Doctor Dilemma Pt. 01

Ashley is someone I know well, but have never had as a patient before. She's my son Trent's girlfriend. Well, to be honest, they actually seem to be some blurred mix of best friends and boyfriend and girlfriend. They've been close friends since the beginning of high school, but for the longest time it always appeared that they were just friends, and nothing more. Trent's always been a very quiet and shy kid, so it was entirely possible he just didn't want to share with us that they were dating. But from our point of view, it always seemed like Trent was the one most interested in keeping things platonic, as whenever his mom and I would gently inquire if there was anything romantic between the two of them, he would genuinely seem disinterested in having their relationship go there. There's no doubt we had zero interest in prodding for more details, so we usually just kept our distance and let the two of them be.

As well as Trent has done academically throughout high school, Ashley has seemed to be even more exceptional. One of the reasons they've become such good friends is they've always ended up in the same advanced classes. And while Trent's grades are great, I'm pretty sure Ashley is a shoe-in for valedictorian this upcoming spring. But despite all their studying, there finally started to emerge some signs of a romance. Trent confided in his mom last year that they had kissed, and that she was his first kiss too. When they hang out now, I see more cuddling and physical closeness, and often there's a playfulness that comes across as more boyfriend/girlfriend behavior than I how used to see them act. But overall, in the end it doesn't really matter. She's a sweet girl, they seem great together, and whatever they want their relationship to be is certainly fine with his mom and me.

But now Ashley is in my office, coming in for what I'm guessing is her first ever pelvic exam and gynecological checkup. As Stacie and I enter the room together, she's sitting up on the exam table with her paper gown adequately covering what I'm sure is a completely naked body underneath. She's quite slender and a very pretty girl. She has a pale complexion with shortish light brown hair that comes to just above her shoulders. Whenever I see her, she's always wearing glasses, and this time is no exception. They suit her well though and definitely add to the smart, sweet, and innocent vibe she gives off. You add it all up, and if I had to hand-pick a girlfriend for our son Trent, I don't think I ever could've found a more perfect match for him than Ashley.

So as we enter the examination room, I exchange a pleasant greeting with my son's girlfriend and at the same time introduce her to my assistant, Stacie. I then take my first look over her chart, which considering she's a new patient only has the bare minimum of information. I see the vitals that the nurse took down moments ago, and that she's currently 5'6" and 103 lbs. As the numbers reflect, she's obviously a very petite girl, or I should actually say "woman" now as I see that she's a month past her 18th birthday.

I look up and start the opening conversation, "So Ashley, what brings you in?"

"Yeah, my mom thought it was time for my first checkup like this?" She says with an intonation that suggests she's just doing as she's told and not sure about any of this.

"Of course, is your mother outside in the waiting room?" I ask.

"Yeah." Ashley confirms.

It's our policy that when we bring younger patients back, even if it's their first time, we'll ask their parent (which is almost always the mom) to stay behind in the waiting room initially.

"Ok great... Now I just want to make it clear that you're more than welcomed to have her come join us at any point if that would make you feel more comfortable." I explain trying to put any potential nerves at ease. "But you're also fine to go ahead with her outside. It's totally up to you."

"Ok. That's good to know." She responds.

I then decide that given how close she is to Trent, it probably warrants a little extra disclaimer about how this will work. So I go on, "I also want to reiterate that everything that is said or done in here is strictly confidential, and Stacie and I are both morally and legally forbidden from disclosing anything about this checkup to anyone. And that includes your parents, or anyone else that you or I may know." As I say that, I'm trying to get the point across that nothing she says will ever make its way back to my son / her boyfriend, but I don't want to come out and actually say Trent's name.

"Ok. Yeah. I understand." She confirms.

After that exchange, we start into some brief questioning about her medical history and her menstrual cycle. But then we soon get to the questions where I'd be lying if I said I wasn't at least a little bit curious as to her answers.

"Are you sexually active?" I ask.

"No." Ashley succinctly responds.

"Have you ever been sexually active?" I follow up.

"No." She answers again.

"Ok." I confirm, trying to make it sound like that's neither a good thing or a bad thing. And then I add, "Even if you're not sexually active, I would highly recommend considering getting vaccinated now for HPV." And as I say that, Stacie chimes in and mentions that she has a pamphlet she can take home to look over, and leaves that next to Ashley's handbag she brought in.

"Ok. Yeah that sounds good." Ashley responds.

So far, she seems pretty calm and not at all nervous, which is great. I'm sure a first exam like this could be nerve wracking under any circumstances, but even more so when your doctor happens to be your boyfriend's dad, like in this case. Even if I hadn't known her, for anyone going through their first exam, I always try to explain everything I'm going to do before I do it.

"So the first thing I'm going to do is give you a breast exam." I tell her. "The purpose of this is to check the development of your breast tissue, and most importantly feel for any lumps or abnormalities we might need to look into."

"Ok." Ashley responds.

"Can you lie back on the table here." I instruct, and she does as I ask. I then walk over to her right side and I pull the sleeve of her paper gown off her arm and lower it until her right breast is exposed. It's an absolutely adorable, perky little tit with the cutest and softest looking pink nipple on it. As I mentioned, she has quite a pale complexion, so her breasts are extremely white. And given her age, it's no surprise that she appears to have perfectly soft and smooth skin throughout her entire body, but especially here on her boobs and chest. That might be the most consistent feature I always see on an 18 or 19-year-old's naked body, the soft, smooth skin. Even when they're in their twenties, the skin starts to show its age, and obviously the older they get beyond that, their skin will consistently show more dryness, wrinkles, and imperfections every year. But whenever I examine someone Ashley's age, I can always tell how young she is just by looking at their reliably flawless skin.

Now that I have her right breast exposed, I start my routine to thoroughly check her breast tissue. Her boobs are quite small, falling somewhere between a small B and a full A-cup I'd guess. Being so skinny, her rib cage is quite pronounced, and in comparison her boob looks like a soft, little pillow in contrast. I always use a number of different techniques with my hand and fingers when I'm examining someone. First, I press down with my four fingers extended flat to stretch the tissue on all sides of the breast and check for any lumps. Then, I'll use a tapping motion with each finger one at a time to feel for any inconsistent areas. And finally, after I've thoroughly checked all the breast tissue, I'll make sure the nipple is fine as well. Ashley's right breast checks out as completely normal, with no areas of concern.

While I'm feeling this breast though, I can't help but notice she's looking up at me the entire time. Usually patients, especially ones I think might be nervous, will look straight up at the ceiling while getting examined. Or sometimes they'll even turn their head completely away from me and look at the opposite wall so their gaze is as far away as possible. Ashley though, isn't just looking at me, but at multiple points while my hands were feeling her breast, we even made direct eye contact as I peered into her innocent eyes directly behind those glasses. It was quite unexpected to see her staring at me like that, to say the least.

After I finished with her right breast, I help her arm back into the sleeve of her paper gown, and then walk over to the other side of the table. Here I go through exactly the same process, taking plenty of time to make sure I check every square inch of her left breast. Her soft, tiny little A-cup feels just as healthy and amazing as her first one did. I then complete the last step of the breast exam, which involves giving her soft nipple a gentle pinch from a few different angles. This is to make sure there's no unexpected discharge coming from it, and there isn't. She has these almost rectangular shaped, puffy areolas with a little horizontal dimple in them that makes her nipples look almost inverted. They look nothing like the extended, pronounced nipples you'll see on older women, and they just contribute even more to that sweet, innocent look she has. And as I'm wrapping up the examination of Ashley's breasts, I can't help but think to myself, I wonder if Trent has seen these beautiful little things?

After I'm done with this step, I let Ashley know that everything so far is looking fine, and I haven't found any areas of concern. I ask if she has any questions to this point, and she replies that she doesn't, so I begin to explain what's next.

"So this next part will be the pelvic exam." I explain. "There will be three parts. First I'll examine your external genitalia, which is your vulva. Then, I'm going to place one hand on your abdomen, while using my fingers from my other hand to check inside your vagina. This will help me feel and check your reproductive organs to make sure everything is fine there. And then lastly, I'm going to briefly feel inside your anus using one finger to make sure there are no issues within your rectum, and also to get a different angle on feeling inside."

As I'm saying this, I'm checking for any sort of an adverse reaction, but Ashley seems totally comfortable with everything. I continue on, "For the last two parts, you will most likely feel a little discomfort or pressure, but if you feel any actual pain, it's important to let me know."

"Ok, I will." She responds.

"Ok." I respond back, and then I pull my sliding, round seat over to the front of the examination table. As I do this, Stacie opens up the foot rests connected to the table and gives Ashley a hand in getting her legs up and onto them.

She's now in position, as her legs are spread wide open and her gown is being held up by her knees. I sit down and move in close to her vagina, and at this point I can no longer see her face because it's obstructed by the paper gown. So I let her know, "If you need me to stop or have any questions, just give me a holler."

"Ok." I hear her say back.

And with that, I start examining her pussy. And I have to say, it's a beautiful vagina. She has very small labia, so it looks like the type of pussy that has that classic camel toe look with a nice clean vertical line and no lips popping out. Of course, my view right now is of her while she's spread completely open, so that's only a guess as to what it would look like in a resting position. The inside of her pussy is a beautiful shade of pink though, which next to her pale, white skin is a wonderful contrast. Inside her vagina, I can see an abundant amount of creamy white secretions coating the inside of her opening. This isn't surprising, as Ashley's currently mid-cycle, and this creaminess can be a sign of how healthy and fertile she is. Often times, 18-year-old vaginas will have the most apparent amounts of this creamy lubrication, simply because their bodies are so fertile and full of hormones. Ashley's pubic hair is a nice shade of light brown, and while she claimed she isn't sexually active, it's clear she does spend some time grooming herself down there. The pubic hair above her clitoris is trimmed to maybe half an inch, and she's clearly shaped it to be smaller than it naturally would be. In addition, she has no pronounced hair anywhere to the sides of her vagina, but there is a faint sign of stubble that makes me think she's recently shaved down there, perhaps even this morning. And then I wonder to myself, perhaps she shaved specifically for this checkup?

The first part I'm examining here is her external genitalia. I'm mostly checking for any areas of inflammation or signs of STDs. Over the years, I've learned that just because a patient says she's not sexually active doesn't mean she's guaranteed to be free of sexually transmitted diseases. But I can see here with Ashley that her pussy is as pristine as can be. I use my fingers to pull her various labia and folds apart to check each crevice to make sure it's healthy, and it all is.

At this point, I can't help but get a few whiffs of her pussy's aroma, and it's quite pleasant. Even with a mask on, it's usually quite easy to pick up each patient's unique smell. And I just love the smell of pussy, too. I always have and probably always will. It doesn't even depend on how physically attractive a patient might be or even their age, I often still find their vaginas to have such a wonderful odor. Now of course, there have been cases where a patient has a smell that isn't appealing at all, but that usually is a sign of an infection or there's at least something else going on. In this instance though, there's no doubt that the aroma coming from Ashley's adorable, virgin pussy isn't just pleasant, it's borderline heavenly.

But enough on that, now it's time to begin the manual portion of the exam. Looking at her vaginal opening, it's clearly smaller than the average woman's. When I do this portion of the exam, I almost always use two fingers inside as it makes it much easier to apply the necessary pressure to feel for the various organs I need to check. There are times, on rare occasions, where a patient is so petite that two fingers is too uncomfortable and I resort to only using one inside, and at first glance I think this might be one of those cases. I start by applying a generous amount of lube to my index finger, and then I slide it gently into her vaginal opening. As soon as it's in, I realize there's no point in even trying to fit two in here as there's barely any wiggle room as is with just the one. Holy shit, this girl is unbelievably small.

I decide to warn her before beginning the actual internal exam. "This is where you might start to feel some pressure." I tell her.

She doesn't respond, but I begin by feeling for her cervix and pressing it from side to side. Next, I press up on the cervix and use my other hand on her abdomen to feel for the movement of her ovaries and Fallopian tubes. Everything seems fine and her lack of a reaction is a good sign as well. It's a little harder than usual to check what I need to using only one finger, but the fact that she's so skinny actually helps quite a bit as it's quite easy to feel her organs since she has so little fat on her body. After only a couple of minutes, I'm done with the vaginal portion of her manual exam, so I remove my finger and pull my chair back a foot or so.

"Are you doing ok?" I ask.

"Yeah, I'm fine." She cheerfully answers without a hint of discomfort or concern.

"Ok. So, final part here... I'm going to check your rectum. This will probably be uncomfortable, but should be quick." I assure her.

"Ok." She responds.

I apply a fresh squirt of lube to my index finger, and then I pull up next to her crotch with my chair. I place my left hand on the inside of her thigh to brace her slightly, and then I slide my finger right into her asshole. As I do, I hear a slight but audible reaction from Ashley as she makes a quiet "ooop" sound from her mouth. I ask if she's doing ok, and she responds that she is, but for the first time sounds a little uncomfortable. I'm going to go out on a limb and assume this is the first time she's ever had something inserted into her ass before.

With my finger now inside her, I immediately feel a piece of stool, but that's totally normal and actually quite common. As I maneuver my finger around her, I can feel that the lining of her rectum is intact and feels totally normal. So the last part of the exam is to use this angle inside of her to feel around for her bladder and womb. I move my left hand back up to her abdomen, apply pressure where needed, confirm everything checks out, and soon enough it's all over.

I withdraw my finger, stand up and let her know, "All done. You did great."

Stacie steps in and lifts Ashley's legs off of the foot rests so she can get back to a normal sitting position as soon as possible. She does, and I then follow up and ask her how she's doing.

"Good." She says, offering up the bare minimum response.

"Do you have any questions?" I ask.

"So that's it?" Ashley asks. And then clarifies, "You don't need to stick that metal thing inside me or anything?"

I know immediately what she's referring to, so I answer, "The speculum? No. And ours are actually plastic." I continue on, "When you start getting Pap smears to check for cancer, we'll use that, but you don't need to do that yet. There are other reasons why we might use a speculum in a checkup, but nothing we needed to do today required it."

"Oh, ok." She says. And then she kind of looks down at the floor as if she might have something else to say, but I'm not quite sure.

"Do you have any other questions?" I ask.

A few seconds of silence go by, and then she finally says, "Yeah." But then she doesn't immediate say what her question is.

So I follow up with, "Sure, what is it?"

Ashley takes another long pause and then says, "What exactly is female ejactulation?"

Being a doctor, I've pretty much seen and heard it all, so it takes a lot to catch me by surprise. But holy shit, did this question catch be by surprise. So much so that I even kind of involuntarily chuckled at her question as soon as I heard it, which is completely unprofessional and something I pride myself on never doing.

So I apologize immediately for that. "So sorry, I wasn't expecting that question." I then gather myself, and am trying to figure out where this question is coming from, so I tell her, "I can definitely try to answer that, but do you mind giving me a little background on why you're asking?"

While still looking down, Ashley starts to explain, "So, I read about it online. I was googling why it might feel like I have to pee when I'm touching myself." And then she pauses before finishing, "If that makes sense."

"Ok, yeah, that makes sense for sure." I tell her trying to reassure her as much as possible. And then I ask to confirm, "So are you saying it feels like you have to urinate when you masturbate?"

"Yeah. Like not at first, but as it builds." And then she repeats herself, "If that makes sense."

I can tell that she's both nervous and uncomfortable, but obviously these questions must be important if she's willing to ask them. So I try to explain as much as I know.

"Ok, so first off, I don't think there's anything to be concerned about here. That's most important." And after I say that, for the first time she's able to look up and make eye contact, both with me, and then with Stacie, who is standing right next to me. "So, online, you saw that the urinating sensation might be a sign of female ejaculation, is that right?"