It was my last day on the OB/GYN floor. As a Resident stationed at Bethesda Naval Hospital, I was ready to weigh anchor and move on to my specialty of general surgery/trauma. GYN was never on my radar as far as specialties were concerned when I became a doctor. Too many women and too wide awake. I prefer my patients unconscious. Not women, I realize that came out wrong. Oh no, I like women and awake and raring to go.
My mentor, Captain Pussyfoot, MD was a seasoned veteran who had been at Bethesda for over the past 10 or so years. He was hardened and craggy, and as a boss, scared me shitless. He was also a prankster of the highest order so with everything I did, I proceeded with caution.
The last patient on the roster was listed as Marge, the Rear Admiral's wife--yearly checkup and pap. I envisioned this battleship of a woman with iron grey hair and no nonsense. I would have to tread very carefully with her.
As I came down the corridor to the exam rooms, I saw the nurse, on duty, bringing in not old Ironsides but a stacked, long haired blonde in stiletto sandals and thought, that can't be Battleship Marge.
My boss was already in the room and had greeted Mrs. Rear Admiral. It was always our protocol to talk with the patient first, fully clothed. It put our patient's at ease; especially patients that we were just meeting for the first time. After we did our meet and talk, we then moved on to the inward exam.
I was introduced by my mentor and then he backed off and let me handle the oral exam. No issues; no new complaints--everything was status quo. Making my notes, I thanked my lucky stars that I would be going out on an easy exam.
We left the patient to get undressed and my mentor, as well as the nurse, were strangely silent. They kept giving one another sidelong looks that I couldn't help but see. Oh well, I thought let's get this over with so that I can get the hell off this floor.
I returned to the exam room, no nonsense, and saw that Mrs. Rear Admiral was already in position and ready to go. Her one arm was already up over her head for the breast exam. I gave her what I thought was a reassuring smile and as I explained what I was doing, started palpating clockwise on her left breast. A second later, Mrs. Rear Admiral began to moan. Actually it was more like a hum. "Hmm. Hummmmm." I immediately stopped what I was doing. "Is everything alright?" I asked.
"Oh yes. Carry on."
I placed my hands back on her breast feeling for any graininess or lumps. "Hmmmmmm," she continued, her eyes closed. I looked up at my mentor and saw that he was standing with his arms crossed against his chest, his hand over the lower part of his face and wondered if I was being played. It was, I repeat my last day on the floor and he was, I repeat, a prankster.
With those thoughts in mind, I took a deep breath and continued on to the nipple where I lightly squeezed, making sure there was no discharge.
"Oh yes!" Mrs. Rear Admiral burst out.
Holy shit! Really? I ignored my mentor and decided to proceed as if nothing was abnormal with this exam. He wasn't going to rube me. I then moved on to the right side and repeated the exam as Mrs. RA continued her obscene moaning.
I swallowed hard and looked to the nurse for guidance. Nothing. She was in the process of prepping the speculum for me.
"Well, your breasts feel normal. Please follow up with your routine mammogram," I said and covered her chest with the sheet. I then moved down to the bottom of the exam table where Mrs. RA was already in the stirrups.
She looked over at the nurse and asked rather sharply, "Is that the largest one you have?"
"Yes, ma'am," the nurse said.
