“Good afternoon I’m Doctor Latch, what brings you in today? New patient, I see. Well, let’s jump right into it then. I will warn you, this visit might run late, I do like to be thorough to get a proper baseline with new patients, I hope you have nowhere to be in the next couple hours.” My patient was looking down at their fidgeting fingers in their lap until I said hours, then your eyes shot up as if to question me but stopped short. “There is a gown on the exam table, please disrobe completely and change into that. Leave it untied in the back.” I straighten my tie as I stand to leave, closing the door behind me.
1800 words, 7-10 minute read. mild noncon (no sex), medical, gynecological, sedatives and restraints, no gore. This is the first story I've ever posted so enjoy! pls be nice to me about it
Part two here!
I was pleased to see my patient had folded their clothes neatly into a pile on one of the waiting chairs. You jumped slightly when you heard the metallic clinking of tools on the covered tray I was rolling in with me. I roll my stool up to the table so we are sitting arms length away and begin asking my slew of questions. It always starts simple, the basics, how much do you eat, sleep, exercise, etc. then onto the more intimate questions that make you squirm and avoid eye contact. Once I feel that I have humiliated you enough with my questions I put your chart aside and don a pair of gloves and my stethoscope from around my neck. “Sit up straight for me” You jump when you feel my gloved hand on your bare back to steady you. “Take a deep breath in for me…and out. Again, deep breath in…and out. Deep breath in…hold…and out” it seems like this goes on forever making you a little lightheaded. “Are you feeling okay? You're looking a little flushed.” I move my stethoscope to the front and slip my hand with the bell down the front of your gown, catching you off guard. I listen with concern for a moment, taking one of your wrists in my other hand to feel your pulse. “Your heart rate is higher than I’d like. I am going to run an EKG just to be safe” I say as I am setting up wires all around you. A hand on your shoulder encourages you to lean back against the table. Before you realise your gown has been folded down to expose your chest. When you reach to cover yourself my hands find your wrist firmly. “Hands by your sides” I chide and you obey. It's not long before the electrodes and wires have been placed. With a couple clicks on the monitor you hear your pounding heartbeat echoing in the room. I study the glowing screen for a couple moments before deciding out loud “I’m going to keep you on the monitor the rest of your exam just for a better picture of your health”
You’re startled by the rip of the velcro as the blood pressure cuff is strapped on your arm, the pulse oximeter too. Trapped by a mess of wires, without pulling your gown back up you are instructed to sit up once more. I look in your eyes and ears, I take a throat culture which makes you gag and your eyes water. You are laid down again for an abdominal exam which leads to your gown being pushed down further, feeling like it barely covered anything at all. You’ve already been at my clinic for over an hour, I don’t think you realized how full your bladder was until my gloved hands were palpating your abdomen. “Is this tender?” I ask the obvious while pressing on the exact spot that made you flinch. Such a shy patient, you barely manage a nod. I let out an inquisitive hmm as my palpating hands move lower, right above your pubic bone. I hear your sigh of relief when I turn away from you, pulling off my gloves, washing my hands. I see you've attempted to cover yourself with the flimsy gown when I turn back to you, pushing the tray I brought in with me earlier, this time uncovered. I see your face drop when you see the array of shiny metal tools, one of the notable few you could identify: the speculum. The stirrups fold out from the table before you know it.
“By your own admission, it’s been far too long since your last visit to the gynecologist. Due to the length of time that has passed, and because it will be my first time exploring your body this might feel more invasive than you're used to but I assure you this is all necessary.” You become aware of the heart monitor again as you hear it announcing your anxiety over a loud speaker. “These are just safety straps, I can’t have you moving around with such delicate instrumentation inside you. I hope you're comfortable.” I know no one is comfortable on my exam table in this position yet I say it anyway. Once I feel my patient is properly secured with the thigh and ankle straps and the one across your hips I take my seat between your legs knowing if you become difficult there are quite a few more straps at the ready under the table. I can imagine you must feel so exposed with the heat of the exam light burning where the light usually doesn’t shine. As I begin palpating your hands go up to cover your face in shame. “Arms by your side, please. The monitors you’re on are sensitive pieces of equipment, I don’t need your inability to hold still to affect the readings.” I am stern and unyielding, like the straps already adorning your lower body. “If you find yourself unable to keep still I can assist you in that.” My patient shakes their head no and lets out a weak apology. “A little bit of pressure now” You jump again as I am inserting the speculum. I sigh standing up and snapping off my gloves “I can’t work like this. I was hoping you wouldn’t be such a disruptive patient. These should make it a lot easier for you to hold still” Thankfully my patient doesn’t fight as the straps are secured to their wrists and across their chest. They do pull a little, testing the strength of their bonds. I hear another jump in heart rate as they realize how trapped they really are, their gown completely removed, fully exposed and unable to escape my scrutiny. I’m sure the thought went through your head of how easily I could decide not to release them at the end of the exam, how vulnerable you are.
I hum a little to myself, enjoying the ability to work on you without interruption. “I’m seeing an unusual amount of vaginal secretions” I announce aloud just to watch you blush. The speculum somehow opens even wider, you let out a stifled groan. “Since it’s been so long since your last pap smear, I think it's indicated to look a little deeper than a standard exam. Take a deep breath, you might feel some cramping as I dilate your cervix” some cramping might have been an understatement but I try to avoid overly worrying my patients, I find that knowing the pain that awaits them leads to higher rates of non-compliance. I’m sure my patient is thankful for the restraints keeping them in place as their body fights to get away from me. “You’re okay. You’re doing so well. I’m almost done with this one then only two more dilators to get through.” my free hand rests on your thigh in an effort of comfort. On the third dilator I have to ask, “Would you like the nurse to bring you a sedative? You might find it easier to relax with the aid of medication.” My patient denies it. I believe you’d be more comfortable with the sedative but I’ll let you make your own decision for now. Your cervix spasms beautifully as the final dilator is removed. “I just need to gather a few uterine samples now, hang in there, we are almost done” You can’t see what I’m doing but hear the clink of metal tools and feel a deep, gut churning scraping inside. There’s a visible look of relief on your face as I release my grip on your cervix and remove the tentaculum but the speculum stays lodged in you.
“All I have left to do down here is get a urine sample…What was that? No, you won’t be needing to urinate in a cup. It’s much easier for me to get a clean sample through a catheter insertion. You’re brave, I know you can handle it” While I am changing my gloves and setting up a sterile tray I hold up the catheter tubing to show you and explain how far inside you this will be going. With generous lube and expert hands I have you catheterized and voiding into a sample cup in no time. What gave you pause was when I connected the catheter to a collection bag and taped it securely to your leg. For the first time you’ve said more than two words in over an hour, “Umm…Aren’t you going to take that…thing out of me?” I’m quiet for a moment as I’m careful to choose my words, “I have decided to admit you overnight for observation and further testing in the morning. I have some concerns about your heart rate, among other concerns I saw in your exam. It can be quite taxing to get a patient on so many monitors to and from the restroom so this is the practical option” This is the part where you start to get agitated, I was worried about this possibility. I tried explaining why it’s important for you to be in my care but you are far too worked up to process that information. When the tears start and I am concerned about you hurting yourself thrashing against the restraints I call in a nurse with the sedative you denied earlier. It’s a quick and relatively painless injection in your thigh, you should be feeling its effect soon. I sit by your head and speak softly, wiping your tears away with soft gloved fingers. I feel your pulse at your neck as you start to settle down, your eyes are starting to glaze over. My nurse and I work together to remove the straps and transfer you to a gurney. We get you comfortable in an inpatient room. After your outburst I decide it would be safest for you and my staff, to keep your wrists restrained to the bed. I have my nurse insert an IV so that we can keep your fluids up. I was kind enough to pull a sheet over you before turning out the lights and closing the door. You are left to sleep off the sedative with nothing but the calm beeping of your heart rate and the regular whirl of the blood pressure cuff to lull you into much needed restful sleep. You looked so tired when you arrived at your appointment. I’m sure you will come to understand this is all for your own good.
