Monday, May 25, 2009

Open Modeling Position- Requires large prostate

As a second year medical student, our medical school paid homeless drunks for allowing students to practice various skills. These skills included pelvic exams, rectal exams, eye exams, & history and physicals. On this particular day, I was extremely nervous b/c we were all learning how to perform rectal exams. They split the rectals into groups of five (total of 80 plus students). Each group performed their first rectal on one patient. The patient recieved 100 dollars per 5 rectals or 20 bucks each finger. Many of these patients smelled of alcohol, had no teeth, had mental illnesses, and were addicted to IV drugs. In my eyes, it was very strange and messed up that we paid the same people each year so they could go buy booze and drugs.

Our patient was a 58 year old male with no teeth and suffered from Hepatitis C. He was a perfect patient b/c he had an enlarged prostate (I assume this is why he was selected over all the other candidates- still wonder if they had tryouts). We all lined up outside the door, and the doctor came out of the room to give us instructions.

He said, "I recommend double gloving on this guy b/c he's got Hep C. When you come in, get some lube on your finger and insert. Then, push deeper to feel the prostate. Sweep around like this (just imagine a doctor pointing with his index finger and then doing a spin with the finger as a pivot) and get a good feel of the prostate. Any questions?"

We were silent as we pondered on how to rotate around our finger to sweep the prostate. One after the other, my fellow medical students went in the room and quickly came out 5 minutes later with their heads down to the floor. So, it was my turn- I knocked on the door (like he didn't know I was coming). I said "Hello sir, it's good to meet you. I'm Student Doctor Sensitive and here to do your rectal!" The homeless guy just got a huge smile on his face and turned around and dropped his smelly,dirty pants onto the floor. I confidently double gloved (just in case of the Hep C) and put lube on. I spread his butt cheeks and pushed hard like the doctor instructed me to and then spun around my finger to feel something. I'm not sure what I felt b/c I was trying to hurry.

As I was taking my finger out of his rectum, Mr. Homeless turned around and smiled sheepishly with his missing, broken teeth and said "I like you, you are charismatic!" At that point, I became alarmed b/c he enjoyed these rectals a little too much. I quickly removed my soiled finger, tossed the glove in the trash, and walked with my head down (as the two before me had done). I still wonder if Mr. Homeless said the same thing to the others that day, but I am pretty sure he still lines up for his 100 bucks of satisfaction. Still gives me chills.

-Doc Sensitive


08armydoc said...

At my school, they hired "actors" for all of our sim patients.

Will never forget the guy with whom I learned testicular exams. Dude was at half mast the entire time. I laughed til almost I peed when my male labmate mentioned the same thing, as I thought it was just me! We've never let him forget it, either.

Maha said...

LOL I guess having a rectal exam done by a bunch of students provides a) temporary shelter, b) $$ and c) backside fun :P

We have a lady that always comes in complaining of rectal pain when a particular doctor is on - she always demands a rectal exam and we can see the poor doctor shivering with fright a mile away.

LivingDeadNurse said...

omg that is soo awful!

HugeMD said...

Creepy. Kind of reminds me of the guy who came to urgent care complaining of being terribly constipated and having tried everything. Halfway through the tap water enema he said to the nurse, "You're halfway done, aren't you? You're going to give me another one, right?"

OK, how would you know the first one isn't going to work before the first one's done? Ick.

I told him we couldn't give him another because it was closing time. In reality, I can order whatever I want whenever I want, but I was NOT sending a nurse in to give this perv another enema. I gave him Go-Lytely.

Anonymous said...

I know this will sound weird - but I wouldn't mind volunteering for practice pelvic exams. They don't bother me (much), so I feel like I could provide good feedback to an intimidated newbie doctor. I once had the opportunity to volunteer in such a capacity through my work (when I was with Planned Parenthood), but by the time I did so, all the volunteer slots were filled! *laugh* Damn hippie women!

Mel said...

So I assume they hadn't taught you in your didactic courses that people are sick bastards?

ERP said...

We learned rectal exams during our mandatory 1 week rotation at urology clinic. We did however pay models for pelvic exams - they were crunchy granola types who at least were not homeless.

Grumpy, M.D. said...

My medical school paid people to do this, but friends of mine at other schools actually had to practice on each other. This was early '90's.

The schools maintained that it taught classmates "professionalism" in difficult situations.

I didn't buy it then, and I still don't. Just not right.

Me said...


vixn said...

Uhmmm pay me $100 for 5 rectal exams, pls? Wait... I don't have a prostate..