Clinic Case Files Ch. 01

This is possibly the first of these stories from my files that I'll be putting in. There's some sex, and a lot of discussion about sex, but the sex itself is mostly not here, or elided (i.e., the curtain is closing as the sex starts. I thought about leaving the actual sex out, but it's important on realizing why the story is important to me. There is a Loving Wife (classical term, she's technically cheating on her husband, though she would disagree) a loving wife-to-be (so, maybe a cross between the Erotic Encounters and Romance), and quite a lot of discussion about something very, very Taboo. And it even is a little graphic in the discussion, but less than most stories here. So enjoy. This is my first submission here. I was not present for what many folks will want further titillation with, but have no objection with someone writing a fictional account of Mark and Lisa's relationship; I won't, because I don't actually know beyond what they told me. Oh, and the names have been changed to protect... well, everyone. I also want to especially thank Todger65, who edited this tale. I accepted almost everything he said that needed to be fixed, and then messed up everything by making a few additional changes. Any errors are on me.

---- Monday April 9 2018

I had just returned from lunch, a 6 inch Turkey and Swiss sub from Ricotti's on Mineral Springs Road, if I remember correctly after all this time. The day though, is indelibly marked in my mind today, and I was looking forward to resuming my duties seeing my patients. I had been in practice only two years in 2018, having just finished my residency requirements shortly before hanging my shingle up in practicing relationship, sexual and fertility issues, which required me to use both my medical and psychological training; acting sometimes as a doctor, sometimes as a therapist and councilor.

At the time, I was 33 years old, relatively young to be in a private practice. I was, as my parents loved to point out to every single female they ran across, a young, single, successful doctor. The emphasis in my own mind should have been on single, as, at that point, I had had only one successful sexual liaison, and only a few more dates, in the last 23 months, with most of my time, thoughts, and energy devoted to developing and growing my practice. I did have to admit, however, that my practice was finally starting to feel like it was no longer on the verge of personally bankrupting me on a week to week basis as I'd grown it sufficiently that it now felt like I was going to become bankrupt only on a month to month basis for the last few months. Progress!

I remember glancing at the clock on the wall between my medical diplomas, and realized that it was now 12:48 PM, and I still hadn't had the next patient brought to me. Normally, I took the half hour between noon and 12:30 PM for lunch; my three staff members worked on a slide schedule to get a full hour at some point between 11:00 AM and 1:00 PM everyday, with Susan, the office manager/assistant receptionist/billing/coordination of care/catch all person having the 11:00-noon slot, Cathy, the receptionist, having noon to 1:00, and Sharon, my nurse, having the 11:30 AM to 12:30 PM slot. That meant someone was always at the reception desk in the lobby, but Sharon wasn't available until after 12:30. Even though I was back at 12:30 myself, if I even left, since Sharon wasn't able to get information from the patients until after 12:30, I normally didn't get someone brought in until about 12:37 or 12:38, but it was never later than 12:40. This would have stood out in my mind regardless of what followed, as it was unlike her to be inefficient in filling my time-slot, but of course, the true surprise was what came later. I, of course, spent those few moments taking a quick re-read of my notes from earlier that day, as well as looking at my schedule for the afternoon.

Sharon walked in with a bit of an odd expression on her face at 12:51; I had never before seen her looking so strange as when she walked in, and I immediately typed into my open "days notes" a reminder to ask Susan and Sharon if there was something wrong I needed to know about why she was so late. Uncharacteristically for her, she dropped the file on my desk with a loud plop, and said, and I remember these were her exact words, "This one is going to be interesting."

I opened the file and started to read her summary notes. You'll pardon me if I change names and a few case pieces, as HIPPA won't allow me to provide details sufficient to actually identify the couple, but the gist is correct, even if some of the details aren't. Couple, Lisa (42) and Mark (22) Carpenter. I remember being surprised, slightly, by the age difference; I had previously had a couple with a larger age difference than their 20 years, but that relationship had been between a 59 year old male, on his second marriage and trying to have a second family, and a 32 year old female on her first of both. The notes stated that Lisa had one child years earlier, in her teens, was still menstruating regularly, no history stated of fertility related illnesses (either side), nor history of accidents that could effect male fertility. The couple lived in Cranston, and had lived there for 4 years. Her occupation was as a legal aide, he was listed as "student".

Sharon stared at me the entire time I reviewed the three sheets of paper in the file with the same unusual expression on her face. Perhaps here I should take a moment and actually fully introduce and describe myself, and I suppose my staff, in these proceedings. I'm Doctor Richard "Rick" Wesson, stand 5'10" tall, weigh a reasonable 171 pounds (or at least did, prior to lunch!), have light brown hair that tends to reddish in the sun, and have green eyes, the most unusual (and during my dating days, enticing) feature to most women. I am not God's gift to women, and have never been, but neither am I unattractive. In high school, and as an undergraduate, I was reasonably successful, though not outstandingly so, with girls and young women I dated. I even had three "long term" relationships, one in High School and two in college, though only one was trending towards real permanence, until we graduated and I went off to med school. My med school schedule was not conducive to a relationship, and she chose to end us (amiably!) a month into my time in med school. While there were hookups (even quite a few during my residency, all of whom were fellow residents), there was never a future long term relationship, and I'd only just started to feel one was possible again.

Susan was the "mother hen" of the office; at 51, she was a reasonably attractive, very married mother of three kids ranging in age from a recently married college graduate to late high school. She stood perhaps as much as 5'6" (in low heels) and had an ample bosom, overly large rear, and weighed a bit more than she should, though her face, bottle blond hair and cornflower eyes suggested just how attractive she had been in her twenties. She and her husband were hoping for their first grandchild in the next few years. She dotes on all of the office, and every Monday brings a plate of some delectable homemade treat or other into the office to share with us. They typically did not last longer than Tuesday in any given week, and I was considering whether or not I'd have to begin going to the gym soon partially on the basis of these treats and my own near term desire to begin dating again.

Cathy was 36, of some mixed heritage (I have even now never asked her, though I think it unlikely that she was not partially or mostly Hispanic), with brown hair, lightly bronzed skin, brown eyes, stood a short 5' or 5'1", and had a daughter of about 7 years of age. Her partner was a light skinned African American named Tre and about the same age. She had been with him "for years", though they had never married per her file. While she has even now never stated that her partner is the father of her daughter, it seems obvious enough on the few times I've ever seen them interact that she has never known any other figure as "dad". Cathy, unlike Susan, was not chatty about her family, except in the most general terms.

Sharon was the youngest of the trio, 29, although she was definitely not "low girl on the totem pole". As my nurse, technically she was the second most powerful person in the office, and while nominally Susan was in charge of the office, and Cathy did scheduling, Sharon was the one who controlled what actually happened. Susan was above average height, about 5'8", although thin, with a smaller chest, shorter torso, a genuinely nice looking rear, long legs, and black hair with brown eyes. She had very expressive lips (prior to this point, normally smiling or relaxed, but as I was soon to learn, often with an erotic smirk). She weighed, as women do, somewhere between "scrawny" and "voluptuous". I'm a man. I can tell you heights because of the measuring marks in my office, as the ladies walked around, but I didn't dare look, guess, ask, or in any way try to estimate her weight. I will simple say "Sharon is attractive, perhaps a 71/2 on the old 10 point scale without trying, and had, at the time, a girl next door vibe to her." Even saying that is likely to get me in trouble, and cause hurt beyond what I care to see or experience. Sharon had a boyfriend at the time, and on any given Monday, frequently regaled the office (well, the other ladies) with the various dates they went on (often to Boston) over the weekend. I'd overhear things occasionally, but Sharon was not one to talk about her intimate activities in general. For some reason, though, I always felt a twinge of jealousy of her boyfriend, Tom.

So, back to where we were. After finishing a quick review, I asked Sharon to please show the Carpenters in. As they entered, I was surprised somewhat to see them. The male, Mark, was a 6'1" young man with medium length dark brown hair, a prominent set of eyebrows half hidden under a pair of silver rimmed glasses in front of brown eyes. A scruffy, two or three day beard on his chin was outpaced by the moderate mustache. He wore an inexpensive knit shirt, over a pair of blue jeans and sneakers. Of average build, but with some evidence of light working out in his arms, he looked to be a low to mid 20s year old man, just as his age stated.

The female, Lisa, was a 5'6" or so woman, with medium length dark brown hair, a well defined set of eyebrows above a pair of turtle shell glasses, hiding brown eyes. She had a somewhat fuller bust, and relatively long legs. She wore a pair of yoga pants or leggings underneath a light sundress, with short, 1" closed toed heels. She looked, mostly, like the quintessential soccer mom, complete down to just the slightest hint of a pooch in her belly. Her large diamond engagement set was one of only three pieces of jewelry she wore, with what looked like a 1 to 2 caret diamond surrounded by small emerald chips, matching her emerald ear studs. While not beautiful, she was attractive, and I could have believed that she was in her mid 30s instead of her low 40s. I remember the emeralds catching the light from the incandescent overhead only because of the conversation and circumstances.

Rising, I offered the couple my hand, and introduced myself. You will, I hope, pardon me if I try to recreate the conversation (and future ones) from memory here; I won't again stop to remind you that this is from my case notes, my memories, and in a few cases from Sharon's memories of the events.

"I'm Dr. Wesson, but if you prefer, you can call me Dr. Rick. How are you today?"

"Hi Dr. Rick, I'm Lisa Carpenter."

"I'm Mark Carpenter."

After shaking hands, we sat down on the small sofa, with Sharon, who would normally leave to start on my next patient, also sitting in on the discussion, taking the examining stool that I kept beside the examination table and casting me a small smirk as she moved to the far corner of the room. I wondered at the point of the smirk, but returned to the couple. I found Sharon's whole behavior unusual, and something that I would either discover soon, or need to discuss with her later in the day.

"Well, how can I help you today?"

Lisa hesitated for just a moment, and a flash of red briefly washed over her face. "I... we... we're trying to get pregnant, and we're having issues. My husband and I want to have two children before I'm too old, and my clock's ticking." Glancing at Mark, she continued "We've been trying now for two years since my husband and I decided to have two more, and with our issues, I'm still not pregnant!"

Now it was my time to lightly smirk, as I responded. "Of course. Relationship, sexual, and reproductive issues are the core reasons why the clinic exists. So, what kind of issues are we talking about here?"

Now it was time for Mark to flush as he answered "I... I'm having... I'm having performance issues. I can't cum, no matter how hard we try."

"Mark, honey, that's not true. You cum multiple times, every time!"

My head on a swivel, I turned back to Mark. "So, you don't believe you achieve orgasm and ejaculate? Is that what you are saying?"

"Nooo... no. That's not what I'm saying. She's right, I cum, er, orgasm multiple times every time we're together. She's right about that. I just can't c... orgasm vaginally."

"It's true. Oral, anal, by hand, even a boob job, he cums no problem. Excuse me, 'orgasms no problem'. It's only when he's in my pus... my vagina that he can't orgasm. It doesn't matter what position, how long, whether he's just.. orgasmed or not, He can't ejaculate in my vagina."

Turning to Sharon briefly, her smirk had become a Cheshire Cat grin, as I asked Mark "So, you don't have much vaginal sex, then?"

"Oh no, Dr. Rick, I pound her puss... um... we have vaginal intercourse two, three times per session, and we have multiple sessions every day, one in the morning, one in the afternoon, sometimes in the evening, most nights. It's great, we have sex a lot, like bunnies. I must orgasm at least 8 or nine times a day. It's just I can't orgasm in her vagina."

Turning back to Lisa, I asked "So, has your husband always been unable to orgasm through vaginal intercourse?"

"Oh no, Bill always cums in my pussy. He's never had my ass, and only once ever finished in my mouth. Oh..." and Lisa turned bright red.

"Bill? Who's Bill?" I asked.

"Uh, he's my dad. When he and mom have sex, he always cums in her pussy."

"Mom?"

"Uh yeah." Mark nodded his head to Lisa. "My mom, Lisa. She and Dad have been married for... what, 24 years now, I think."

Lisa suddenly had the smirk; it must have been contagious. "You thought Mark was my husband? No, Mark is my son. Bill and I agreed to have two more, and while I will always be married to Bill, Mark is the great love of my life. I want to have the rest of babies with him being the father!"

In shock, I looked over to Sharon, who now not only had a grin, but was gently and surreptitiously massaging one of her breasts. "I told you so." she mouthed to me.

"Um, madam... Mrs. Carpenter..." I began.

"Lisa, Dr. Rick."

"Lisa... um, do I understand that you are Mark's biological mother? You gave birth to him?"

"That's right, Doc. It was 19 hours of labor, but I knew the moment that I held him in my arms that I had just met the love of my life." Lisa turned and smiled at Mark, then leaned over and kissed him in a romantic, passionate kiss.

"Mrs. Carpenter... Lisa... that's incest. It's illegal."

"Not in Rhode Island, Doc. I can't marry Mark, true, but we've never broken any law here; incest isn't illegal between two consenting adults. We didn't even make love until his 18th birthday, two years after he reached the age of consent here; it was the day he became not just legal, but a man. It was the greatest birthday gift I could give him, me, and all of my love." She again reached over and kissed her son, softly putting her hand on his chest while doing it. As they broke after a moment, they both turned and smile at me.

"Is that correct? Did I hear that right? Incest isn't illegal in Rhode Island if the two are over the age of consent?"

"Yes, doc. I did a lot of research on that when I realized I was in love with Mark. Rhode Island and New Jersey, we aren't breaking laws in either. Of course, we didn't move to Rhode Island from Ohio until Mark was 17, but I still waited!"

"Ok, then... um... right. Ok." I remember stammering. The silence and the pause even became awkward for them, until Sharon looked at me and coughed, pointedly.

"Ok, so let's figure this out then. You realize that being so closely related there is a significantly increased risk of abnormalities, deformities, miscarriage, etc.?"

"Oh, Doctor Rick, I don't care about this. I just want to see my beautiful love, swollen with our child. Our child. I know he or she will be loved, nurtured, cared for. I'm the original 'Mama's Boy'," and at that Mark chuckled. "I'll always be with her, to our dying days. I love her, and we'll take any children that fate brings us. Besides, aren't the odds still pretty low?"

"Uh... no, but it's not quite that bad, either." I stated as I started to gain steam and get my head around the problem. "Every child is born with some genetic defect; most are compensated for and 'fixed', as it were, by other segments of the genetic code. However, when the same bad genetic effect interacts with itself during reproduction, it causes the genetic abnormality to be expressed. I'm simplifying the effect, but that's the basis. So, if, for example, you, Lisa," and I nodded to Lisa, "developed the genetic defect for, say, albinism, which is recessive, and you passed it to Mark, which would have been a 50% chance, then there would be a 25% chance that your offspring would have both of their genes encoded for albinism, and your child would have one."

"I don't have albinism doc, unless you mean my lack of tan!" piped in Mark.

"I know, that's just an example. There are thousands of little defects like that, and you may have hundreds yourself. In that case, you'd be guaranteed that some small percentage would arise in your offspring. The good news is that most of them would be relatively minor in their effects. Some could be severe, but most would be minor."

Lisa looked at me with her big brown eyes, and then removed the turtle shell glasses. "I'm willing to risk that, doctor, to have children with the man I truly love."

"Ok, then, what does your husband think about this?" I asked next, trying to deflect from the inevitability of the discussion.

"He's excited at the idea of becoming a father again, and he's trying his best when he's in town. It even puts a cramp in our love life." she stated as she reached again for Mark's hand. "Of course, I wear my diaphragm when he and I have sex, but he doesn't need to know that."

"So, your husband doesn't know that you're having sex with your son?" I asked.

"I don't have sex with my son, I make love with my son. I have sex with my husband, when he's in town and wants some." was the quick reply.

"But your husband doesn't know?"

"No, dad doesn't know anything, Dr. Rick. He's always on the road, always has been, he's a long haul trucker, and his cab is his true home. He's never there for mom, and she was always so lonely when I was growing up. I love my dad, I do, but he's gone so much... last month he was home a grand total of three times, for less than a full day each time. And that was him making an effort to be with mom to help her get pregnant!" Mark spoke in.

"I see. So when your husband... uh, Bill, is home, you don't have sex... make love with your son?"

"We find a way. I think we've only not made love a handful of days since the first time, four years ago. Even with Bill in the house. God, the difficulty sometimes! I remember one time we literally had to do it in the shower while bathing in order to get away from Bill! We even do it when I'm on my period, though normally I douche first." quipped Lisa. A soft moan escaped from Sharon's direction, and I pointedly did not look towards her. As Mark started to turn his head, I questioned him.