An adventure in medical education

Retired from teaching, I may be. But I find I can still make a contribution to the education of young people.

I recently made an appointment with my doctor for my annual physical exam, and in the week before the day of the appointment, I developed a rash and a little cluster of pustules low on my posterior, at that chasm between the two halves of the body (I’ll spare you a description of the contortions I had to go through to see what was causing the painful itching I had). At about the same time, and I didn’t know whether this was related or not, I began to experience some pain urinating.

I was in an examination room when Ted opened the door. He is just a few years younger than I and has been my doctor for about 30 years. I have great confidence in him and consider him a friend. During my annual physicals we have often spent more time just chatting than with the exams themselves.

He is an avuncular, generous fellow, and over the years he has hosted students from local medical schools —always females, in my experience—who move from room to room with him as he makes his rounds. He explains to them his diagnoses of the complaints his patients bring to him and answers their questions.

Usually, he has had just one student in tow, but this time, four lovely young women with fetching smiles and wearing starched and shiny lab coats stood behind him in the doorway. He and I greeted each other and he asked why I was there. It was time for my annual physical, I said. “But I have something else I need to talk to you about.”

“What’s that?”

I looked at the smiling doctors-to-be.

“I’d rather tell you privately.”

He would be back, he said. In the meantime, he would have another young woman, a Chinese who was studying to be a nurse practitioner, go through the preliminary work. She went down the checklist about my general health, took my pulse and listened to me breathe.

Ted returned with one of the young women, and introduced her as a first-year medical student. She beamed. He told her to wait outside and dismissed the nurse practitioner student.

It was time for the piece de resistance, the digital exam of my prostate.

I took off my slacks and stood next to the examining table.

“So what’s this private matter,” he asked, as he snapped on a latex glove.

“You’ll see it when you are down there.”

“Drop your shorts.”

I did as I was told, and shorts around my ankles I bent over the table. He looked.

“Shingles,” he exclaimed. He was exuberant.

“Classic shingles,” he said, as he checked the condition of my prostate.

“Your prostate is enlarged,” he said, “and that’s because it has been infected by the shingles. There’s no evidence of an abnormality. But that’s what’s causing the pain when you urinate.”

He took off the glove. I resumed breathing.

“Would you mind if I showed the student?” He asked me.

Modesty gave me pause. “I’d hate to get her all excited.”

He laughed. “Pshaw.”

I agreed to let her see and I assumed the posture of a shy ostrich. He opened the door and asked the student in.

“Classic shingles,” he said to her. She looked at my 75-year-old nether region—I assume she looked—while he discussed the symptoms. I wondered whether she was still smiling.

When Ted finally ushered her out, I dug my face out of the examination table and dressed. He and I talked about the remedies for shingles and he prescribed a couple of pills for me to take during the next week. Then he was off to another room.

The young woman passed me without a word as I was leaving. But I understood. She probably didn’t recognize my face.