The Doctor’s Office–Part 2

This is part two of another exercise from The Fiction Writer’s Workshop, by Josip Novakovich.  The idea is to write the same scene from three different perspectives, and see explore how the exact same event can be different from a different character’s point of view.  This is similar to the four part “Genesis” exercise I did earlier, except instead of first person I’m utilizing subjective third person.  I used Novakovich’s suggestion for the event my scene is based around, which takes place in a doctor’s office.

Elliot Herbert was the best doctor the clinic had, and he knew it.  His patients were usually older women; for some reason younger women didn’t want a male doctor for a gynecologist.  He found that a little sexist but didn’t take it personally.  All of his patients said he was the best doctor they’d ever had; that he was patient, intelligent, and sensitive to their needs.  One woman had jokingly told him she wished her husband was as sensitive as Elliot.  He’d laughed, of course, but those types of comments made him feel uncomfortable.  He never viewed his patients as sexual objects, and it bothered him when they made these kinds of innuendos.  He found it inappropriate.  He viewed their bodies as bodies; not as objects of desire, or lust, or any of that nonsense—just bodies.  Bodies that needed to be cared for, and treated with the greatest sensitivity and respect—but just bodies none-the-less.  It was wrong to look at a patient in any sort of sexual way, and he wished they would stop looking at themselves that way.

He supposed that’s why his older patients liked him.  The society they lived in these days was so sex crazed, it was probably nice for them to just be a woman without feeling objectified or sexualized.  Some of the other doctors at the clinic—all of them younger and female—would sneer that a gynecologist who couldn’t talk to his patients about sex was worthless.  Elliot found this to be a very narrow perspective.  He could talk to his patients about sex, if they had to talk about it.  He understood the female reproductive system perfectly; it wasn’t as if he needed to have one in order to answer his patients’ questions about it.

Still, even the most cynical workers at the clinic had to admit Elliot was good with nervous patients.  Again, these were usually older woman who’d never been made to feel comfortable about their bodies.  He helped them feel comfortable.  It was as if he gently eased them into their own bodies.  Elliot was, after all, the best.

So when a new patient came in—one Lisa Hayes—with concerns about doing a pap because she had pelvic floor dysfunction, he was the obvious doctor to assign to her.

Nurse Vidic stopped him outside the exam room, just as she was leaving to get the exam materials together.  “I just wanted to make you aware that this is a younger woman, Dr. Herbert.  You might want to talk to her a little differently than you do with most of your other patients.”

Had he not been aware of his over-confidence, he probably would’ve brushed the nurse off without even addressing her concern.  But—being a patient man, sensitive to the needs of others and well aware of his own flaws—he thanked Nurse Vidic for her insight, and assured her he’d put the patients feelings and comfort above all else.

Nurse Vidic rolled her eyes at this, and muttered, as she went on her way, “It’s that attitude that worries me.”  Elliot just laughed it off.  He’d long ago learned not to let sarcasm and backhanded remarks worry him.  He was the best with patients—he could anticipate their needs before they asked.  Why should a little barb here and there bother him?

He knew to be direct and open right from the start, or else the patient wouldn’t be inclined to trust him.  He checked her name again—Lisa—before he knocked and entered the exam room.  She was young, probably early 20’s and not as experienced with this as his other patients, and she looked ill at ease—probably from Nurse Vidic.  At least he was here now.  Elliot extended his hand to her.  “Hello, Lisa.  My name is Doctor Herbert, but you can call me Elliot if that makes you feel comfortable.”  There; he’d been open and direct in identifying himself immediately, and he’d let her know that her own comfort was his main priority.

The patient was obviously shy.  She didn’t shake his hand, and only glanced at Nurse Vidic for reassurance.  Much to Elliot’s surprise, the nurse did just that.  Lisa nodded, and looked over Elliot with round eyes.  “Okay, then . . .” she said.

She was a bit child-like, Elliot decided—mistrustful of him only because she wasn’t familiar with him.  He would stay in the room while she undressed; that would give her time to acclimate to his presence before the exam.  Elliot pulled back the curtain for the patient, gave her brief and reassuring instructions so she could feel familiar with this process, and thus be more at ease.

The patient hesitated, and stared at him with an intensity he’d never seen in his other patients.  Best to be stable—sudden changes would send mixed messages, causing her to be more guarded.  He smiled, and stepped aside but made no move for the door.  That way she could have the comfort of his presence without feeling like he was invading her space.  She must have received this intention, because she walked into the changing area and closed the curtain behind her without a second glance at him.

Elliot looked at Nurse Vidic for some recognition while the patient—name “Lisa”—undressed.  Nurse Vidic, however, only shook her head at him.  He gestured that she should leave—her negative attitude would only cause the patient more distress.  Nurse Vidic, however, pretended not to notice with stubborn inconsideration of the patient.

Speaking of the patient, she was taking some time.  Not wishing her to feel abandoned, Elliot placed his fingers on the edge of the curtain—a visual confirmation he was there—and voiced his concern.

“You almost done, Lisa?”

“No.”  Good—she was all right.  He voice was strong; she had to be feeling at ease.

When the patient emerged, Elliot gave her a quick once over: she obviously exercised, given her toned muscles; the pigment and condition of her skin indicated she had a healthy diet; her posture betrayed nothing of physical defects, just insecurity.  Elliot smiled to himself—he couldn’t foresee any problems with her health, which was a refreshing change for him.

As the patient made her way to the exam table, Nurse Vidic stood, and—finally thinking of someone other than herself—said “Did you want me to leave, Lisa?”

“Actually, I’d prefer it if you stayed,” said the patient.  Elliot liked her attitude—trying to consider others before herself.  As long as it didn’t put her on edge having Nurse Vidic there . . .

The patient had a strong heart and a healthy set of lungs.  He reflexes were a little quick and strong, but Elliot attributed that to the nervousness of getting a physical.  He wished he could have more patients this healthy.

The patient did have pelvic floor dysfunction—or, more specifically, vaginismus.  Seeing her steadiness through the first part of the exam, Elliot decided it would be best to get the pap test out of the way, so they could end the physical with something less distressing.

“Now,” he said, “I’m just going to have you scoot to the edge of the table.  As far as you can go, until you bottom is all the way off.”

The patient followed his instructions better than he expected.  He knew he’d need to acclimatize her to his touch.  She jumped after he placed his hand on her thigh, but he kept his hand present and firm.  If he grew jumpy as well, that would only make her more uncomfortable.

“It’s okay, Lisa.  I’m not going to hurt you.  I’m about to touch your outer labia now.  Okay.”

She jumped again.  He would have to do this as quickly as possible without sacrificing the integrity of the exam.  He checked the tissue—pink and firm, a healthy but tense labia.  He reassured the patient of this, though she seemed to take little comfort in it.  She wasn’t going to get through the actual pap if she didn’t calm down.

“Okay, Lisa, now I really need you to relax.  I’m going to insert the speculum.”  To make sure she understood the importance of his instruction, he added “it’s going to hurt if you don’t relax.”

The patient did not follow instructions—she refused to relax.  Her entire body went taut.  He was wondering if he should get some anesthetic when the patent sat up and suddenly he felt a burning in his right ear.

Elliot fell back, clutching his ear, and to his amazement he saw the patient was holding a scalpel.  “What the hell?” he said, before he could check himself for professionalism.  But what the hell was a scalpel doing in an exam room?  That was a surgical tool, and a dangerous one at that.  The stress of the exam, and the sight of something so unnerving, combined with the potential for violent reactions against doctors as can be found in vaginismus sufferers must have set the patient off.  And she’d been doing so well.

Nurse Vidic made herself usefull in Elliot’s confusion.  “I’m so sorry, Lisa.  We’ll get another doctor to finish the exam.”  At least Nurse Vidic could be sensible some of the time—a sense of continuity would calm the patient.

After the nurse helped Elliot out of the exam room, he said “I believe the patient needs a psychologist.  She’s unable to take the least bit of stress, which makes her a danger to herself and others . . . we should probably give her some sedation if we’re to finish the exam.  If I couldn’t ease her level of stress, then another doctor here certainly won’t be able to.”

Nurse Vidic only sat him down and set to disinfect and bandage the wound.  “You’re a smart man, Dr. Herbert.  But you’re really not too smart about people.”

Whatever that meant, Elliot couldn’t brush it off as easily as the other snarky comments he’d heard from her.


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