Anthony and Ava

"Take some big, deep breaths. This is your pulmonary valve. Can you tell it sounds a little different than the aortic? You are hearing the different timing of the valves' opening and closing and the blood flowing through."

She took some deep breaths. The whoosh was interesting but she wasn't quite sure what she was supposed to hear. It was mechanical, but also biological and natural. Her heart was beating fast. She needed to chill out, but even if he meant well, he wasn't helping by running the scope around her tits.

He slid the stethoscope head down to the middle of her chest, slightly below the nipple line, to where the gown was closed, and then went under the fabric just a bit. "This is your tricuspid." He waited a few breaths for her to hear it. Her mouth made small movements as she concentrated on the sounds of her heart.

Then he slid from there laterally towards the underside of her left breast, hidden by the gown. With his other hand, he gently folded up the gown, exposing just part of the skin of her breast, below the nipple. He loved the underside of a woman's breast, accentuated by its lightly colored skin and abrupt junction with the flat abdomen, a lovely private curve that was taboo to show in public.

"And this is your bicuspid valve." He waited a moment watching her breast pulse up and down. He imagined her getting turned on listening to the sexy beat of her own heart, and maybe even by his standing there next to her, over her, holding the stethoscope on her body.

"That's it, you are now an expert!" He moved the scope back to her sternum. "I'm going to work on some paperwork for a minute. You can hold it there yourself. You can even close your eyes to try to relax. Yes, good, like that. It's useful to think of a vision, maybe a beach or other quiet place where you know you can be calm. Try to forget you are in a doctor's office."

That wasn't very likely, she thought, but she was glad to have his attention away from her for the moment. She closed her eyes and breathed deeply, and listened to more whooshing. The beach vision was a good idea. She loved beaches, and imagined lying on one of those recliners with the little vinyl bands pressing into her back, a soft cool wind coming up into her face and the sound of the waves rolling in, maybe a sunset in progress. And how about a hot guy with dark hair serving me drinks. Damn, she thought—that's going to get my heart going faster, not relax it!

He went back to his desk but instead of working on anything useful he gazed back at the table. He couldn't take his eyes off her face, her chest, her hips, even her calves and delicate feet below the blue leggings, with toe polish carefully applied over smooth olive skin. He knew he was perving on her in a minor way, checking her out like this—it was a challenge he struggled with in the job, wanting to do the right thing but being a sexual person, occasionally being given an opportunity that was very difficult for him to resist. So he stared, wary of being caught if she opened her eyes, but he couldn't help himself.

After a minute he cleared his throat and put his hand to take the scope back. She opened her eyes. Her heart rate was still high. She looked uncomfortable lying on that hard exam table with her gown gapped open and the prospect of a strange guy pawing at her chest. He took stock of the whole situation and thought to himself, Anthony, you are a bad boy as Nadine always says, but you should do the right thing, for this nervous and very pretty girl. A chance for redemption.

I can give her an out, he challenged himself.

"Look, Ava, . . . your heart is still beating too fast to get a good ultrasound. Can I ask you a direct question?" She looked at him, vulnerable, not knowing what he was going to say next.

"We see a lot of women here, and some of them are, well, to be honest they aren't comfortable with this exam. It's technically not classified as an invasive procedure, you know, like, . . ." and he stopped, not wanting to name vaginal ultrasounds specifically, He merely said, "Well, like other procedures. So it's not standard to offer an observer when the tech is of a different gender."

She was listening attentively. Anthony could tell that he struck a nerve with this topic of discussion. He continued. "But we do have a female ultrasound tech on staff here."

She brightened up. "You do?"

"Yes. She only works Tuesdays and Wednesday though; she's not here today. But tell you what, how about if I go check the schedule and see if she can see you next week?"

She let out her breath and leaned back in relief. It was clear she was eager to seize this opportunity. "Yes, I would really appreciate it if you could check. Thank you."

He gathered his scope and clipboard and started to head out of the room. "I'm sorry to cause you the trouble," she said meekly as he turned away from her. "I don't mean it as an insult, or anything."

"It's no problem at all. Really." It both pained and elated him that he had this moment of strength to resist her temptation—it was not something in his character that he could always count on. This will definitely result in more blue balls and cold showers later, he knew, but at the moment he was proud of himself, that he managed to do the right thing. He flashed her a warm smile. He was definitely not letting her leave this time without getting a contact number.

He was really head over heels for this sweet and shy girl, in a way he had never experienced. As he walked up the hallway to talk to Marsha he felt a lightness in his step. Even Nadine would be proud of him this time.

*****

Ava

The door clicked shut as Anthony left the room. Oh my God, she thought. What a roller coaster. What is going on today?

She had watched him move silently. He was such an attractive man to her, the way he spoke, the way he looked, the way he controlled his body. Her feelings were not simple about watching him leave the room; she was conflicted. Maybe it was even a let down after the build up. Did part of her brain want her to be forced to go through with an exam? To have a hot guy inspect her chest, rub a scope all around her breasts?

She wondered about that whole thing where he let her listen to her own heartbeat. What was that? She'd never heard of that being standard procedure, but then again she'd never heard of having too fast a heartbeat for an exam either. Maybe she was the exception, not him. She admitted that it was pretty interesting to hear—she hadn't realized the different sounds that parts of her heart made, and she could see it would be soothing, even sexy, to lie still and listen to that in a quiet room, or listen to someone else's heart beating.

She sighed. As intriguing as Anthony was to her, and for whatever attraction she felt towards him, she was better off to get this exam set up with a woman instead. It felt like stepping back from the edge of a cliff, or backing out of a commitment that she knew was going to be over her head. There was a little bitty touch of disappointment in not challenging herself, but the relief was palpable. She'd come back in next week and get this done and then get back to her life at school. Maybe this would give her the confidence to go ask Samson for a date. It was all practice, right? So in this way, Anthony had already helped her face up to some fears of hers and overcome them, even in a small way. Adriana would be proud. Was this the breaking of the ice that she wanted?

Then a small wave of embarrassment came over her. I was made so noticeably nervous by this hot tech that he asked me if I wanted to switch to a woman, she thought. Am I some kind of freakishly shy girl? Has that happened before? It was a day of firsts.

He was taking a long time checking the schedules so she settled back on the table, letting her muscles relax all over her body. She took some deep breaths on her own without the stethoscope. It was much more effective when she was doing it herself than with him in the room, she thought. Without the anxiety of an upcoming exam, she even let her mind start to wander about Anthony, the hot ultrasound boy. She imagined running her fingers through his hair, and him holding her, even leaning down to kiss her on the lips. Maybe she was back on her beach chair and he, dressed in a tuxedo tails with no pants, was holding a glass of champagne on a serving tray. This caused a small giggle.

She was getting into this enough that she didn't startle when he knocked quietly and came back into the room. She didn't even sit all the way up, but just tilted her head over towards him from her fully prone position on the exam table. He didn't seem phased. Maybe he was used to women lying down for him, she mused.

"Unfortunately she's out of the office next week—Gloria, I mean, she's the echo tech I mentioned—and Doc Michaels is on vacation the week after, but there is room the following week. Marsha does the scheduling out front. She's nice, and don't worry, it's totally normal for female patients to request a female ultrasound tech. Don't be shy asking, she won't give you any trouble about it." His face fell as he noticed her expression. "That doesn't work?"

"I'm only here for spring break through next week. I go to college in Ithaca."

"Oh. I see. Well . . . you could find a cardiac doctor up there at school. Or wait until summer if you'll be back then. Of course—don't mistake this for medical advice—but it would be unlikely for someone at your age to have an issue that would need immediate attention. Unless you started feeling some direct pain." He pointed to his own chest for emphasis.

"Thank you, but I promised my mother I would get this checked out soon. To put her mind at ease, after . . . you know, last week."

"After what happened to your grandmother, you mean? Ah, I understand. That makes sense." He looked at her prone, relaxed, on the exam table, and had an idea.

"If you don't mind, I can just check . . ." he said, and without asking permission popped his stethoscope back in his ears and reached over to aim the diaphragm towards her sternum. She didn't have time to answer before he put his other hand on her shoulder and told her to lean back. The cold metal hit her chest again in that gap up high between her breasts. "Now breathe deeply."

She was annoyed, but she complied. What was with the way medical people just assume they can grab you, she thought, and order you around, invade your privacy? He even brushed his arm against her gowned breast slightly when he reached over to scope her sternum. It was only a glancing touch, but it lit up her senses. He didn't seem to notice.

"Your heart rate is normal now. Relaxing on the table was a good idea. We could proceed with the exam. What do you think?"

She was caught by surprise, plunged back into that panicked feeling after the relief of finding safety. The bottom of her stomach fell out again. It's like in those horror movies, she thought, where they are running from the T-rex and they get away, and they look to the side and it's all clear. Then they look back to the other side and surprise! T-rex! Jump scare! Although in this case her dinosaur was a dark, deep-eyed man with a devilish smile, fantastic figure, and Southern European ancestry. Maybe he had the same T-rex unwavering gaze, though. It seemed that he was ready to get back to business.

She didn't know. She had really liked the idea of a female tech. It was a lifeline that was hard to give up, to go back to a guy, this guy, after being teased with that option. It must have shown in her facial expression.

"We're already a third done," he encouraged. He pulled the ultrasound wand out of its holster on the big machine in front of him and waved it in the air, showing it to her, like see, it's not so scary. She felt a little bit like a dog being allowed to sniff its collar before a walk: see, it's not so scary, come on and be a good girl!

"We just use the want to get the pictures; they show up over here." He pointed to the screen.

He seemed so eager to do his job. Speaking of dog analogies, she thought, he seemed like the puppy now, jumping up and down dying for its walk. And for some reason the part of her brain that was ready for adventure—the part that was trying to impress a non-existent Adriana in the room—combined with the other part of her brain that desired to go with the flow of things and not cause an exception, conspired so that she said, "Okay," before she could think twice about it.

"Great," he said, and flashed a smile. "Just lean back and I'll get the machine ready."

So suddenly she found herself back on the roller coaster. It was two parts being anxious and one part exciting. She looked over at his handsome profile while he typed in commands to the computer, took a big breath and waited for what was going to be next.

*****

Anthony

He checked other time slots for Ava, but nothing seemed to work for her. So when he saw her lying there prone on the table and looking a lot more comfortable than before, he decided to try a flier to check her heart rate. She surprised him by agreeing to continue the exam.

Obviously he was thrilled to be spending more time with Ava. Hadn't he given it a try, being the good guy, referring her to Gloria? But she had agreed to go on. To be able to give an attractive young woman an echo was a dream come true for a guy like Anthony working on old folks, day in and day out. He struggled to stay professional in these cases, but it was like putting some really good shit in front of a drug addict who was trying to come clean—there was no way they could refuse to take a few puffs. He did owe her a heads up to what was coming, though, now that she had agreed to continue.

"Ava, you remember how this exam went with your grandmother, right?" She nodded. "So you know that I'm going to be taking images of your heart. And even though, like I said earlier, it's not considered an invasive procedure, regarding the privacy aspects, I mean, I will need access to your chest."

She nodded again, with a little more hesitation this time. She hoped by this that he meant something brief and manageable.

He was eager to explain the procedure. "If you remember how this goes, first we'll set up a baseline EKG. That's an electro-cardiogram. The 'K' comes from the German spelling for cardio; sometimes people in the US call it an ECG. The ultrasound is an echo-cardiogram. So one is 'electro' and the other is 'echo'—but both measure your heart." She nodded at all of this. He was passionate about his job, it was clear.

"This type of EKG is an easy one, called a three-point, just three electrodes. I'll put those on your chest now." She held still and looked steadily at the ceiling as he opened up the sterile package and pulled out a little circular disc, one side covered in conductive adhesive and the other a small metal knob.

"Sorry, this will feel cold," he said, as he cleaned her skin with a rubbing alcohol gauze. The electrode went high on the right side of her chest. To do this he had to open the top of her gown and it revealed the curve of her breast; creamy skin with a faint tan line from a conservative swimsuit worn some time in the past. This girl really was shy; he noticed a small intake of her breath even for such a minor disrobing. He clipped the lead on and dangled the wire across her chest to the stand, and flipped her gown back in place.

The second one went low just under her left rib. Like the first, it also required him to uncover her slightly, this time from the bottom of her gown which exposed the smooth skin of her stomach. Again he noticed her beautiful olive coloring when he clipped on the lead, then covered her up.

He pulled the third disc out and peeled off its backing to expose the adhesive, holding it in front of her. "This one we call LA," he explained. "It's a bit more tricky, sorry for my reach here, it goes on the outside of your heart."

At that, he peeled down the left flap of her gown, further this time, exposing more of her breast but still no more than a formal evening gown would. And no nipple. He was curious about that but it would have to wait. The curve of her breast was beautiful, just as it would be in a low-cut dress, he thought, and the image of taking Ava out to a formal ball flashed through his mind. He made a mental note to get his tux cleaned; who knows, maybe he'd have a chance soon!

He turned on the EKG monitor and adjusted the display. Everything was fine. The continual oscillations of her heart showed that all the connections were good.

"Ava, before we start the ultrasound, do you have any implants?"

She thought about it, then pointed to her mouth. "You mean, like dental implants?" She shook her head. "I don't have any."

"No, I mean, uh . . . I'm talking about breast implants."

"Oh," she said quietly, embarrassed to have misunderstood him.

"Sorry, it's a standard question. The saline interferes with the scan. We can still get pictures, though."

She smiled a little and looked down at her chest. "No; no implants. I'm just . . . natural, I guess you say." Now it was Anthony's turn to blush a little, hoping that she didn't think he was taking too much interest in her breasts.

He spontaneously thought of something he could try. It was also out of the ordinary, but this whole situation was already getting off the rails. His enthusiasm over this woman on the table got the better of him and he blurted out. "We've got these eye masks, and some patients relax better if they put them on. Let me see if I can find one."

Before she could think about this and respond, he jumped up to dig a mask out of the cabinet drawer and swung back to her, abruptly stretching the bands over her head. It was a thick and black padded fabric that blocked out all light. She put her hands up to begin to protest but the mask was in place over her eyes in a moment and her hands were left in the air. She paused without saying anything, then lowered them to her sides in concession.

He looked down at this girl, lying quietly on the exam table in front of him, now with her eyes covered, her gown split open showing the midline of her chest and the top hem of her blue leggings.

What was he doing with the eye mask thing? Oh come on, he confessed to himself, he knew why he did it. There was only one reason and it wasn't for her benefit; it was so that he could perv on her more easily, and he scolded himself. But he just couldn't resist the temptation. Oh my God, he thought as he looked down, she is the most beautiful thing I have ever seen. He started getting a hard on and noticed his hand itching to wander down there. No, he said firmly to himself. I'm not going to do that. No way. Keep it under control, fella.

Instead, he focused on the task at hand. "Ava, I'm going to start the first of four views I'll take. Remember the acoustic windows we talked about with your grandmother. This first one is called the parasternal long-axis view, PLAX we call it, and it shoots down from the top, here." He pressed his hand on the skin at the top of her chest.

She began to raise her hands to her head. Was the mask about to come off? He wasn't sure, but he surprised himself by reaching out to intercept her left arm and lower it back to the table.

"You can just relax and keep your hands by your sides for this one." After a brief moment of uncertainty, she laid her arms back to the table by her sides. She didn't put up a fight. It's amazing how people will obey when you have a confident, commanding tone, he thought with satisfaction.

He dabbed on the ultrasound gel and brought the wand over, pressing it into her upper chest. "Now give me a deep breath when I say. You'll need to breathe in and try to hold still for ten seconds while I get the pictures. Okay, ready? Now."