Tuesday, November 02, 2004

What an Asshole

I clearly remember my first ever rectal examination, that is, I remember the first one I gave someone else. I recall feeling as if I had violated him. As if I was tormenting my patient all for the sake of learning what a prostate is supposed to feel like or just what the feeling of sticking your finger in a stranger’s ass feels like.

It’s kind of an uncomfortable subject to discuss both here on this blog and also with my patients. I never really know how to approach it. As an intern I used to say “This is something I have to do, unfortunately, but we have to check if you’re bleeding down there..or back there” (whatever). Then I would watch them wince in horror and I’d try to laugh it off. After a year of apologizing for a rectal I think I’ve lost all shame in it. In fact, there are times that all I really need is a rectal exam result and if I could stick my finger up the patient’s ass before saying “hello” I probably would.

Now, I say things like “flip over, WE have to do a rectal examination” (As if he’s participating). Or even better yet (snotty English accent) “Oh intern, we need a rectal exam on Ms. D, would you kindly skooch on over there and do it?”

I’ve found, strangely enough, that I usually connect much better with the patients whose assholes I explored. In a way, it brings us together. In a really sick, kind of demented way.

Rectals are also a great way to punish patients. At least the really annoying ones or those that try to take advantage of us. I’ve lied to patients before and spent an extra long few seconds checking out a prostate. Really checking it out. You now know why this blog is anonymous right?

On the last hour of his rotation my Student told me he had made it through three months of wards without ever doing a rectal exam. He did 15 rectals that hour alone and our service was colonic bleeding foolproof. The language I use is vulgar because the act itself is barbaric. The truth is that I’ve had other doctors give me rectals before, I’ve even had a colonoscope shoved up there. You know, once you get used to it it’s kinda fun. (I didn’t just say that publicly, did I?)


Well, if this posting didn’t have you pissing in your pants then I give up. I don’t really have any more rectal exam stories to tell. I do have one of a manual dis-impaction I did my first year. Wanna hear it?