So today I got to have my first “Harrell Center Experience.” To clarify, the Harrell Center is a teaching center for nurse practitioners and medical students to get practice with different skills either on virtual simulation patients, or on a paid model “patient”. What we went in for, was to get our first experience with performing pelvic exams (pap smears), and prostate exams. In my profession, half the time is performing pelvic exams, and I have had plenty of experience with those working in labor and delivery. The prostate exams on the other hand….I was more than a little uncomfortable with that. Not that I was nervous about performing it, but the whole thought of the “inserting a finger into the rectum and palpating your prostate” just seemed like such an uncomfortable experience to the person receiving it, that it made me feel awkward just thinking about it. What was even more confounding/astonishing, was that they actually PAY these people to let us do exams on them. Not just like they were pulled off the road for crack money for this, but they are actually paid professional instructors that are experts on getting these exams to teach you the best ways to do them. Crazy, I had no idea that kind of a profession existed. That would definitely be something to watch on Dirty Jobs.
The female exam went great. Being the only OB/GYN specialty student, I was nominated from my group to go first and be the guinea pig on the lesson. Awesome. Fortunately, I found the cervix and all the other organs without any problems, and it was a piece of cake; I wouldn’t have expected any less.
Then came time for the male exam, dun dun dunnn. Based on previous opinions from my other colleagues that have gone before me, they all advised to avoid the younger guy, and go with the old “creepy” looking guy. Based on the younger dude, he looked like a super creeper to me, so once I saw which exam room he went it, I made a beeline for the other room. So happy I did. Our instructor/patient was an older gentleman that has earned a living doing this kind of thing, traveling all over to different medical schools, get paid the big bucks, and keeping up an easy beach bum life style. I knew I was going to like him from there, but oh man this guy was HYSTERICAL! He had a great sense of humor, and by cracking so many jokes, totally relieved all the awkwardness. He also really clued our group (3 out of 4 of us were females) on what kinds of things go through a guys mind during these exams: that they are totally terrified of anything and everything, and want to run home at the first opportunity. Poor things. So when its my turn for the prostate exam, I was not as nervous as I thought I would be, just worried that my tiny little fingers would never be able to reach high enough to feel the prostate. The rule of thumb is pretty much that if you cant feel anything, then thats pretty much normal (usually problems result in these structures becoming larger). So as I was in there…feeling, the guy kept saying well, “I feel like you are putting downward pressure too soon, just point your finger farther forward,” which was exactly what I was doing. Then he says to me, “well I don’t know what it is, but do you have your thumb in there?” Panicking slightly, because fingers are always notorious for being in the wrong places at the wrong times during these exams, I checked my hand position, which was exactly how it should have been. So I told him “No, I think its just how my finger bends…” and he tells me I shouldn’t be bending my finger, to keep it straight and forward. I told him it was that too. The guy must have thought I was an idiot. I guess I had forgotten to mention that my fingers are double jointed. See picture. So after the exam, I removed my gloves and showed him, and he goes, “WHOAAAAAA!!! I have never seen anything like that!”
Hahaha, so apparently that was the problem we were having. He was feeling my middle knuckle giving downward pressure, as the rest of my finger pressed onward. This gave him quite a laugh, and of course, I always end up with some sort of story to talk to much about.