Saturday, November 20, 2004

What an Asshole

(This post was first published on Election Day. I wanted to give readers a break from the standard voting coverage. Retrospectively, I now believe that regardless of the winner, it was, unfortunately, ironically appropriate)

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 and also with my patients. I never really knew 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.

Now, after a year of apologizing for a necessary exam I think I’ve lost all shame in it. In fact, there are times when a rectal is really necessary and if I could stick my finger up the patient’s ass without even 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 maybe he gets to give me one afterwards). 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 medicine wards without ever doing a rectal exam. He did 15 rectals that last hour alone and our service was 100% free of colonic bleeding. I believe his finger now graduated medical school.

In fact, I have no idea what the horrible reaction is for. 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 write that, did I?)

Well…If this post 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?