Date: Tue, 11 Apr 2006 17:46:24 -0700 (PDT) From: Dr. Jeremy Subject: Jeremy's Exam Jeremy is a typical 15 year-old living in a suburban town. He is about 5'11", 170 lbs. with dark hair and dark eyes. Over the past year, his body has taken a dramatic turn from boy to young man. He has grown a few inches, put on 10 or 15 pounds of muscle, and hair has sprouted where previously there was none. Jeremy has started to notice girls a lot more and spends quite a bit of time thinking about them. And the girls have noticed him, too. They especially like his lean, taut, athletic body, which has begun to mature perhaps at a quicker pace than his facial features, which are still quite boyish. He has large, dark eyes and a small nose. When he smiles his wide smile, his plump cheeks still display dimples on both sides. His complexion is dark year-round, but even more so after being outside bare-chested for a good chunk of this summer. Jeremy is both a good student and a good athlete. His good nature and friendly, gregarious demeanor have won him lots of friends-both male and female-but he does not have a steady girlfriend yet. He comes from a good, loving family. Simply put, Jeremy is the All-American boy. A few weeks ago, Jeremy's mother told him she had made an appointment with a new doctor to have his annual physical examination. Ever since he found out about his physical, Jeremy has been a little apprehensive about the prospect of a checkup with a new doctor. He has been going to his female pediatrician for annual exams for as long as he can remember, and it has never bothered him. His pediatrician was used to dealing with children and was therefore very gentle and warm. She never made him undress for the exam and never examined his "private" parts, unlike the unlucky boys at school who told stories of having to turn their heads and cough while the doctor cupped their genitals. But Jeremy's mother thought it was time for him to see a "grown-up" doctor, and she has scheduled an appointment with the male family physician, Dr. Anderson. Jeremy doesn't understand why he needs an annual physical anyway. He thinks he's young, healthy, and invincible. But Jeremy's mom insists, and there's not much he can do about it. As Jeremy and his mother pull up to the medical building, Jeremy is still nervous. He isn't sure he likes the idea of another guy examining him-touching him-especially in some of his more sensitive areas. But Jeremy isn't sure whether his buddies at school were just making up stories or if they really did undergo such embarrassing exams. Whatever the case may be, Jeremy has become a little more self-conscious since puberty kicked in with a vengeance over the past year or two. He hopes Dr. Anderson's physicals will be like his past ones-just a quick once-over. Jeremy sits in a chair in the waiting room while his mother checks in with the receptionist. There are two or three other people in the room. Jeremy's mom returns with a clipboard. She fills out some insurance paperwork while he works on his medical history. He knows most of the answers, but he has to ask his mother about some of his vaccinations. Once the paperwork is completed, it's time to sit and wait. After about twenty minutes, a young female nurse comes out of the door and calls, "Jeremy?" Jeremy gets up, along with his mother. "Hello. Come back with me, please," she says, as she leads mother and son down a brightly-lit hall with white walls and ceramic tile. "First door on your right." The nurse motions Jeremy into a straight-backed chair next to a blood pressure cuff. They're in a small room with just a couple of chairs, a sink, a blood pressure monitor, and some jars with various medical supplies in them. The nurse asks some benign questions to confirm the purpose of their visit and to verify some of Jeremy's medical history and personal information. She then takes his pulse and asks him to pull up the sleeve of his T-shirt so she can take his blood pressure. The nurse places the cuff around Jeremy's toned, tan left arm. After she has successfully taken the reading-a perfectly normal 120 over 60-she puts a plastic cover over a thermometer and places it under Jeremy's tongue. "Not too bad so far," Jeremy thinks to himself. The nurse records her patient's temperature and then takes a specimen cup from a shelf and hands it to Jeremy. "You know what to do," she says coolly while motioning to a restroom across the hall. Jeremy goes to the bathroom and emerges several couple minutes later with a full cup. The nurse turns toward Jeremy's mom. "Ma'am, the doctor would like to have a few words with you before he sees Jeremy, so please wait here while I take Jeremy to the exam room." With that, Jeremy follows the nurse to a door marked "Exam Room 2". The nurse motions him inside. "Please take off everything but your underpants, and Dr. Anderson will be in after a few moments to examine you." With that, she closes the door and leaves a somewhat surprised Jeremy inside. Jeremy is not an overly-modest boy, and has even enjoyed showing off his developing body for the girls this summer at the pool, while playing shirts-and-skins basketball, or just hanging out shirtless in the park on a hot day. But there is just something about being alone in your shorts in front of another guy. Jeremy, however, has no choice but to undress. He pulls his T-shirt over his head and drapes it over the back of a chair in the exam room. He bends over to take off his shoes and socks and place them under the chair. Finally, he slides off his knee-length athletic shorts and tosses them over his shirt on the chair. Jeremy is left standing in his plaid boxer shorts. He feels the cold tile under his feet, and the air itself in the exam room is a bit chilly from the air conditioning. Jeremy has time to survey the examination room before Dr. Anderson comes in. The room is basically square and contains a padded, paper-covered exam table, a counter with a sink and numerous medical supplies on it, a scale, a short stool on rollers, a couple of chairs, and a tray with various medical instruments next to the exam table. Jeremy recognizes some of the instruments-a reflex hammer, tongue depressor, tape measure. On the wall are the devices Jeremy knows to be used to examine the ears and eyes, and also another blood pressure machine. Other walls have posters with anatomical diagrams and other health information. Jeremy decides to have a seat on the exam table. He hears the crinkle of the paper as he sits down. His long, well-defined legs hang over the side of the table. He is still a bit chilly as he sits and waits for the doctor. This adds to his sense of vulnerability. Here he is, sitting almost naked in a cold room, waiting for the doctor to inspect his pubescent body. His stomach begins to feel funny, a nervous feeling. Jeremy is anxious to get the exam over with. The firm knock on the exam room door makes Jeremy jump a little bit. Almost simultaneously, the door opens, and a middle-aged man with a white lab coat enters the room. He holds a clipboard and has a stethoscope draped around his neck. He closes the door behind him and turns to look at his young patient. "Jeremy, I'm Dr. Anderson. How are you today?" he asks in a cordial yet professional manner. "Fine, sir," Jeremy answers, but with a crack in his voice. Dr. Anderson smiles and walks toward the boy, then pulls over the small stool and has a seat. "I see here that you need to have your annual physical. I've looked at your paperwork, and you seem to be in generally good health. But we just need to do some basic checks to make sure. Complete physicals are especially important at your age, when your body is growing and changing so rapidly." Dr. Anderson asks a few mundane questions. Any medications? Any aches or pains? How's your appetite? Jeremy gives satisfactory answers to the doctor's questions. "The first thing we need to do is get your height and weight," Dr. Anderson says. "Normally, I have my nurses record these measurements, but I like to weigh and measure youngsters like yourself on my own, just to make sure we're getting accurate statistics at such an important time in your growth and development. So please hop down from the table and step on the scale." Jeremy does as he is asked. The doctor fiddles with the bars on the scale until they balance. "172 pounds," he pronounces. "Well within the normal range for a boy your age." Then he asks Jeremy to turn around and face away from the scale. He places one hand on Jeremy's shoulder and pulls up the measuring stick on the back of the scale with his other. Dr. Anderson lets the bar come down to the top of the boy's head. Now he places both hands on the boy's shoulders and orders, "Stand up nice and straight for me." Jeremy sticks out his chest and throws his shoulders back while he looks straight ahead. Dr. Anderson grips Jeremy's chin to make sure his head is level. "5'11-1/4"," he says while patting Jeremy's shoulder. Dr. Anderson motions Jeremy off the scale and makes some notes on the patient's chart. He picks up the cloth tape measure off the tray and steps toward the boy patient. "Jeremy, I need to take some measurements of your body to make sure you're growing properly. Stand up very straight and relax while I measure your head circumference first." The doctor wraps the tape measure around Jeremy's head, around the forehead just above his ears. Jeremy doesn't know what to think about this. His pediatrician had never taken body measurements before. Jeremy feels a bit like a choice steer at a cattle auction, but he complies with the doctor's requests. He stands in the middle of the exam room with his hands at his sides, dressed only in his boxers. The boy is the picture of health-nearly flawless, unblemished skin that is evenly tanned. He is tall and lean with barely a trace of body fat. His muscles are not bulging, but he has nice size and definition in several places. His broad shoulders and strong back sport visible muscles. His pectoral muscles are slightly rounded and have excellent definition. His triceps appear very sharp when he straightens his arm, yet his biceps bulge somewhat when flexed. Jeremy's abs all are visible and cut, and there is no fat on the teen's belly. A thin trail of hair runs from his groin to his belly button, which can still be classified as an "outie". His legs are nicely muscled, with sinewy definition in the calves and not insignificant bulk in the thighs. A thin layer of fine hair covers his lower legs. The doctor goes on to measure Jeremy's chest span. He wraps the cloth around the young man's chest at the nipples, asking him to take a deep breath and hold it. Dr. Anderson gets two chest measurements-expanded and normal. Jeremy comes in at a healthy 37 inches, 38.5 inches expanded. The doctor continues by measuring Jeremy's waist, arm span, thighs, and calves. He has Jeremy make a muscle with his right arm. His 14-inch biceps are quite impressive for a young lad. "Jeremy, you have a very fit body. You have excellent muscle tone, and everything seems to be in proportion. You must work out," Dr. Anderson says. "I lift weights for football and I jog on a couple times a week," Jeremy explains dutifully. Dr. Anderson records Jeremy's measurements and asks him to have a seat on the exam table. "Jeremy, it's time to start your head-to-toe physical examination now. Just sit up nice and straight there on the table for me and we'll get started." Jeremy again tightens his abs and brings his shoulders back. He keeps his hands on his thighs while his muscled calves and feet dangle over the edge of the exam table. Jeremy is not so much nervous now as he is anxious to get through this exam so he can head to the pool. Dr. Anderson takes the otoscope from its base on the wall and puts a plastic probe cover on the ear probe. He grips Jeremy's earlobe with one hand and holds the scope with the other as he peers into the teenager's ear. Dr. Anderson nimbly switches the otoscope to his other hand and shifts his feet to examine Jeremy's other ear. After replacing the scope on the wall, the doctor picks up the other device with a light on it from the wall unit and shines it in Jeremy's eyes. Dr. Anderson places his left hand on Jeremy's right shoulder. "Just look straight ahead, please," doctor says to patient. When Jeremy's eyes check out alright, Dr. Anderson takes a tongue depressor and penlight from the instrument tray and has a look in Jeremy's mouth. "Say 'Ahhh', son," Dr. Anderson says. "Ahhhhh," Jeremy responds, a little embarrassed at the bizarre routine. "You have beautiful teeth, Jeremy. I see that you take very good care of them," the physician remarks. Next Dr. Anderson uses both hands to feel along Jeremy's neck. The doctor is checking for any swelling of the boy's glands. Jeremy notices how warm the doctor's hands are as Dr. Anderson asks him to swallow while feeling around his Adam's apple. "OK, Jeremy, please place your hands behind your head." Jeremy complies with the doctor's request, but doesn't understand what test the doctor is performing. There is a healthy nest of hair under each of the teenager's arms, which again are slightly flexed. Dr. Anderson palpates the boy's underarm regions with the fingers of both hands. Jeremy feels very exposed as the doctor invades this unusual part of his body. He does not understand that the doctor is checking for swollen lymph nodes. "I see you have a copious amount of hair growth under here, Jeremy. That's a good sign that puberty is underway," Dr. Anderson says as he gently pulls Jeremy's hands down from behind his head. "Have you noticed any hair coming in on your chest yet?" Jeremy barely has time to process the question until Dr. Anderson is gently and slowly running the palm of his hand and his fingers over Jeremy's taut bare chest. "I don't feel any yet, but it's not unusual for chest hair to be one of the last stages of puberty. And some men never have any chest hair," Dr. Anderson explains. "Let's just feel around the nipples more thoroughly, since that's often where chest hair first shows up." The doctor uses his left index finger and thumb to massage the perimeter of Jeremy's left nipple, then his right. Jeremy tenses as Dr. Anderson's fingers and hand brush against the sensitive nerves in his quarter-sized nipples. He certainly never expected to have a nipple exam during this physical! And now, as he looks down, Jeremy can see that his nipples had become more erect from the doctor's touch and the prolonged exposure to the cool air in the exam room. "None there, either," Dr. Anderson says, and abruptly moves his hands to Jeremy's face. A few open-palmed strokes of the boy's face to feel for stubble convince the doctor that Jeremy is maturing, but his patient still has a long way to go until he completes puberty. "I'm sure you'll be shaving in no time, young man," he says in a patronizing tone. Jeremy is now thoroughly uncomfortable. Not only has he been stripped of his clothes and weighed and measured like a thoroughbred horse, now he has to endure this humiliating exam and the resulting comments from his new male doctor. And Jeremy has a feeling that he hasn't yet seen the worst of his physical examination. Dr. Anderson puts his stethoscope in his ears and asks Jeremy to take slow, deep breaths in and out through his mouth as he listens to the boy's lungs. Jeremy feels the cold metal disk of the stethoscope on his skin as the doctor moves it around to six different spots on his back. Dr. Anderson rests his other hand on Jeremy's shoulder while he listens intently to the teenage boy's breath sounds and observes his diaphragm expand and contract with each respiration. Now the doctor places his stethoscope on the left side of Jeremy's chest and instructs him to breathe normally. Dr. Anderson concentrates on the adolescent's strong, regular heartbeat for any signs of trouble. Jeremy's heart rate is slightly higher than normal, but the doctor suspects the boy is just nervous. The physician's spare hand is flat against Jeremy's back. The hand moves slightly with each movement of the stethoscope to a new spot on Jeremy's firm, rounded chest muscles. "Please lie back for me, Jeremy," Dr. Anderson says as he moves to the foot of the exam table and pulls out an extension of the table on which Jeremy can rest his legs. The doctor auscultates his patient's chest again in this supine position, again moving the stethoscope all over Jeremy's chest. Then he moves to Jeremy's abdomen and listens for bowel sounds. Jeremy is a little ticklish in this area and tenses when his doctor lightly places his instrument on his belly. Dr. Anderson notices the boy's reaction but now begins to survey the boy's lower torso with his hands. Jeremy flinches every time the doctor moves his hands to press against his tight abdomen. Jeremy again is asked to take deep breaths as his physician checks his liver and spleen and makes sure the boy has no unexplained tenderness or hardness in his tummy area. "Jeremy, I just need to check your bladder and femoral pulses now. Just relax for me," says Dr. Anderson. The doctor lifts the waistband of Jeremy's boxers enough to press his right hand on Jeremy's groin, just above the base of the penis. The doctor is making sure Jeremy's bladder is healthy. Next he presses on the areas where Jeremy's legs meet his groin. He is feeling for Jeremy's femoral pulses to make sure Jeremy is getting strong circulation to his lower body. Everything checks out OK, but Jeremy is starting to sweat after being palpated in his groin area. "Good man, Jeremy. Now let's check your range of motion." Dr. Anderson picks up Jeremy's long, muscled right leg with both hands and bends it at the knee. He moves Jeremy's leg toward the patient's head. Now he does the same with the boy's left leg. Now he bends and twists Jeremy's feet at the ankles to make sure he has no flexibility problems. The doctor finds nothing wrong with the boy's lower body. "Jeremy, you have a nice layer of hair on your lower legs, here. And excellent muscle tone, as well," Dr. Anderson says as he strokes the boy's calves. "Flex your calf muscles for me, please." Jeremy obeys by pointing his toes at right angles to his legs. Dr. Anderson squeezes the boy's young, rock-solid legs. "Excellent development here, son." Dr. Anderson asks Jeremy to sit up. His hairy, toned legs are now hanging over the exam table again. By now, Jeremy feels dirty and wants to take a shower after being poked and prodded all over his young, developing body. He has never had another man touch him in so many places before. Little does Jeremy know that his exam is only half over. Dr. Anderson continues the boy's range of motion tests by manipulating his patient's arms in all sorts of different positions. He has Jeremy flex his biceps and feels the boy's firm, rounded arm muscles. Then he repeats the process with Jeremy's triceps. Jeremy is proud of his precocious musculature, but he'd much rather have a girl exploring his bare body than this male doctor. Dr. Anderson switches gears and performs some neurological tests on Jeremy. He uses his rubber hammer to tap the teenager's knees. Jeremy's knees oblige and give a small jerk. Dr. Anderson moves to the boy's ankles, and then up to his elbows and wrists. All of Jeremy's body parts give the appropriate response, and the doctor is satisfied. He takes the sharp metal handle of the reflex hammer and runs it along the bottom of Jeremy's feet. Both of Jeremy's feet recoil at the tickling instrument as Jeremy tenses and tries to move his legs away from the doctor. Dr. Anderson then repeats the test on the sides of Jeremy's abdomen and rib cage, and the boy lets out a gasp from the contact on such ticklish points on his body. "Time to do some orthopedic checks, lad," Dr. Anderson says as he motions Jeremy to hop off the exam table. "Please bend over and touch your toes without bending your knees." Jeremy bends over and touches his toes. Dr. Anderson runs his hand up and down Jeremy's spine to check for any unnatural curvature that could indicate scoliosis. He has to pull the teen's boxers down just a bit to check the bottom of the spine and the tailbone. Jeremy's bottom is fully covered by this boxers, but the doctor's hand is within centimeters of his young sphincter. The doctor can't see Jeremy's face, but Jeremy is blushing after being in such a humiliating position. The doc gives Jeremy a light pat on his back and asks him to stand up straight. Then Doctor Anderson pulls two latex examination gloves out of a box on the counter and quickly snaps them on. He pulls the stool over in front of Jeremy and sits down on it. Jeremy is getting a sinking feeling. He seems to remember hearing about some of his friends standing naked in front of their doctors while the doctors manipulated their genitals. "Son, have you ever had a hernia and testicular exam?" Dr. Anderson asks in a straightforward manner. "No, sir," Jeremy responds, again with a cracking voice. "OK, son. We need to make sure you're developing properly and that you don't have any problems down here. Please lower your shorts to your knees." This is the moment Jeremy has feared. His friends weren't just pulling his chain about undergoing such exams. Jeremy hesitates a few seconds before complying with the doctor's requet. He slips his index fingers under the waistband of his boxers and methodically lowers them to his knees. He is now standing, fully exposed, just inches in front of his doctor. Jeremy is just like any other young man going through puberty. He is a little concerned about the size of his penis and testicles. He has heard some of his friends brag about how long their dicks are, and Jeremy isn't quite sure that he "measures up". Nonetheless, Jeremy now stands naked in the exam room, his penis dangling freely. "The first thing we need to do is a hernia check. I'm going to press under your testicles and ask you to turn your head and cough," Dr. Anderson explains carefully. Dr. Anderson places his gloved index finger under Jeremy's right testicle. Jeremy flinches as the doctor's hand makes contact with the very sensitive area around his scrotum. The doctor rather forcefully puts upward pressure into the area where Jeremy's testicle meets his groin. It is slightly uncomfortable, even painful, but Jeremy does not say anything. Dr. Anderson asks him to cough. Jeremy turns his head and gives a light hack. "Again, please, a bit harder," Dr. Anderson orders, clearly unsatisfied with Jeremy's effort. Jeremy tries again, and Dr. Anderson moves to his left testicle, and the process is repeated. "Good," Dr. Anderson says. "I'm now going to check your testicles for any lumps that could be a sign of testicular cancer. I'll also assess the size and shape of your testicles to make sure you're developing properly." With that, Dr. Anderson uses both of his gloved hands to manipulate Jeremy's testicles by rolling them between his testicles. The exam feels very strange to Jeremy, and he has to shift his feet a bit as Dr. Anderson lifts and squeezes his testicles a bit. Jeremy has never felt so vulnerable. A grown man is handling his developing genitals, and there's nothing he can do but endure it. Worse yet, Jeremy is beginning to sport an erection! He is not fully erect, but the intimate contact with his scrotum has excited the teen. Jeremy's face turns a bright shade of red. He is sweating. He is shaking. He doesn't want the doctor to think he's gay or anything. "Well, Jeremy, everything checks out OK. No hernia, no abnormalities in your testicles. Your genitals are of perfectly normal size and shape. You have a healthy amount of pubic hair. And I can see you have no trouble getting an erection..." Jeremy gasps a bit and begins to search for words to explain his condition. "Don't worry, son," Dr. Anderson reassures him. "It's perfectly normal to develop an erection during your physical exam. I'm sure you have several erections during the course of a normal day even if no one is touching you, right? It happens to all boys your age, and it happens to many of the kids I see for routine physicals." Jeremy is only slightly relieved by the doctor's words. He is still very embarrassed as he stands naked in front of the doctor. Jeremy assumes Dr. Anderson is finished with this most humiliating check of his privates and begins to pull up his boxers. "Just one more thing, Jeremy," Dr. Anderson says as he gently grabs Jeremy's arm to halt him from covering his nakedness. "Because you are developing so well, even slightly ahead of most other 15 year-old boys, I need to check your prostate to make sure there's nothing abnormal. Normally this is reserved for older men, but you seemed to be in an advanced stage of puberty compared to other teens." Jeremy looks blankly at Dr. Anderson. He doesn't even know what a prostate is. Dr. Anderson directs Jeremy to turn around, bend over the exam table, and place his head and chest flat while gripping the sides of the table with his hands. Jeremy's buttocks are now sticking straight out, exposed to Dr. Anderson, who is still sitting on his stool. Jeremy's boxer shorts are still barely still dangling from his knees. Jeremy still isn't sure what is about to happen, but he doesn't like the sound of this exam. He now seems to remember the term "prostate" from his high school sex education classes, but he can't quite remember what a prostate is. Jeremy watches Dr. Anderson pick up a tube of K-Y jelly from the tray of instruments and squeeze some onto his gloved right index finger. "Try to relax, Jeremy," the doctor says as he lightly places his left hand on the boy's left buttocks. "This may feel cold as I insert my finger. It might be easier if you bear down a bit like you're going to the bathroom." Jeremy now has the sickening realization that the doctor will be penetrating his young ass in order to examine his prostate-whatever that is. Dr. Anderson begins the process. Jeremy feels the cold gel on his anus. Dr. Anderson slowly and gently penetrates Jeremy's pink, rigid sphincter by moving his finger back and forth and twisting it a bit. Jeremy's penis is now rock-hard, but he doesn't care. His immediate concern is that some old man is now violating him anally. Dr. Anderson asks Jeremy to take deep breaths as he tries to penetrate the young man's rectum, which has never been penetrated before. Jeremy takes slow, deep breaths and tries to imagine he is somewhere else. Finally, Dr. Anderson gets all the way into Jeremy's rectum. He checks the interior walls of the boy's rectum to feel for any abnormalities, and then moves on to search for the boy's prostate. Often, teenage boys' prostates are fairly small in comparison to those of a middle-aged man-no bigger than a walnut. But Dr. Anderson has given many prostate exams and quickly locates his target. He wastes no time in pressing and massaging the small gland. "Jeremy, you may feel the need to urinate. Don't worry, this won't take too long." Jeremy's whole body tenses and jerks a bit when contact is made with his prostate. He has never felt anything quite like it. In fact, he is experiencing the most intense sexual feelings of his young life. He is more stimulated now than he was during any of his most intense masturbation experiences. Jeremy lets out a few groans and whimpers as Dr. Anderson does a thorough 20-second prostate exam, then quickly extracts his digit. Dr. Anderson uses a tissue to briskly wipe the boy's anus. He gives Jeremy a light pat on the butt with his left hand, then pulls off and throws away his exam gloves. "All done, son. You're in perfect health. Go ahead and get dressed, and I'll see you in a year at your next physical to see how you've grown and matured." Jeremy is in a daze, but after his first prostate exam, he's already looking forward to his next physical!