up and down and side to side, pushing her inner parts gently, of course with no pain at all and only a very little pressure. As for Dr. Welch, he was fascinated by the feel of the relationship between his two fingers as they explored Joan’s deep interior, realizing how closely the rectum and the vagina were oriented and how much the doctor could ascertain from this examination. And of course he basically just loved the look of his fingers pushed inside of his patient. From his vantage point as he looked down at Joan, he took in the sight of her spread legs, her open and exposed vulva, and his hand moving inside her. It was delightful.
“Everything feels fine here, Joan.” After a few more moments of internal palpation, Dr. Welch slowly withdrew both his fingers and quickly pulled off the soiled glove. “I hope that wasn’t too uncomfortable for you,” he said as he tossed the glove away. “You did very well.”
“Thanks, it wasn’t bad. Not what I expected” Joan said, grateful to feel Dr. Welch now taking some tissues and wiping the excess lubrication from around her rectum and perineum. She watched in her hand mirror as he cleaned her up, his hands sure and proper in this procedure, too.
“In a few years I’d recommend a sigmoidoscopy or colonoscopy, but everything seems fine at this point,” he mentioned as he once again picked up and consulted his notes. “Let’s see…I still need to do a bimanual exam on you, Joan,” he reported as he set the notes down and re-gloved his right hand. “I’ll be placing two fingers inside your vagina and pressing upwards and I push down on your abdomen in order to feel your ovaries. Normally I’d be feeling for your uterus, but since you’ve had a hysterectomy that doesn’t apply, of course,” he explained as he positioned his fingers at her vaginal entrance. “Okay, just relax and you’ll feel my fingers going inside you,” he narrated as he began to push his two fingers deep into her vagina as far in as he could go, until his hand pressed against her vulva. Now Dr. Welch took his free hand and pressed it down on Joan’s lower abdomen, just above her pubic mound, pushing down with some pressure and then concentrating the movement with just the index, third and fourth fingers in order to better identify the structures. At the same time he pressed down on her abdomen, he was pushing upwards with his fingers inside her vagina, and as his two hands found their orientation, he was able to push up and he thought he could feel her right ovary. At this moment Joan gave a small moan.
Dr. Welch stopped his movements. “Did that hurt, Joan?” he asked, concerned.
“No, my bladder’s sort of full and it feels like I need to urinate when you press like that,” she reported, somewhat sheepishly. “It doesn’t hurt, though.”
“That’s good, I’m almost done,” he said, returning to his palpations, now moving his fingers and attention to Joan’s other quadrant where he felt for her other ovary. Even knowing that Joan’s bladder was full, Dr. Welch didn’t stop right away, as he knew that the sensations Joan was feeling weren’t bad in a playexam situation, but rather enhanced the patient vulnerability, slight unease and embarrassment she might be feeling, if only as part of the scenario. He pointedly moved his upper hand even lower to press specifically on her bladder, wanting her to experience the pressure again, teasing her a bit. “All right, Joan,” he finally said, “everything feels fine,” and slowly withdrew his fingers from inside her vagina, watching as his glove emerged slick with Joan’s internal lubrication. There was no doubt being a playdoctor was a very good thing indeed, he thought, as he drew off his used gloves.
“Going back to what we discussed before, I think we should definitely spend a little time checking your clitoral sensitivity,” he said as he checked over his notes again. “Let’s see, yes…I need to get a urine sample, too,” he added, looking up at her, “and actually this would be a good opportunity to do a voiding observation to detect any obvious potential continence problems. How does that sound?” he asked, more rhetorically than expecting an answer.
Joan didn’t know what was coming, but she was game. Dr. Welch had been an excellent playdoctor so far and she trusted him completely. He reached for a large glass vessel that sat on the far edge of his instrument tray. “Joan, go ahead and take your legs down from the supports, and I’m going to have you stand up at the end of the table.” Following his instructions, Joan moved her legs off the chairbacks and sat up, then scooted to the end of the table. She rearranged the paper vest around her, and slid down until her feet touched the floor and she was standing, nude from the waist down.
“Joan, I’m going to be seated in front of you. I’ll hold this container between your legs, and I need you to spread your legs apart as far as is comfortable. I’m going to hold your labia apart with my fingers, and then you can begin to urinate. At some point I’m going to ask you to stop and hold, then continue; this will help me to assess your urethral and bladder control.”
If Joan hadn’t just undergone such a thorough exam from her playdoctor, these instructions would have been tremendously embarrassing and impossible to follow, although somehow she wasn’t sure that it would be easy to comply anyway. Joan wasn’t sure she could relax enough. Still, she opened her legs, putting her into a slight squat, then watched and felt Dr. Welch arranging his hand above her mons and then pulling her labia apart from above. “You can start now, Joan.”
No doubt Joan had to pee; she knew her bladder was full and remembered how it felt to have the doctor pressing on her abdomen, and yet, though she was mentally willing herself to begin to urinate, nothing came out. “This is very difficult, Doctor,” Joan confessed, still trying to relax enough to begin the flow. “That’s okay, Joan, take your time. I realize it’s hard to begin,” he sympathized. “There’s no hurry,” he consoled.
In some ways this was so much more weird than the exam had been, and yet it was also exciting and an important part of the playdoctor experience for Joan. Even more so than having her intimate areas probed, standing here and trying to pee while the doctor watched was so personal that she almost regretted agreeing to try it. For the first time she felt a little foolish. “Doctor, I’m not sure I can do this…” she said quietly, still trying, though, to start her urine stream.
“That’s all right,” Dr. Welch said, still sure that she would be able to complete this part of the exam. “Just relax,” he reassured.
And just a second later, Joan made a small sighing noise and indeed it did start to come, just a little trickle of yellowish liquid at first, then the flow became stronger and the bottle began to slowly fill. Dr. Welch watched closely as the urine exited her urethra in a steady stream; after a few seconds he said, “Joan, please stop and hold now.”
Joan tightened her internal muscles and stopped her urine neatly, holding back the flow as instructed. After fifteen seconds, Dr. Welch said “Continue,” and Joan started to pee again, this time uninterrupted until the last drop. The doctor pulled the glass container away, then brought a moistened clean tissue between Joan’s labia to wipe her vulva and then he removed his fingers from between her legs.
“Very good, Joan. You’ll get your lab report early next week. You can sit back on the table now,” he instructed her as he set the urine-filled vessel aside and consulted his notes again. “Let’s see,” he said quietly.
Joan settled back on to the table, reaching again for the towel and covering her lower half for the moment. Dr. Welch looked up from his clipboard. “If we can spend a few minutes assessing your clitoral function, then we’ll be just about done. Can you place your legs in the supports again and recline back, Joan?” he requested.
“Of course,” she answered, as she arranged herself – and the drape – again in preparation for this part of the examination. She watched as Dr. Welch took out a cotton-tipped swab and slipped on another pair of gloves, turning to her with a quick smile.
“Okay.” Pulling back and setting the drape aside, Dr. Welch once again arranged his seat between her spread legs and adjusted the lamp again so that it shone directly on her. “I’m going to probe your clitoral area with the swab, and what I’m basically doing is mapping your sensitivity zone. I will ask you on a scale of one to ten what level of sensation you’re experiencing. For this exam, I prefer that you don’t watch in the mirror but only go by what you feel.”
Joan relaxed, and felt Dr. Welch’s left hand pull apart her upper vulvar region, as the other hand picked up the swab and first touched it slightly above her clitoris.
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