The Doctor Will Grope You Now

Doctor D, what are your thoughts on the TSA?

Okay, so no one actually emailed me this, but it’s high time Doctor D set things straight!

Dr. D’s prescription for America:

Stop being such snively, self-important, brats!

So what gives a medical doctor any right to speak on transportation and counter-terrorism?

Doctors also do full body searches. We call them physical exams.

During these exams we touch and look at every part of the body. I stick my fingers in vaginas, rectums, and mouths. I even sometimes do these exams on children—Oh, the horror! Lock up that sick man!!!!

How do doctors get away with this disgusting violations of your rights? We feel you up under the guise of keeping you safe. The TSA learned their trick from doctors!

These exams are theoretically voluntary, but most doctors will decline to take care of you unless you submit to some sort of medical pat-down. What an outrage!

Is All Touching Dirty?

Look, we all recognize that this is a weird situation. Touching a stranger’s body is awkward for both the toucher and the touchee. It is human nature to reserve close physical contact for family, intimate friends, and lovers. But sometimes we must do things that feel unnatural.

It is my job to touch every person who seeks my help.

Sorry, but when we spend all day touching bodies we kind of get used to it. You may see your body as a unique and private expression of yourself, but we see it simply as a dull object that must be checked for signs of danger.

You may feel violated because I had to check your prostate, but it didn’t bother me one bit. Checking your rectum is no more disturbing to me than checking your ear.

Of course, we try to be sensitive. Doctor D has had to do some invasive exams on little kids and sexual assault victims. We should take our patients’ feelings into account, but not not doing our job at all isn’t sensitivity—it’s incompetence.

Here's The Naughty Part (Stop here if skimming!)

What everybody's getting really worked up about is genitals! You only let people touch those in the most intimate of moments, except of course at the doctor’s office or the airport. Then you get a stranger poking around some sensitive spots.Doctor D will go ahead and answer your question now:

No. We are not thinking about sex, and if you are that’s your problem—not ours.

We aren’t eunuchs or anything like that—we are just focused on the job. Doctor D is a red-blooded heterosexual man who loves women as much as the next guy, but D can honestly say he has never once felt anything amorous about a patient during an exam. You could be a supermodel or an 80 year old grandmother and Doctor D feels exactly the same about touching you during an exam. Doctors learn quickly to see the bodies we work on as tasks to be completed rather conduits of passion.

Sure there is the occasional true sicko, but these people so rare that you chances of having one of them examine you is pretty minuscule. Doctor D has known quite a few doctors who were walking hormones and hit on everything of the opposite sex they ever met, and still these docs were nothing but professional and trustworthy when doing physical exams. A professional touching of the private parts is about as unromantic a situation as possible.

The attracting effect of the human body has no power over me when I wear the white coat! "Sorry, but I just don’t feel that way about you. It’s not you—it’s me"

Can We Handle This Like Grown-Ups?

I feel for the TSA agents. They are getting harassed for just doing their job. Physical exams suck. I’m sure pat-downs do too. But if they are necessary in order to ensure your safety and they are required to fly, then you should either grin and bare it or plan a long road trip.

This TSA fiasco irritates Doctor D to no end! It’s not that people dislike body searches. That is understandable. It’s the attitude of enraged entitlement that irks Doctor D. Everybody demands everything be done perfectly, safely, and cheaply and with no inconvenience to them whatsoever:

“I feel bad! I demand your full attention. Don’t make me wait; don’t poke at me; and don’t you dare tell me the treatment has risks or side effects! I have a constitutional right to everything I want right now and without any bother!”

And we wonder why the rest of the world thinks we are spoiled assholes?

Doctor D will be flying over the Christmas holidays, and when it’s time for his pat-down he will thank the beleaguered TSA agents for keeping us safe.

Your thoughts?

Any of you out there who's had a TSA pat-down that thinks it is worse than a pelvic exam?

Do you think patients should get treatments they want while “opting out” of the physical exam?

While Doctor D always loves to hear your thoughts, if your comments are too whiny or bratty Dr. D will hunt you down and administer a punitive rectal exam!

Getting To Know Your Body (First Visits)

Now back to a question I only halfway answered before:

One thing I would like to see answered on your blog is, what do you do on a first visit? Especially if you're not sick?

On your first visit with Doctor D:

• First, you and Doctor D size each other up. A doctor-patient relationship can be a complicated thing. You gotta know who you're working with. What is the doctoring style of the physician? What are your wants and needs as a patient? How will the relationship work? It is a lot like a first date. We may not be discussing it directly, but Doctor D and his patients are carefully listening and watching to figure out if we are compatible. If you have strong opinions about your care, you should probably let me know, especially if your expectations are out of the norm: "Doctor D, I want you to take care of me without using any medicines" or "I refuse all preventive care." This helps prevent misunderstandings later.
  

• Second, we go over your medical history. This is when you tell Doctor D all the stuff that has happened to your body in the past. We talk about surgeries, pregnancies, illnesses, drug reactions, as well as any current diseases, symptoms, and medicines. For some of you this will be a short discussion but for those who have been through the ringer in the medical system this could take a while.

• Third, we evaluate your risks. We talk about what might happen with your body in the future. Doctor D will ask about diseases your family members had. He'll ask about your habits (diet, drugs, exercise, sex life, etc.) and do a review of systems to look for symptoms you may not have noticed. Then we talk about how to either prevent diseases or catch them early. Any Primary Care doc who only treats what you have now without preventing future illness isn't doing their job correctly.

• Finally, Doctor D takes a look at your body. I might find some hidden disease on this exam, but I usually don't. The real purpose is so Doctor D knows how your body looks, sounds, and feels when it isn't sick. Diseases change the body; to properly recognize these changes it helps to know how the body looked when well. You may say, "Come on doc, I feel and look great!" Doctor D also suffers from a delusion of physical perfection he developed as a cocky 19 year old, but the fact is that even healthy bodies still have lots of little quirks or abnormalities. If I see you for the first time when ill I might mistake one of these physical quirks for a new problem and misdiagnose you. Similarly I might assume some small abnormality has always been there when it's really an important clue to your problem.

A while back Doctor D was in the ER and a dude comes in with a runny nose and headache--pretty standard viral cold, except that one eye was much bigger than the other. This gets Doctor D thinking about tumors in the eye socket and other scary stuff.

Doctor D asks about the eye and the guy says he's never noticed any between his eyes. Uh-oh! Then Doctor D shows the dude his own face in a mirror and the man is like, "Which eye doc?"

WTF? How does someone totally not notice one eye is fricking huge compared to the other? We doctors are trained to notice physical weirdness you stopped paying attention to when your mom taught you not to stare, so maybe this dude never noticed his funny eye? So Doctor D calls the family from the waiting room and they say he looks normal. Dr. D points out the eye and they are all like, "Well, what do you know? It is bigger!" Nobody knows how long it's been this way.

Luckily somebody had a childhood picture of this dude, and D discovered one eye has always been bigger. Apparently this guy has had a odd eye his whole life and nobody noticed! Stuff like this happens more often than you think. A lot of times this dude would have gotten his head pumped full of radiation in a big workup just because he was born funny looking.

It is really important that you have a doctor that knows you and your body well. First visits take a while even if you are healthy, but they are really important so don't skip out on them.

Incidentally Doctor D has his first visit with his new Primary Care doctor next month. What is the weirdest thing that ever happened to you on a first doctor's visit? Doctor D would love to hear your stories in the comments.