Congratulations to Laura, general surgery resident, on her hilarious winning entry, posted in its entirety below. And thanks to Dr. Grumpy for the help in judging!
When I was 16, I got a job as a “standardized patient”. My neighbor worked for a medical school, and they needed standardized patients for their medical student to practice talking to. Because apparently you can make it through 4 years of undergraduate, a rigorous medical school application process, and, you know, normal life experiences, but still require formalized practice in speaking with other actual humans.
So I showed up for training, and was assigned my patient role. I was hoping for a TV-medical-show mystery type patient… some vague symptoms combined with a fascinating and intriguing back story. I expected this to be my dramatic acting debut, complete with genuine tears of pain and suffering when recounting my medical symptoms.
Instead, I was told that I was a slut. Apparently, their medical students were not comfortable talking to young teenage girls about their sexual escapades. So I was there to be a big-ole slut.
My character profile was a real gem. I worked at Taco Bell after school, and I started sleeping with my manager. He was 23 and had a motorcycle. We had unprotected sex because he didn’t like condoms. So I was looking for birth control pills. I was supposed to act embarrassed and shy, and evasive and reluctant in answering questions. The young doctors-to-be were supposed to recognize that I was at risk for STD’s and domestic violence and set me on a better path.
It was awkward. It was beyond awkward. Awkward was a dead fly on our rear view mirror. I would’ve killed for it to just be “awkward”. I had to pretend I was there for a headache, because I was too embarrassed to come out and say I needed to talk about sex. So the medical student would start on a rigorous course of questioning about my headaches to which I infuriatingly answered “I don’t know” to every questions. This charade continued until finally, exacerbated after wasting 12 of their 15 minutes on my obvious non-headache, they would ask, “So what are you really here for?!”
I got more frustrated than they did with the “headache” prologue. Sometimes I would try to make my own transition…. They would ask “Does anything seem to make the headache better?” and I’d say “Yes, having unprotected, crazy, statutory rape sex.” The doctor-teacher sitting on the other side of the one-way glass did not like that.
The other awkward part was the physical exam. In the real world, a teenager at risk for genital warts and cervical cancer would get at least a glance-over of her down-there-ness from a doctor about to prescribe birth control. But the medical school did not want their fumbling mini-doctors poking around my junk. Probably because paying a 16-year-old to let people repeatedly perform pelvic exams qualifies as a child sex crime.
But the medical students didn’t know whether they were supposed to exam me or not. In an attempt to make up for the awkwardness of the encounter up until they point, they would charge confidently ahead in stating that I needed a pelvic exam. I was supposed to tell them I was on my period, and about 80% of them got the point and backed down. Another 19% got the hint when I said I was really uncomfortable with having an exam, but promised to come back next week for an exam. Then there was 1% of medical students who still persisted. They thought the “I’m on my period” bit was like the “I have headaches” ruse, and they were too smart to fall for that twice. They were going to exam me whether I liked it or not.
Here’s a tip for medical students- if an standardized patient encounter ends with a 16 year old girl yelling to get your hands off of her, then you have failed.
All that being said, being a standardized patient was the best job you can possibly give a teenage girl. I literally got paid $30 per hour to be lectured about having safe sex. At 16 years old, I knew more about syphilis, HPV and how teenage pregnancy would ruin my life than any other virgin ever.
Once I was in medical school, it was my turn to awkwardly harass pretend-patients. One night, we had a special, after hours, standardized patient session. Instead of the usual daytime, on campus session- this one was on a Thursday night at a ‘special venue’. They even fed us dinner beforehand. Like a naïve school girl, I missed all the hints… late night, dinner prelude… things were about to get inappropriately intimate.
It started with pelvic exams. The women who volunteered to be standardized patients for fumbling medical student to learn pelvic exams on them are… um, well… interesting. One was a midwife, who was so used to seeing lady bits that she believed her own were no more personal than her bony elbows. Another was the owner of the local sex shop. She taught weekly classes like “Oral Sex 101” and “G Spot Roadmap”. She had an overly aggressive style of grabbing our hands and repositioning them while saying something vaguely sexual like, “Now twist like this, move in, push up and yes, that’s my cervix, right there!”
Male medical students were the worst. We had a very simple script were we supposed to follow while we did the exam, “OK, we’re going to get started now. This is my hand on your leg. You’re going to feel a little pressure now. Alright great, everything feels normal and healthy. We are all done.” But somehow the awkward males would manage to turn every phrase into a pseudo-sexual come-on. “I’m going in now. Oh, that feels good. I’m about to finish.” My vagina clamped down like a steel trap just listening to them fumble through it.
I can’t say that the female medical students fared much better when the tables were turned. It was fairly obvious which ladies had never seen an uncircumcised member before, as they fuddled with the extra cloaking. Do we pull it back? Do we peek inside? Is there a zipper somewhere? And how long can one spend feeling the testicles for lumps and bumps before it seems like foreplay?
The last event of the night was prostate exams, aka finger up the butt. For some reason, this was where our teachers drew the line about what it was appropriate to have the standardized patients do. So instead of feeling real prostates, they lined up a series of plastic models to practice on. Inside each butt-hole model was some different variant of a prostate, so we could learn what normal felt like, and how to recognize a cancer. The act of guessing what something is based on how it feels while jammed inside someone’s butt has never been, and will never be anything but hilarious. It’s fun for all ages!
I recently went to dinner with the attending surgeons of the colorectal surgery division. We hadn’t even received our appetizers before the conversation turned into a sparing match of who had found the craziest thing in a patient’s butt. This scenario is international, and it transcends cultures. I truly believe I could travel to rural Ethiopia, meet with a surgeon, and start showing off x-rays of things-stuck-in-colons and we would bond instantly. However, stories about things stuck in butts are like stories of the fish that got away- greatly exaggerated in every direction and conveniently never witnessed by a second party.