ndab Ah Yes, Medical School: Taking A Trip Down Hershey Drive

Thursday, October 14, 2004

Taking A Trip Down Hershey Drive

How do you spell "fun"?

R-E-C-T-A-L E-X-A-M*

In what will likely become a yearlong trend, the clinical skills component of my second year medical school curriculum has once again provided a stunning array of ways for me to feel completely and utterly embarrassed, with today being no exception. Yes, today was the day I learned what it felt like to stick my finger up another man's asshole. But it was oh so much more...

It began with a little introduction by our doctor reminding us that while a genitourinary exam (for men, a schlong and balls exam) and rectal exam might seem really awkward now, by the time we are done with school it will not seem weird at all and we'll be ready to do it at a moment's notice. Not getting enough time to consider the idea that maybe playing with a random person's genitalia should never be considered routine, we entered the room and met our "professional model" (yes, this is how it was described to us via email - perhaps it is better than saying "starving student desperate for cash", "sketchy old guy with rectal prolapse and hemerrhoids", or "middle-aged man with anal fetish looking for a good time"), who was a young man wearing only his gown. The four of us (and the doc) sat down around him as he sat elevated above us, in his gown and spread eagle. It made me think about Sharon Stone in "Basic Instinct", with the minor difference being this was a guy and his balls were bulging in my direction. Lovely.

The doctor demonstrated all of the aspects of the genital exam. First you feel the balls. Then you "palpate" (fondle) the penis. Then you stick a finger up their inguinal canal (sorry kids, I'm not even gonna try to explain that one, but I will say that it is not invasive and will not result in any fluid ending up on your gloves). Then you roll 'em over and stick your finger up there ass and mazel tov you're done.

Easy enough, right? So for some reason I volunteer to go first (I think there is something to be said for getting it over with) and I wash my hands and put on gloves. I walk over to the patient as he is flat on the exam table and begin my examination. First I play with the testicles, placing each ball in my hands as I inspect for lumps. Surprisingly, I have little trouble holding back laughter at this point.

Then, it's time for the penis inspection. The doctor reminds me that I should inspect and palpate the shaft as he kind of passes over it with his hand to show me how. So I do the same thing, although as I move my hand over the shaft I realize that in essence what I am doing is stroking his penis. That's just...swell. The doctor recognizes this too and demonstrates that I should be pushing down on various spots to check for scarring rather than stroking it gently (luckily, I am pretty sure it was done subtly enough that no one else noticed. I'll find out tomorrow if there are any "Fake Doctor Knows How To Stroke It" signs posted on the white board in class). Anyways, I was then supposed to inspect the urethra and the inside shaft. At this point, I should make it clear that as a Jew, I have no foreskin and do not have any experience in moving foreskin out of the way in order to get to the main item (how's that for a really vague euphemism for penis?). So when I approached this task, I really didn't know what to do. I mean, what the hell is that shit for anyways? Seems like it just gets in the way of everything. I just do not understand. So I try to move it and fail miserably, of course. I try again and realize I am supposed to roll it down, but I was afraid of further strokage action so I just pretend to do stuff and roll that shit back up.

A little inguinal canal probing later, and I embarked upon the journey that made a candy bar legendary and classified a whole set of pirates. Yes, I squirted the KY Jelly on my finger and inserted it into this guy's anus, up his rectum, and into the edge of his colon. My first thoughts were, predictably, "Oh lord my finger is up this guy's ass. Eww. Gross. Awful." I noticed that it was exceedingly warm up there. I should add that a rectal exam is not just sticking your finger up the asshole - it is: Stick finger up ass. Find colonic ridge and spin your finger around it for 180 degrees. Spin finger around some more until you find prostate. Palpate prostate. Remove finger. Sprint to sink to wash hands over and over and over again. I should note that the model guy got paid handsomely to have this done to him by 8 people over the course of 4 hours. Can you put a price on dignity? I think that's for another time...

Surely, a rectal exam is enough awkwardness for one session. Four hours later, my finger still feels warmer as a result of it's brown travels. And yet, that was only part of it, because no clinical skills session would be complete without the doctor humiliating me in front of everyone. After the model congratulated us on doing a good job and left, we proceeded to do abdominal exams on each other. The doc demonstrated the intricacies of it on the other guy in our group, and two of us did it on him first. Then we switched, I took off my shirt, and lay down on the exam table. Another student began the exam on me, and I instantly regretted those two veggie burritos I ate for lunch (courtesy of El Pollo Loco) for reasons covered previously. However, that was not the worst of it. As one student was practicing the exam, the doctor peered over my chest and suddenly had a very excited look on his face. Which led to this exclamatory revelation:


Everyone rushes to take a peek at what I had always considered to be a random patch of hair on a characteristically hairy Jewish guy.

"See, 5% of people have this. It's a SUPERFLUOUS THIRD NIPPLE!!! Well there's technically no actual nipple there, but this is what you'd see - he has this characteristic patch of hair in line with his actual nipple, which is exactly what most third nipples amount to."

I thought that after 23 years I knew just about everything I would know about my own body, but apparently I was wrong. Also, as if there was any doubt that the creators of "Friends" stole my appearance and personality, essentially my entire life, and transported it into Chandler Bing, who also has a superfluous third nipple. Beyond that, I would just like to make a small and subtle point for any future doctors out there who might be reading this: DON'T FUCKING ANNOUNCE EMARRASSING SHIT ABOUT ONE PERSON IN FRONT OF A LOT OF OTHER PEOPLE. I mean honestly, who does that?

OK this was way too long and I'm tired. I'm going to go wash my hands for the 17th time this afternoon, and then I'm going to admire my third nipple in the mirror for a while. And if you are a hot Jewish girl with a third nipple fetish, let me know.

*Yes, you can also spell "fun" f-u-n. Asshole.


Blogger Katie said...

When I had the privilege of "learning" this exam, I had a standardized patient who was unaware he wasn't circumcised. My supervising physician said, "so describe what you see." I stared at him blankly. Then, "Well, start with this. Is he circumcised?" I said, no. Then the patient says, "Yes I am."

I, being but a lowly female first year medical student thought, wait, am I CRAZY??

Then the doctor looks and says, "What? Who told you you were circumcised??"

Patient: "My mother."

(Real) Doctor: "Well, your doc sure didn't finisht the job!"

2:40 PM  
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Anonymous Anonymous said...

Oy! An old timer showed me how they did rectal exams in the "old days" before gloves. Take a piece of paper, fold it in quarters and tear a small piece out of the center. Set that piece aside for later. Open the paper and put your index finger through the hole in the center of the paper. This keeps the remainder of your hand clean during the exam. Once finished, use the small bit ripped from the center to clean under your fingernail.

Thank your lucky stars for latex & go wash your hands again.

3:27 PM  
Blogger Rib said...

Think yourself lucky, I'm a vet in England. A finger? Try up to your shoulder in cow! And human don't try to kick, bite or gore you!
Oh and on sheep we dont bother with gloves

5:14 AM  
Anonymous Anonymous said...

When I was learning how to do this priceless exam, I accidentally (but reassuringly) patted the standardized patient's ass as I turned around to grab the KY. It was totally subconscious because I didn't even realize I did it until he turned around and proceeded to lecture me and my GU-partner about how inappropriate it is to do that. It was possibly the hardest I've ever silently laughed from embarrassment in my life.

12:20 PM  
Anonymous Anonymous said...

In my experience it's amazing how many patients THINK they're circumcized even when you point out they don't have a scar. And the reason is always just like you said: "My Momma told me I was".
I blame the entire English language "circumcized" and "immunized" are just too damn similar for Mommas to remember what's what!

5:29 PM  
Blogger Christopher said...

Wow you seem like a real squeemish weenie for a med student. It's a body. Docs like you make us feel like creeps when we get our physicals.

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