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Thursday, October 5th 2006

Feeling Around For A Right Of Passage

This Venturian Has Been Used In Plenty Of Rights Of Passage…
…Just Not The One This Post Is About

There are rights of passage as a medical student. The white coat ceremony, that first time through the anatomy lab, your first day on the wards. And of course, that first DRE.

That would be a digital rectal exam.

I walk into the room with two others. There’s a fourth year and an elderly gentleman waiting for us. He has some experience with this, his first words are for us not to be nervous.

Yes, Don’t Be Nervous While Doing This

I try not to think about what prompts a standardized patient to “sacrifice” themselves for such a task. A fourth year once told me he asked a female standardized patient during a pelvic exam how much they were getting paid to have so many medical students invade their privacy. It was enough to go on a cruise apparently.

But, still these very generous individuals must be much more comfortable with themselves, much more altruistic than I am.

The SP was right on the money. These encounters are just for that purpose – to get us comfortable with it. We were never going to feel any pathology in there, not even if their prostate felt like a rock.

I watched the 4th year sweat through “showing” us how to perform the exam. Maybe the thermostat was just turned up. Maybe if I just slide out the door no one will notice…

I’ll be honest, the aprehension was greater before my turn rolled around. You sit on the stool and no one expects anything of it, except you don’t harm the SP. It isn’t like there’s a lot to the actual technical aspects of the procedure. Finger. Anus. Insert. Feel Prostate. Rotate. Retract.

The Rectal Exam Participant’s Favorite Paper Product

I didn’t embarass myself, the patient wasn’t embarassed, and I have one under my belt. It is hard to define success in this experience as more than that.

Even when more than this becomes common during my daily practice, I think it’ll be a while before I forget the gentleman kind enough to let me feel my first prostate. Maybe because of him and a few other “lucky’ individuals, someday a prostate cancer will get detected. Or even better, allow me to cure someone of intractable hiccups.