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Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated: 1 00:00:16,720 --> 00:00:17,720 Well, this is it. 2 00:00:19,560 --> 00:00:20,980 You have a lovely voice. 3 00:00:21,300 --> 00:00:26,120 Thank you. I mean, it's not much, but it's all I could afford while we were in 4 00:00:26,120 --> 00:00:27,058 school. 5 00:00:27,060 --> 00:00:28,320 Well, I understand. 6 00:00:28,620 --> 00:00:29,620 I understand. 7 00:00:30,120 --> 00:00:35,220 Yeah. Thank you again for inviting me over. 8 00:00:35,760 --> 00:00:36,739 Of course. 9 00:00:36,740 --> 00:00:41,460 Of course. I'm just, I'm really glad that we're all done with this, because I 10 00:00:41,460 --> 00:00:43,660 don't know how I did it without you. 11 00:00:45,160 --> 00:00:46,160 Wow. 12 00:00:49,179 --> 00:00:52,660 I'm okay with the terminology. 13 00:00:52,900 --> 00:00:56,480 I've always been having problems with the practical version. 14 00:00:57,220 --> 00:01:00,680 You know, I find it to be just the opposite. 15 00:01:00,900 --> 00:01:05,319 I mean, it's the written that I'm having the most trouble with. Some of the 16 00:01:05,319 --> 00:01:11,140 terminology is way beyond me. But as far as the practical exam, I'm an expert. 17 00:01:11,300 --> 00:01:14,680 I've been doing it my whole life, and now I just need a license. 18 00:01:15,900 --> 00:01:17,680 So, what are you having trouble with? 19 00:01:18,560 --> 00:01:23,040 Well, I could, but I'll be blunt about it. 20 00:01:23,720 --> 00:01:24,880 Female anatomy. 21 00:01:26,060 --> 00:01:28,300 I've been sheltered as a kid. 22 00:01:28,500 --> 00:01:34,300 Oh, okay. I've seen this a lot in some of the younger students. 23 00:01:35,480 --> 00:01:40,400 It's usually because they were raised to be so polite that they would never want 24 00:01:40,400 --> 00:01:44,740 to offend. And now that you have to go up to a woman and examine her. 25 00:01:45,180 --> 00:01:46,260 It feels rude somehow. 26 00:01:46,780 --> 00:01:51,420 Yeah. Yeah. But, I mean, I'll tell you. Here, we'll go get this out of the way. 27 00:01:51,460 --> 00:01:52,460 Come with me. 28 00:01:52,600 --> 00:01:53,600 And you know what? 29 00:01:54,080 --> 00:01:55,180 I'll show you how it's done. 30 00:01:55,900 --> 00:01:59,240 It's a very, very straightforward, very clinical way to do this. 31 00:02:00,160 --> 00:02:01,160 Everything's going to be fine. 32 00:02:01,540 --> 00:02:02,540 Okay. 33 00:02:04,040 --> 00:02:07,640 So, there's absolutely nothing to be afraid of. 34 00:02:08,039 --> 00:02:13,840 You know, if you just kind of think of women like everybody else, like men, 35 00:02:14,060 --> 00:02:15,060 like... 36 00:02:15,410 --> 00:02:19,890 So, first things first is to make your patient comfortable. You sit them down, 37 00:02:20,010 --> 00:02:25,050 you ask them why they're in the office today, why they came to see you, and 38 00:02:25,050 --> 00:02:29,950 you have to determine, based on what they tell you and what you discover, 39 00:02:29,950 --> 00:02:31,290 may or may not be wrong with them. 40 00:02:31,590 --> 00:02:36,390 Before you go through the expense for your hospital or your office of running 41 00:02:36,390 --> 00:02:40,390 blood tests, because you run out of those bills and you're going to get 42 00:02:40,390 --> 00:02:41,950 privileges. So, we start here. 43 00:02:43,530 --> 00:02:44,650 You asked me what I'm doing. 44 00:02:45,590 --> 00:02:46,590 Why am I here? 45 00:02:46,890 --> 00:02:47,890 Good afternoon. 46 00:02:48,330 --> 00:02:49,330 How are you doing? 47 00:02:49,470 --> 00:02:50,590 I'm fine, doctor. Thank you. 48 00:02:51,370 --> 00:02:53,170 So, why'd you visit? 49 00:02:54,950 --> 00:03:00,770 Well, you know, I was having an issue with my lower back, and it just seemed 50 00:03:00,770 --> 00:03:02,850 crazy around my hip. 51 00:03:03,050 --> 00:03:04,570 And I've tried everything. 52 00:03:04,830 --> 00:03:05,709 I've tried stretching. 53 00:03:05,710 --> 00:03:10,730 I've tried those muscles in the area. I just, right here in the small, I think I 54 00:03:10,730 --> 00:03:11,730 might have cracked a bone. 55 00:03:11,890 --> 00:03:12,890 Oh. 56 00:03:13,360 --> 00:03:17,420 Oh, let me go get one of my nurses to help me with that. 57 00:03:17,780 --> 00:03:18,780 You're doing great. 58 00:03:18,900 --> 00:03:20,260 You're doing so good. 59 00:03:20,680 --> 00:03:24,880 First things first. Never contradict the patient because they are certain 60 00:03:24,880 --> 00:03:29,620 they're right. Always right. Instead of contradicting, add suggestions in 61 00:03:29,620 --> 00:03:31,020 addition to what they may think. 62 00:03:31,480 --> 00:03:32,880 You don't need the nurse. 63 00:03:33,180 --> 00:03:36,260 You're the doctor. This is your health. You're in touch. 64 00:03:37,000 --> 00:03:38,000 Okay? 65 00:03:38,480 --> 00:03:41,780 You're going to be fine. I promise you. I promise you. 66 00:03:42,560 --> 00:03:47,140 So, again, you're making the patient feel comfortable, saying, well, in 67 00:03:47,140 --> 00:03:51,520 to what you're observing, these other things may be possible, and this is how 68 00:03:51,520 --> 00:03:52,520 we're going to find out. 69 00:03:52,720 --> 00:03:53,720 Right? 70 00:03:54,260 --> 00:03:59,020 First things first, you've got to check for swollen lymph nodes to make sure 71 00:03:59,020 --> 00:04:00,960 that it's not an infection of some kind. 72 00:04:01,200 --> 00:04:06,920 And infections can be discovered easily by palpitating the lymph nodes in the 73 00:04:06,920 --> 00:04:10,360 neck, the adenoids and the tonsils, just like you taught me last week, remember? 74 00:04:10,700 --> 00:04:11,700 So here you go. 75 00:04:12,220 --> 00:04:15,700 You're going to see if the glands under here are swollen. 76 00:04:17,420 --> 00:04:19,660 And you're going to roll your finger around a little bit. 77 00:04:20,640 --> 00:04:25,560 And then as you're doing this, you're going to talk to your patient so they 78 00:04:25,560 --> 00:04:26,560 don't feel creeped out. 79 00:04:26,860 --> 00:04:29,080 Okay. So tell me about your day. 80 00:04:30,320 --> 00:04:31,740 Day's going okay, doctor. 81 00:04:32,580 --> 00:04:35,660 Do you feel anything here? Do you want to tell them what you're observing or 82 00:04:35,660 --> 00:04:40,040 observing? Oh, well, your lymph nodes aren't swollen, so there's no... 83 00:04:45,080 --> 00:04:50,200 There are also lymph nodes under the arm and on the inside of the thigh. 84 00:04:51,080 --> 00:04:56,200 But if you don't feel the full -on lung tear, you're probably not going to 85 00:04:56,200 --> 00:04:58,640 elsewhere unless it's a local infection. 86 00:04:59,080 --> 00:05:01,980 Next, you want to check my respiration. 87 00:05:03,420 --> 00:05:05,580 Make sure that there's no fluid in my lungs. 88 00:05:09,040 --> 00:05:12,440 Because if there's fluid in the lung, you might have missed something. 89 00:05:13,360 --> 00:05:19,260 And it is very, very important to determine without any question that the 90 00:05:19,260 --> 00:05:20,260 are working properly. 91 00:05:20,560 --> 00:05:24,720 Well, let me check your lungs. 92 00:05:31,160 --> 00:05:34,960 Now, when you check the locations here, you also need to check the back. 93 00:05:35,260 --> 00:05:36,580 Because sometimes... 94 00:05:38,220 --> 00:05:43,700 Long time pneumonia or even clot and high on different sides of the lungs. We 95 00:05:43,700 --> 00:05:44,700 want to check both. 96 00:05:44,980 --> 00:05:47,040 So you're going to listen to my back. 97 00:06:07,720 --> 00:06:12,560 Great, you're healthy and alive, and you have no fluid in your lungs. 98 00:06:12,780 --> 00:06:13,780 That is wonderful. 99 00:06:13,860 --> 00:06:18,240 Now, did you notice anything weaving? Because I actually do have asthma, and 100 00:06:18,240 --> 00:06:21,480 might hear, it almost sounds like a whistle sound. 101 00:06:21,880 --> 00:06:22,880 Yes, I did actually. 102 00:06:23,400 --> 00:06:25,740 It is beautiful, but you're not going to hear me say it. 103 00:06:26,180 --> 00:06:32,380 Now, after you identify there was prepping issues during the exam, and you 104 00:06:32,380 --> 00:06:36,180 of course, different infection, and then fluid in the lungs, 105 00:06:36,970 --> 00:06:38,850 You need to look into the heart rate, my heart beat. 106 00:06:39,510 --> 00:06:44,410 The nurse will take blood pressure. But next you need to look for signs of 107 00:06:44,410 --> 00:06:48,010 injury, inflammation, redness, swelling. 108 00:06:48,390 --> 00:06:53,330 These are all very important things to determine ahead of any blood tests or x 109 00:06:53,330 --> 00:06:57,990 -rays that you might decide are necessary because it will save you money 110 00:06:57,990 --> 00:07:03,410 often money. So you need to look at the area where the patient says that there 111 00:07:03,410 --> 00:07:05,550 are areas of pain or concern 112 00:07:06,619 --> 00:07:11,520 Even immobility, because immobility is often a sign of injury, and most people 113 00:07:11,520 --> 00:07:17,540 don't see it that way. So, this is the area where the patient says she's having 114 00:07:17,540 --> 00:07:19,060 unresolvable pain. 115 00:07:19,400 --> 00:07:24,800 Now, do you see, in that area, anything that indicates injury? 116 00:07:25,160 --> 00:07:32,020 Swelling, or maybe an abrasion, a bruise, any signs of fracture? 117 00:07:32,600 --> 00:07:35,040 You gotta touch it. Oh, uh -huh. 118 00:07:36,400 --> 00:07:37,400 Yes, okay. 119 00:07:37,900 --> 00:07:41,120 You've got to touch. And then, you know, you've got to get the surrounding area 120 00:07:41,120 --> 00:07:45,820 because it could be an injury in the area that is transmitting the pain to a 121 00:07:45,820 --> 00:07:46,820 different spot. 122 00:07:47,100 --> 00:07:48,360 Do you feel anything there? 123 00:07:48,960 --> 00:07:49,960 No. No? 124 00:07:52,800 --> 00:07:55,920 Now, you remember that area in the book, that's where the bottom of the spine 125 00:07:55,920 --> 00:07:56,920 is. Mm -hmm. 126 00:07:57,320 --> 00:08:00,260 That's got a whole bunch of nerves, and then you've got that itty -bitty 127 00:08:00,260 --> 00:08:03,500 sciatica thing in there that's a mess, and it's horrible for everybody. I don't 128 00:08:03,500 --> 00:08:04,500 know. 129 00:08:04,730 --> 00:08:06,710 I don't feel any inflammation. 130 00:08:07,050 --> 00:08:13,550 I don't see any signs of injury. There's a lot that seems to be... 131 00:08:13,550 --> 00:08:15,550 There's a lot? Okay. 132 00:08:16,030 --> 00:08:21,410 A lot is going through my head right now. Okay. So we are, instead of saying 133 00:08:21,410 --> 00:08:25,530 lot, because we don't like to be described as a lot, we're large. No, no, 134 00:08:25,550 --> 00:08:26,890 Never do that. Never do that. 135 00:08:27,790 --> 00:08:31,450 You're considering different things. 136 00:08:32,280 --> 00:08:36,299 You want to keep feeling around until you've got the whole area out. 137 00:08:36,580 --> 00:08:38,440 So you can't feel anything on the surface. 138 00:08:39,700 --> 00:08:44,480 Then it's possible that there could be an internal injury from, you know, maybe 139 00:08:44,480 --> 00:08:50,500 a bone fall or a bad fall or even a herniation of the intestines or the 140 00:08:50,500 --> 00:08:54,340 abdominal wall. And these are things you have got to find out because if it's a 141 00:08:54,340 --> 00:08:56,980 herniation, it could become a life -threatening situation. 142 00:08:57,500 --> 00:08:58,840 So wear your gloves. 143 00:09:00,000 --> 00:09:01,000 Okay. 144 00:09:25,040 --> 00:09:26,060 My goodness, you've got big hands. 145 00:09:26,340 --> 00:09:29,040 I think they make those in a bigger size for next time. 146 00:09:29,600 --> 00:09:30,600 Hi! 147 00:09:32,500 --> 00:09:33,780 Oh, hello. 148 00:09:34,140 --> 00:09:37,500 Yeah, you don't want any articles of clothing to be in the way of your 149 00:09:37,500 --> 00:09:38,500 diagnosis. 150 00:09:40,660 --> 00:09:45,420 Alright, well, if you put a dry finger into your patient's rectum, you're going 151 00:09:45,420 --> 00:09:46,940 to be in a lot of trouble with a lot of people. 152 00:09:47,420 --> 00:09:48,860 Get some jelly on that, sir. 153 00:09:51,400 --> 00:09:57,390 I assure you, this is part... of what you do every time there is, you know, an 154 00:09:57,390 --> 00:10:00,670 injury in this area. You've got to check the insides. And the only way to do 155 00:10:00,670 --> 00:10:01,670 that is to get in there. 156 00:10:02,150 --> 00:10:05,930 Oh. Because, I mean, at the bottom of the spine, it could be something in the 157 00:10:05,930 --> 00:10:09,130 intestines or, you know, any one of the surrounding connective tissues. You've 158 00:10:09,130 --> 00:10:10,150 got to get in there and feel around. 159 00:10:10,490 --> 00:10:14,850 Okay. So... So? There you go. 160 00:10:15,090 --> 00:10:16,090 Okay. Now what? 161 00:10:16,690 --> 00:10:17,690 Well, 162 00:10:17,930 --> 00:10:22,350 you've got to look at the area. Is there anything around that area that you can 163 00:10:22,350 --> 00:10:23,350 see that... 164 00:10:23,370 --> 00:10:24,830 That could say injury or infection. 165 00:10:25,050 --> 00:10:25,869 Oh, my. 166 00:10:25,870 --> 00:10:26,870 Oh. 167 00:10:27,590 --> 00:10:28,590 Hold on. 168 00:10:28,650 --> 00:10:32,350 Well, I'm going to squeeze it so you know that it's not a paralytic issue. 169 00:10:32,650 --> 00:10:35,650 Mm -hmm. That the muscles and the nerves are still working in the area. 170 00:10:35,890 --> 00:10:36,890 Yes. 171 00:10:38,890 --> 00:10:42,450 And I do have sensation. Are there any signs of injury? 172 00:10:43,210 --> 00:10:44,750 No. That you can see? 173 00:10:45,450 --> 00:10:46,710 None that I can see. 174 00:10:47,850 --> 00:10:48,850 Beautiful. 175 00:10:50,810 --> 00:10:52,570 Healthy, I mean. Healthy. Yes. 176 00:10:54,379 --> 00:10:56,940 That's the correct term I could be using. 177 00:10:57,520 --> 00:11:00,940 Okay, you've really... I can see that you're nervous, David. 178 00:11:01,240 --> 00:11:02,079 I am. 179 00:11:02,080 --> 00:11:06,060 But this is part of your final exam. Before they're going to give you a 180 00:11:06,140 --> 00:11:07,580 you've got to learn to be able to do this. 181 00:11:08,220 --> 00:11:09,380 I know that you're nervous. 182 00:11:10,020 --> 00:11:12,100 So why don't we start with something simpler? 183 00:11:12,440 --> 00:11:17,560 You've got to get used to the female body. It's not such a scary thing. 184 00:11:18,200 --> 00:11:20,220 Most women, when they come to you... 185 00:11:20,440 --> 00:11:24,680 They need help. They're trusting you to find something that's wrong, to make 186 00:11:24,680 --> 00:11:28,940 them feel better, to make sure that that help is what it needs today. 187 00:11:29,400 --> 00:11:35,160 So before you go from, you know, backside to any other part of the body, 188 00:11:35,160 --> 00:11:36,160 going to remove your gloves. 189 00:11:36,420 --> 00:11:39,880 Throw those out. That's why they buy so many, so you can change them when you 190 00:11:39,880 --> 00:11:40,880 need to. 191 00:11:41,500 --> 00:11:44,840 Okay. So let's start with something simple. A simple breath. 192 00:11:45,660 --> 00:11:46,660 Yeah. 193 00:11:49,000 --> 00:11:51,200 Start with one. Use both hands. 194 00:11:53,360 --> 00:11:55,920 Do the circles. You're going to feel around. 195 00:11:56,140 --> 00:11:57,340 Feel the whole boob. 196 00:11:58,320 --> 00:11:59,320 Squeeze a little. 197 00:12:00,960 --> 00:12:02,360 Do you feel any lump? 198 00:12:03,400 --> 00:12:04,940 No, not really. 199 00:12:05,580 --> 00:12:08,040 I've got to get the whole area. 200 00:12:08,480 --> 00:12:10,520 It's a large area. 201 00:12:17,550 --> 00:12:18,910 It's heavy, too, isn't it? Yeah. 202 00:12:19,450 --> 00:12:25,130 I think this one weighs maybe 11 pounds. 203 00:12:25,970 --> 00:12:27,150 Yeah. Wow. 204 00:12:27,370 --> 00:12:28,370 Yeah, they're big. 205 00:12:29,310 --> 00:12:31,450 Mm -hmm. 206 00:12:31,690 --> 00:12:32,890 There you go. You let it move. 207 00:12:33,170 --> 00:12:36,170 Oh, okay. You want to make sure that there's... Do you hear anything? Do you 208 00:12:36,170 --> 00:12:38,830 hear any squishy moving around? Do you hear any noises? 209 00:12:39,090 --> 00:12:40,890 You go, shake it off, squeeze it, have fun with it. 210 00:12:42,490 --> 00:12:45,870 But you're laughing, which means you're not as nervous, right? 211 00:12:46,090 --> 00:12:47,090 Oh, that helped. 212 00:12:59,600 --> 00:13:01,580 Do you notice anything unusual? 213 00:13:02,040 --> 00:13:04,500 No. Other than how big it is. 214 00:13:06,120 --> 00:13:10,220 No problem. But it seems perfectly round and natural to me. 215 00:13:10,880 --> 00:13:12,220 Now the other one. 216 00:13:13,280 --> 00:13:14,860 Now every breast is... 217 00:13:15,150 --> 00:13:19,810 is different from his sister so they're not supposed to be twins they're 218 00:13:19,810 --> 00:13:23,210 supposed to be cousins i just learned something new i didn't know that it 219 00:13:23,210 --> 00:13:27,010 like eyebrow you know do you see anything in here you want to make sure 220 00:13:27,010 --> 00:13:31,890 that area by the lymph nodes because sometimes a little bad situations can 221 00:13:31,890 --> 00:13:37,230 there too you're doing great david see this isn't so bad is it 222 00:13:37,230 --> 00:13:42,230 let me get the nipple and the areola area okay 223 00:13:43,180 --> 00:13:47,620 You really want to examine that because sometimes the worst problems start in 224 00:13:47,620 --> 00:13:50,920 that area right there. Is that okay? Yeah, you've got to pull the nipple out 225 00:13:50,920 --> 00:13:51,819 little bit. 226 00:13:51,820 --> 00:13:55,020 And then with your other hand, feel around the area while the skin is 227 00:13:55,200 --> 00:13:56,200 Oh, okay. 228 00:13:56,260 --> 00:13:57,259 Oh, 229 00:13:57,260 --> 00:13:58,260 that's great. 230 00:13:58,340 --> 00:14:02,260 Go ahead and pull it a little. You want the skin to be nice and firm. 231 00:14:03,620 --> 00:14:05,960 Do you feel anything unusual there? 232 00:14:06,300 --> 00:14:07,300 No. 233 00:14:08,520 --> 00:14:11,540 Now the breast, are there any areas of hardness? 234 00:14:14,560 --> 00:14:19,700 No, but I feel right now currently no now you want to you want to look at them 235 00:14:19,700 --> 00:14:24,020 both at the same time Do you see do you see anything? 236 00:14:24,580 --> 00:14:27,200 Like any swelling any surface area? 237 00:14:28,400 --> 00:14:32,600 discoloration any dimples that you think might be a problem 238 00:14:44,440 --> 00:14:45,480 Not everything looks good. 239 00:14:45,960 --> 00:14:46,960 Yeah, okay. 240 00:14:47,100 --> 00:14:48,480 Now, what about in here? 241 00:14:50,080 --> 00:14:54,200 What am I looking for? Anything that looks unusual. 242 00:14:55,400 --> 00:14:56,400 Well, that's great. 243 00:14:56,780 --> 00:15:01,580 After you're done examining the breath area, you want to move your weight down 244 00:15:01,580 --> 00:15:07,980 to the abdominal area because, oh boy, that is almost always where every pain 245 00:15:07,980 --> 00:15:08,679 going to start. 246 00:15:08,680 --> 00:15:12,860 All right, so we need to do the abdominal exam, and for this we need to 247 00:15:12,860 --> 00:15:15,940 sure that patients, are laying flat on their back. 248 00:15:16,260 --> 00:15:20,900 So anything that might be happening in the abdominal area, it's necessary to 249 00:15:20,900 --> 00:15:21,920 have the patient lay flat. 250 00:15:22,180 --> 00:15:26,800 This way you can identify something more easily if it's not, you know, where it 251 00:15:26,800 --> 00:15:27,479 is today. 252 00:15:27,480 --> 00:15:32,440 So for this, I need you to put both of your hands on my abdomen right here. 253 00:15:33,320 --> 00:15:38,660 And you're going to examine the entire abdominal area all the way down to the 254 00:15:38,660 --> 00:15:39,660 hips. 255 00:15:43,600 --> 00:15:47,280 I need you to get your hands up. You're doing a great job, but I need you to 256 00:15:47,280 --> 00:15:52,200 really roll your fingers around and try to identify if any of my organs are 257 00:15:52,200 --> 00:15:56,220 swollen or if I have any areas of pain in any of the quadrants. 258 00:15:56,520 --> 00:15:57,520 Very important. 259 00:15:57,760 --> 00:16:02,700 And where the pain is will help you to decide what it may or may not be. 260 00:16:02,940 --> 00:16:06,060 So you want to use flat fingers like this. 261 00:16:08,120 --> 00:16:10,800 And feel around. You have the liver over here. 262 00:16:11,450 --> 00:16:13,770 And you've got the small intestine up here. 263 00:16:14,410 --> 00:16:18,450 And the colon is right around this area here. So you've really got to press in 264 00:16:18,450 --> 00:16:21,270 there. Dig in there with your finger. There you go. Do you feel anything? 265 00:16:21,970 --> 00:16:26,410 I feel your organs. I don't feel anything swollen, nothing inflamed. 266 00:16:26,830 --> 00:16:28,090 Okay. Wow. 267 00:16:29,530 --> 00:16:30,530 Well, that's wonderful. 268 00:16:30,730 --> 00:16:32,090 What else do you notice about this? 269 00:16:32,590 --> 00:16:35,750 Make sure to get the entire abdominal cavity. 270 00:16:36,630 --> 00:16:39,710 I feel the muscles underneath and the way that you tighten them. 271 00:16:40,339 --> 00:16:41,520 I'm going to be relaxed. 272 00:16:41,720 --> 00:16:42,720 I do feel alive. 273 00:16:44,580 --> 00:16:50,140 Wonderful. Now, if a patient comes to you, like I said, with back pain, that 274 00:16:50,140 --> 00:16:54,340 be caused by an injury to an organ in the area. 275 00:16:54,560 --> 00:16:59,200 So what you need to do is check the lymph nodes here because those can be 276 00:16:59,200 --> 00:17:01,820 swollen. There are lymph nodes right here. You need to check these. 277 00:17:02,240 --> 00:17:08,720 The lymph nodes in this area right here on either side of that area. 278 00:17:09,079 --> 00:17:14,460 And if those are not swollen, then the likelihood of an infection is far, far 279 00:17:14,460 --> 00:17:16,380 less going to be the case. 280 00:17:17,200 --> 00:17:19,920 Do you feel any swelling? 281 00:17:21,060 --> 00:17:23,780 No, I don't feel any swelling or inflammation. 282 00:17:24,339 --> 00:17:28,000 David, you've got to look at your patient while you're feeling on them. 283 00:17:28,079 --> 00:17:30,020 Otherwise, they're going to think you're creepy. 284 00:17:30,720 --> 00:17:33,120 You're doing an exam. It's okay to look. 285 00:17:33,400 --> 00:17:36,860 You have to look at your patient. They're going to get the bad idea. This 286 00:17:36,860 --> 00:17:38,640 very clinical. There's nothing wrong with this. 287 00:17:39,000 --> 00:17:43,820 So, now, do you see anything on the outside of the vaginal area which could 288 00:17:43,820 --> 00:17:47,660 cause, you know, maybe a dislocated pain that the patient is feeling? 289 00:17:48,700 --> 00:17:49,980 Labia majora minor. 290 00:17:50,500 --> 00:17:52,160 That's still all there. 291 00:17:52,440 --> 00:17:55,480 Well, of course, the men missed the clitoris. It's right there. 292 00:17:55,840 --> 00:17:59,080 Look. Right there. Okay. So, all the pieces are there. 293 00:17:59,320 --> 00:18:00,900 Yes. Nothing looks broken. 294 00:18:01,160 --> 00:18:02,820 No. Nothing looks injured. 295 00:18:03,240 --> 00:18:07,180 Right. So, we've determined that lymph nodes are not solid. 296 00:18:07,660 --> 00:18:11,980 all the abdominal cavity feels like it should, you know, regular. 297 00:18:12,740 --> 00:18:16,000 And you don't see any, you know, external signs of injury. 298 00:18:16,900 --> 00:18:22,080 So what's happening right now, before we go to the blood test or, you know, the 299 00:18:22,080 --> 00:18:25,980 scans, is you have to do a digital exam. 300 00:18:27,040 --> 00:18:30,260 And if that's not deep enough, then we have to go a little bit more advanced. 301 00:18:31,080 --> 00:18:32,120 Okay? Okay. 302 00:18:32,460 --> 00:18:34,320 All right. So got to get your gloves on. 303 00:18:49,740 --> 00:18:55,120 It's helpful for some people if you make them a hawk while you're doing exams, 304 00:18:55,340 --> 00:19:01,220 you know, just asking them about their job, their TV shows they might be 305 00:19:01,220 --> 00:19:03,660 watching. What would you say your favorite color is? 306 00:19:04,160 --> 00:19:08,380 Blue. Blue? Oh, yeah. Well, unfortunately, I don't have blue gloves 307 00:19:08,380 --> 00:19:09,380 only have black. 308 00:19:09,400 --> 00:19:12,500 But it is in the blue bag, so it's in there. Yeah. 309 00:19:13,560 --> 00:19:16,620 Now, normally there's a special table because it has it. Right. 310 00:19:16,920 --> 00:19:18,440 But we're going to have to provide it. 311 00:19:24,320 --> 00:19:28,540 Always warn the patient that the gel is going to be cold. Yes. It always is. It 312 00:19:28,540 --> 00:19:29,179 always is. 313 00:19:29,180 --> 00:19:31,500 So you want to make sure to lube up the outside area. 314 00:19:35,040 --> 00:19:36,400 Just here. 315 00:19:36,660 --> 00:19:37,680 Oh, the lube. Okay. 316 00:19:38,040 --> 00:19:39,300 This lube. Uh -huh. 317 00:19:40,380 --> 00:19:44,420 You want to make sure to get all those tiny little cracks on the outside of the 318 00:19:44,420 --> 00:19:49,140 area lubed up. Because if you don't, you just put a glove in there, you might 319 00:19:49,140 --> 00:19:50,140 get a shoe in the face. 320 00:19:50,480 --> 00:19:51,480 Ah. 321 00:19:53,050 --> 00:19:55,590 Nobody wants a shoe in the face. Nobody wants a shoe in the face. 322 00:19:57,470 --> 00:19:58,570 Can't beat up a doctor. 323 00:19:59,030 --> 00:20:00,030 Great. 324 00:20:00,310 --> 00:20:03,110 Just massage the area. 325 00:20:03,830 --> 00:20:06,190 Make eye contact with your patient. 326 00:20:06,550 --> 00:20:09,050 Yes. Tell me about your day. 327 00:20:09,750 --> 00:20:16,670 Work has been a little stressful, doctor. I think I fell on the ice 328 00:20:17,730 --> 00:20:19,430 Maybe that's how I hurt myself. 329 00:20:20,270 --> 00:20:21,270 Oh, I see. 330 00:20:21,810 --> 00:20:22,810 That's unfortunate. 331 00:20:24,310 --> 00:20:28,250 And you want to assure them when you don't see anything wrong that everything 332 00:20:28,250 --> 00:20:29,630 looks good so far. 333 00:20:29,890 --> 00:20:31,750 Yeah. Everything looks good so far? 334 00:20:32,070 --> 00:20:33,190 Yeah. Wonderful. 335 00:20:33,650 --> 00:20:38,490 Okay, now this next part has to be done. 336 00:20:39,090 --> 00:20:45,990 Okay, the tip of your glove needs to be inserted from that much because you need 337 00:20:45,990 --> 00:20:49,330 to get the patient used to the idea that they're about to receive an internal 338 00:20:49,330 --> 00:20:50,330 exam. 339 00:20:50,830 --> 00:20:54,870 Okay. And you don't want them to feel yucky about it. So how would you say 340 00:20:57,790 --> 00:20:58,810 Hmm. Over here. 341 00:21:00,050 --> 00:21:01,130 Well. Right here, doctor. 342 00:21:02,010 --> 00:21:05,690 I would like to know that I'm about to perform an internal procedure, and I 343 00:21:05,690 --> 00:21:09,270 would hope that you're comfortable with that. Or would you like a female nurse 344 00:21:09,270 --> 00:21:12,190 to be able to come in here and do that for you? 345 00:21:12,810 --> 00:21:17,210 Thank you for offering. There should almost always be a female in the room. 346 00:21:17,210 --> 00:21:21,070 for me, no. We're just doing this for us, between us. We're practicing right 347 00:21:21,070 --> 00:21:21,909 now. Okay. 348 00:21:21,910 --> 00:21:27,170 Never, ever, ever touch a female patient without a female nurse to witness in 349 00:21:27,170 --> 00:21:27,669 the room. 350 00:21:27,670 --> 00:21:29,330 Ugh, love this. Okay, I admit. 351 00:21:29,570 --> 00:21:30,570 It's awful. 352 00:21:31,010 --> 00:21:36,510 Okay. So, this much. You're going to put that much of your glove into the 353 00:21:36,510 --> 00:21:38,190 rectum. Okay. 354 00:21:38,390 --> 00:21:40,470 But you're just going to put it this much. 355 00:21:40,830 --> 00:21:42,150 This much? Yep, that much. 356 00:21:43,370 --> 00:21:44,650 And only one finger. 357 00:21:44,890 --> 00:21:48,710 Only one finger. Oh, my God. The last student I tutored in this subject was, 358 00:21:48,810 --> 00:21:51,040 ugh. What a dick he was. 359 00:21:51,760 --> 00:21:55,060 He just, all three fingers, he just jammed it right in there. I'm like, yo, 360 00:21:55,060 --> 00:21:57,860 buddy, we're not, you know, out on a date or anything. I know, all right. Get 361 00:21:57,860 --> 00:21:58,519 back to work. 362 00:21:58,520 --> 00:22:02,240 Okay. Okay, just a little bit. Just the tip of the finger. Just a little bit. Mm 363 00:22:02,240 --> 00:22:03,680 -hmm. Look at your patient. 364 00:22:04,040 --> 00:22:05,580 Are you all right? Is this okay? 365 00:22:05,780 --> 00:22:06,619 Yeah, that's fine. 366 00:22:06,620 --> 00:22:08,180 Okay. And it's gone in. 367 00:22:08,420 --> 00:22:10,920 Okay. And there it is. Is it? 368 00:22:11,140 --> 00:22:14,140 Yes. Okay, now hold the finger there. Mm -hmm. 369 00:22:14,480 --> 00:22:18,560 Because you don't know what the patient's internal situation is. 370 00:22:19,050 --> 00:22:21,730 But take notice of the sensations around the finger. 371 00:22:22,010 --> 00:22:23,050 Mm -hmm. Okay. 372 00:22:23,270 --> 00:22:24,270 Yeah. 373 00:22:24,470 --> 00:22:28,190 It should feel smooth. Yeah. And tight. 374 00:22:28,530 --> 00:22:29,349 It is. 375 00:22:29,350 --> 00:22:35,870 If it's bumpy anywhere or if there's, you know, a crevice or a crack, that 376 00:22:35,870 --> 00:22:42,330 be a cause of pain. It could be an injury to the rectum. Oh, well. Do you 377 00:22:42,330 --> 00:22:43,329 anything in that way? 378 00:22:43,330 --> 00:22:44,330 No. None of those. 379 00:22:44,910 --> 00:22:47,390 No cracks, no micro tears, no bumps. 380 00:22:48,040 --> 00:22:49,040 Wonderful. 381 00:22:49,140 --> 00:22:50,180 So it's in good shape? 382 00:22:50,380 --> 00:22:54,000 Yes. Okay. Well, make sure that the rest of your finger's lubed up. 383 00:22:54,560 --> 00:22:55,560 Okay. 384 00:22:57,640 --> 00:22:59,420 You want to put more lube on the same finger. 385 00:23:03,760 --> 00:23:04,900 You're doing great, David. 386 00:23:06,000 --> 00:23:06,959 Thank you. 387 00:23:06,960 --> 00:23:11,060 That's the fingers lubed up. 388 00:23:12,060 --> 00:23:13,060 Are you ready? 389 00:23:13,260 --> 00:23:14,260 Mm -hmm. 390 00:23:14,590 --> 00:23:20,750 you're doing just parked at the entrance and it's going in okay perfect 391 00:23:20,750 --> 00:23:26,690 oh wow okay doing great now you want to go a little bit deeper this time because 392 00:23:26,690 --> 00:23:32,490 the o -ring is about about an inch wide oh and the tip of your finger is only 393 00:23:32,490 --> 00:23:37,650 going to feel the very initial entry of that area so you need to put more of 394 00:23:37,650 --> 00:23:39,350 your finger in there would you like 395 00:23:42,060 --> 00:23:44,740 You're great. You're totally good. Oh. They're good. Oh, wow. 396 00:23:44,960 --> 00:23:45,960 Huh. Interesting. 397 00:23:46,320 --> 00:23:47,320 Right. 398 00:23:47,520 --> 00:23:49,520 Do you feel anything unusual in the area? 399 00:23:50,040 --> 00:23:53,660 No, I don't. It is exactly as you described. 400 00:23:54,120 --> 00:23:55,120 Mm -hmm. 401 00:23:55,140 --> 00:23:56,420 Well, see, this feels good. 402 00:23:56,780 --> 00:23:57,800 No, not bad at all. 403 00:23:58,080 --> 00:24:01,880 Now, you really want to reach in there, so go ahead and push the thing all the 404 00:24:01,880 --> 00:24:02,399 way in. 405 00:24:02,400 --> 00:24:04,460 Okay. As far as you can get it. 406 00:24:04,760 --> 00:24:05,760 Uh -huh. 407 00:24:06,160 --> 00:24:07,160 Oh. 408 00:24:07,820 --> 00:24:10,460 Oh. See, now, areas of concern. 409 00:24:11,500 --> 00:24:15,880 are actually a little bit higher than that. Is your finger all the way in like 410 00:24:15,880 --> 00:24:19,100 that? Oh, it's all the way in there. I'm at my knuckles. 411 00:24:19,880 --> 00:24:21,200 Oh, okay. 412 00:24:22,380 --> 00:24:29,180 Well, you've got to get up in there because there could be 413 00:24:29,180 --> 00:24:30,980 injuries to the intestines. 414 00:24:32,040 --> 00:24:33,040 Yeah, 415 00:24:34,600 --> 00:24:35,820 this is as far as he's going. 416 00:24:37,200 --> 00:24:38,880 All right, go ahead and remove your finger. 417 00:24:39,400 --> 00:24:41,640 Take off your gloves. 418 00:24:42,440 --> 00:24:45,120 And you're going to throw that out. Always change clothes. Remember, 419 00:24:47,140 --> 00:24:53,140 Now, you have options, of course. You've got a patient, and you really need to 420 00:24:53,140 --> 00:24:55,800 get this manual examination complete. 421 00:24:56,160 --> 00:25:00,180 Or you could leave thumbs unturned. That could hide very serious issues. 422 00:25:02,480 --> 00:25:05,460 Unfortunately, you have... 423 00:25:05,710 --> 00:25:11,570 really beautiful hands, Doctor, but the areas that need to be examined are 424 00:25:11,570 --> 00:25:14,190 farther away than what your hands will allow. 425 00:25:14,970 --> 00:25:21,750 Yeah, so we need to examine deeper in order for me to be sure 426 00:25:21,750 --> 00:25:24,430 that there are no problems happening. 427 00:25:24,950 --> 00:25:27,470 I might have just torn them up. We don't know. 428 00:25:27,770 --> 00:25:29,990 So here's what we're going to do. 429 00:25:30,650 --> 00:25:36,580 Since your hands aren't big enough, and we don't have any any tools with us, 430 00:25:36,640 --> 00:25:43,320 you've got to feel around in there. So I'm going to tap on your dick and I'm 431 00:25:43,320 --> 00:25:44,320 going to get it wet. 432 00:25:44,760 --> 00:25:51,480 And then you are going to feel around my rectum and my intestines with your 433 00:25:51,480 --> 00:25:52,480 cock. 434 00:25:53,120 --> 00:25:56,520 And this way we can be absolutely sure that everything is okay. 435 00:25:57,580 --> 00:25:58,580 I think it'll work out. 436 00:25:59,240 --> 00:26:03,140 I'm okay with the static pregnancy if you want. Sure, sure. I mean, what other 437 00:26:03,140 --> 00:26:04,200 way are you going to find out, right? 438 00:26:04,720 --> 00:26:10,340 Okay, so, um, you just be, uh, all right, well, I suppose you've just got 439 00:26:10,340 --> 00:26:13,880 pull that thing out. I mean, after all, I can't, like, predict through the 440 00:26:13,880 --> 00:26:14,880 pants. 441 00:26:15,780 --> 00:26:17,040 Okay. Mm -hmm. 442 00:26:17,800 --> 00:26:19,020 That's... Sorry. 443 00:26:19,380 --> 00:26:23,420 I didn't even know we actually needed to be evac'd in order for me to, um, 444 00:26:23,420 --> 00:26:24,420 insert it. 445 00:26:25,080 --> 00:26:29,280 Well, for you to insert it, I mean, this is all you need. I'll just put, I'll 446 00:26:29,280 --> 00:26:29,879 just relax. 447 00:26:29,880 --> 00:26:30,739 I'll just relax. 448 00:26:30,740 --> 00:26:31,740 I'm still nervous. 449 00:26:31,840 --> 00:26:32,840 No. Oh. 450 00:26:33,320 --> 00:26:35,590 Oh. Your anatomy doesn't work. 451 00:26:36,390 --> 00:26:40,330 No, no, it doesn't work. We need it to work so we can, oh yeah, that's 452 00:26:40,330 --> 00:26:41,330 definitely going to reach. 453 00:26:41,750 --> 00:26:45,750 Okay, so what we need to do is we need to make sure that it's nice and lared 454 00:26:45,830 --> 00:26:46,970 Otherwise, it's going to hurt. 455 00:26:47,590 --> 00:26:49,590 And, you know, you don't want to get a shoe wet. 456 00:27:10,890 --> 00:27:11,910 Yeah, that would agree. 457 00:27:12,130 --> 00:27:15,990 That's a great practical study moment. 458 00:27:16,270 --> 00:27:20,270 I mean, you know, I've got really heavy tits, but I can't imagine how heavy the 459 00:27:20,270 --> 00:27:23,690 appendage is. I mean, no wonder you walk funny. 460 00:27:26,590 --> 00:27:29,030 Well, I do walk on my toes, so... 461 00:27:49,820 --> 00:27:52,980 It's really important to make sure all of the skin on the appendage is 462 00:27:52,980 --> 00:27:54,660 lubricated. 463 00:27:55,500 --> 00:27:59,040 This way we don't have any abrasions on you while you're doing my internal 464 00:27:59,040 --> 00:28:00,040 examination. 465 00:28:02,600 --> 00:28:05,380 Well, I mean, that's important. 466 00:28:05,680 --> 00:28:06,960 You know we learn as we go, right? 467 00:28:07,220 --> 00:28:08,220 Yeah. 468 00:28:08,620 --> 00:28:10,280 Yeah, I'll tell you what. 469 00:28:10,860 --> 00:28:16,720 The last person that I tutored, he couldn't make it. He was having trouble 470 00:28:16,720 --> 00:28:20,820 staying focused the whole time. So I really appreciate your professionalism, 471 00:28:20,820 --> 00:28:22,680 Doctor. Very kind of you. 472 00:29:06,550 --> 00:29:13,250 Oh, yeah, you're definitely more than any rep you uh to complete the 473 00:29:13,250 --> 00:29:19,990 examination And you definitely are you definitely are lubricated 474 00:29:54,279 --> 00:29:59,760 Well doctor, I think as 475 00:29:59,760 --> 00:30:03,960 long as your examiner 476 00:30:05,080 --> 00:30:06,680 As a woman, she's going to be alright. 477 00:30:07,240 --> 00:30:13,780 We'll definitely take this into account. 478 00:30:43,600 --> 00:30:45,780 It's always important to keep that particular side warm. 479 00:30:46,380 --> 00:30:53,380 I understand. I'm going to... Oh my 480 00:30:53,380 --> 00:30:55,400 gosh. 481 00:30:56,160 --> 00:30:57,660 I'm glad I can be of service. 482 00:31:21,390 --> 00:31:22,790 So what do you think? 483 00:31:23,230 --> 00:31:24,209 You're ready. 484 00:31:24,210 --> 00:31:28,270 How would you like to examine the prostate? 485 00:31:28,830 --> 00:31:34,830 Well, patients always feel more comfortable when they're relaxed, and I 486 00:31:34,830 --> 00:31:40,630 beginning the examination with me on my back would be good practice for you. 487 00:31:45,110 --> 00:31:46,990 You're just going to have to take all that off. 488 00:31:47,250 --> 00:31:48,300 Okay. Mm -hmm. 489 00:31:49,160 --> 00:31:51,340 Oh, don't you worry. Everything's going to be just fine. 490 00:31:52,140 --> 00:31:53,760 This is done all the time. 491 00:31:55,260 --> 00:31:58,180 Oh, this is totally normal. 492 00:31:58,400 --> 00:32:00,100 This is actually part of your final exam. 493 00:32:01,100 --> 00:32:06,100 I mean, you know, you don't think all the angry women would look so happy on 494 00:32:06,100 --> 00:32:07,100 test day, do you? 495 00:32:07,500 --> 00:32:08,500 My goodness. 496 00:32:08,660 --> 00:32:09,860 Okay, here we go. 497 00:32:11,260 --> 00:32:13,060 You just put that right there. 498 00:32:16,240 --> 00:32:17,240 Nice and easy. 499 00:32:17,560 --> 00:32:20,200 Yeah, if you just shove it in there, you're going to get a shoot of the head. 500 00:32:22,760 --> 00:32:23,760 There you go. 501 00:32:25,240 --> 00:32:27,340 There you go. 502 00:32:30,240 --> 00:32:33,800 You just, yeah, you want to really take your time about it. 503 00:32:34,240 --> 00:32:38,940 Make sure that your patient is comfortable with the exam that you're 504 00:32:43,480 --> 00:32:44,480 How's that feel? 505 00:32:45,480 --> 00:32:45,799 That's fine. 506 00:32:45,800 --> 00:32:46,800 That's just fine. 507 00:32:47,420 --> 00:32:52,560 You want to take your time. You want to get in there and really do as many 508 00:32:52,560 --> 00:32:56,180 repetitions as you can to feel every last bit. 509 00:32:56,740 --> 00:32:57,900 You don't want to miss anything. 510 00:32:58,980 --> 00:33:01,660 I'm not missing anything. I feel everything. 511 00:33:02,320 --> 00:33:03,299 Oh, that's good. 512 00:33:03,300 --> 00:33:04,680 You're doing good, doctor. You're doing good. 513 00:33:08,780 --> 00:33:11,180 Nice and easy. Like a walk in the park. 514 00:33:14,780 --> 00:33:21,220 Very different from a walk in the park, but oh It's great But 515 00:33:21,220 --> 00:33:25,340 you're also analyzing area at the same time right yeah, okay? 516 00:33:25,700 --> 00:33:30,040 Yeah, now. We're going to need you to remove your top because that's going to 517 00:33:30,040 --> 00:33:36,680 get in the way of this of the mechanics of this analysis, yeah You don't want 518 00:33:36,680 --> 00:33:37,880 your shirt to block your view 519 00:33:44,360 --> 00:33:45,319 How does that feel? 520 00:33:45,320 --> 00:33:47,300 That feels nice and deep, doctor. Okay. 521 00:33:48,000 --> 00:33:51,240 Now, while you're in there nice and deep, do you notice anything unusual? 522 00:33:52,500 --> 00:33:56,120 Oh, uh... No. 523 00:33:56,380 --> 00:33:58,280 They're healthy indeed. 524 00:33:58,800 --> 00:33:59,800 What? 525 00:34:00,140 --> 00:34:04,180 Well, we're going to need to do many repetitions of this exam just to make 526 00:34:04,180 --> 00:34:08,000 that you didn't miss anything. There's a large area inside that needs to be 527 00:34:08,000 --> 00:34:10,120 manipulated. Okay. 528 00:34:10,780 --> 00:34:13,280 Lots of repetitions. 529 00:34:13,690 --> 00:34:15,270 Faster or same speed? 530 00:34:15,489 --> 00:34:18,110 This is just, yeah, you're doing great. 531 00:34:19,610 --> 00:34:21,610 See, this isn't weird at all, is it? 532 00:34:22,290 --> 00:34:24,610 No, no, this is a great story question. 533 00:34:25,290 --> 00:34:27,310 Oh. There you go. 534 00:34:28,429 --> 00:34:29,429 Hmm. 535 00:34:32,850 --> 00:34:33,850 Oh. 536 00:34:34,590 --> 00:34:37,510 Well, it's definitely going to take your mind off your stress, that's for sure. 537 00:34:37,989 --> 00:34:41,510 Stress is late and non -existent. There you go. 538 00:34:42,879 --> 00:34:46,320 Just be sure to do this when you go into the examination or tomorrow. 539 00:34:47,400 --> 00:34:48,400 Oh, I see. 540 00:34:48,920 --> 00:34:50,360 Well, okay. 541 00:34:50,639 --> 00:34:51,699 Will you be there tomorrow? 542 00:34:52,320 --> 00:34:56,120 I don't know. I'm not giving a test, but, you know, Mrs. Smith is going to be 543 00:34:56,120 --> 00:34:56,879 giving a test. 544 00:34:56,880 --> 00:34:58,860 You're going to have to start with it. You know how to do this. 545 00:34:59,520 --> 00:35:01,760 Okay. I will show Mrs. Smith. 546 00:35:10,670 --> 00:35:16,810 At some point, if you identify pain and swelling, you can administer 547 00:35:16,810 --> 00:35:20,450 treatment directly to that area. 548 00:35:21,010 --> 00:35:22,010 Oh, okay. 549 00:35:22,950 --> 00:35:24,310 We'll get into that later. 550 00:35:25,330 --> 00:35:32,230 Right now, we need to make sure that you've got the whole area under your 551 00:36:04,310 --> 00:36:06,730 You've got such a strong mannerism. 552 00:36:08,250 --> 00:36:09,830 Thank you. 553 00:36:10,870 --> 00:36:11,990 You're doing a great job. 554 00:36:12,210 --> 00:36:13,230 Just keep going. 555 00:36:13,470 --> 00:36:14,470 Just keep going. 556 00:36:28,940 --> 00:36:31,400 Reactions to your exam are perfectly normal as well. 557 00:36:31,680 --> 00:36:37,260 That doesn't mean that you're hurting. It just means that you're reaching spots 558 00:36:37,260 --> 00:36:40,160 that normally aren't touched or bothered. 559 00:36:40,440 --> 00:36:46,080 So you want to make sure to repeat these repetitions often. 560 00:36:46,860 --> 00:36:47,860 Often. 561 00:36:53,560 --> 00:36:54,560 It's very good. 562 00:36:55,800 --> 00:36:57,860 It's very, very good. You're doing a great job. 563 00:36:58,740 --> 00:37:02,220 I want you to pay attention to what it feels like. 564 00:37:02,620 --> 00:37:05,580 And remember to pay attention to the o -ring, too. 565 00:37:05,980 --> 00:37:08,760 Oh, I certainly am. How snug it is. Uh -huh. 566 00:37:09,520 --> 00:37:15,620 Because there are going to be fluctuations that might get tighter 567 00:37:15,620 --> 00:37:16,620 you the deeper you go. 568 00:37:17,120 --> 00:37:21,080 Oh. You're going to squeeze your appendage there. 569 00:37:28,750 --> 00:37:33,730 Now there's certain nerve senses in that area that your female patients are 570 00:37:33,730 --> 00:37:34,730 really going to love. 571 00:37:36,350 --> 00:37:41,170 Now this reaction is totally normal, and even a good sign that you're doing the 572 00:37:41,170 --> 00:37:42,770 exam the proper way. 573 00:37:47,810 --> 00:37:51,670 And you are certainly hitting the right nerve. 574 00:37:53,090 --> 00:37:54,910 Just keep doing what you're doing. 575 00:37:56,870 --> 00:37:57,870 Got it. 576 00:38:00,010 --> 00:38:03,710 I know he might even relieve the pain without a need for treatment. 577 00:38:04,330 --> 00:38:08,310 Well, that would be the best doctor's appointment ever. 578 00:38:08,630 --> 00:38:09,488 Oh, yeah. 579 00:38:09,490 --> 00:38:10,490 Oh. 580 00:38:11,050 --> 00:38:12,050 Oh. 581 00:38:12,650 --> 00:38:14,710 Oh. Oh. 582 00:38:15,110 --> 00:38:16,110 Oh. 583 00:38:17,270 --> 00:38:19,190 Excellent. Excellent procedure. 584 00:38:19,710 --> 00:38:21,550 Oh. Oh. 585 00:38:22,530 --> 00:38:24,130 Oh. Oh. 586 00:38:24,590 --> 00:38:25,590 Oh. 587 00:38:41,580 --> 00:38:43,740 look like the end of tomorrow for me? Of course. 588 00:38:44,800 --> 00:38:49,820 She's very, very difficult, though. She insists on details. 589 00:38:51,300 --> 00:38:52,300 Yeah. 590 00:38:53,240 --> 00:38:58,620 You are going to need to be very thorough with her, and I anticipate that 591 00:38:58,620 --> 00:39:03,000 though your exam right now is wonderful, she's much taller than me, you might 592 00:39:03,000 --> 00:39:04,000 have to use your whole arm. 593 00:39:04,520 --> 00:39:05,960 Understood. Yeah. Okay. 594 00:39:06,200 --> 00:39:07,158 Just be gentle. 595 00:39:07,160 --> 00:39:08,160 I'll be. 596 00:39:08,620 --> 00:39:11,930 Now, you want to slow it down a little bit, Doctor, because We don't want to 597 00:39:11,930 --> 00:39:13,230 miss anything around the side. 598 00:39:14,150 --> 00:39:16,510 Take your time with it. 599 00:39:19,830 --> 00:39:25,250 Now are you paying attention to the texture along the surface? 600 00:39:27,270 --> 00:39:31,770 Lots of times when you're going to examine women, you're going to have to 601 00:39:31,770 --> 00:39:33,190 to see with your sense of touch. 602 00:39:34,230 --> 00:39:36,690 Very important for things you can't see with your eyes. 603 00:39:43,400 --> 00:39:44,540 You're doing a great job. 604 00:39:45,660 --> 00:39:46,660 Thank you. 605 00:39:46,780 --> 00:39:47,920 I'm a great tutor. 606 00:39:49,940 --> 00:39:51,720 I do it as a side hustle. 607 00:39:52,260 --> 00:39:58,560 You know, every Tuesday and Thursday night, I attend to two young male 608 00:39:58,560 --> 00:40:00,900 who are having trouble with their technique. 609 00:40:03,120 --> 00:40:04,800 Haven't received a bad review yet? 610 00:40:05,340 --> 00:40:07,540 No, I can't imagine why you would. 611 00:40:10,300 --> 00:40:11,320 Oh, fantastic. 612 00:40:13,610 --> 00:40:19,630 Very nice. Now, you know, just be sure that you do an absolutely complete 613 00:40:19,630 --> 00:40:26,550 examination. You need to change your angles of approach just because you 614 00:40:26,550 --> 00:40:29,010 don't want to miss anything on the opposite side. 615 00:40:29,330 --> 00:40:33,970 So you want to get a feeling for the sensation all the way around on the 616 00:40:33,970 --> 00:40:34,729 of the body. 617 00:40:34,730 --> 00:40:35,730 Okay. 618 00:40:36,450 --> 00:40:41,110 Okay, so you relax. I'm going to turn over. 619 00:40:41,550 --> 00:40:46,070 and you are going to, you're going to approach me from a different angle. This 620 00:40:46,070 --> 00:40:50,030 way, the skin of your appendage is going to touch different contact points. 621 00:40:50,710 --> 00:40:51,710 All right. 622 00:40:53,350 --> 00:40:54,390 Right through there. 623 00:40:54,750 --> 00:40:57,250 There you go, doctor. You got that. 624 00:40:58,810 --> 00:40:59,810 Perfect. 625 00:41:00,710 --> 00:41:06,050 Perfect. Now, again, taking your time to feel all of the areas around it. The 626 00:41:06,050 --> 00:41:07,870 sensation is just slightly different. 627 00:41:08,110 --> 00:41:09,110 Yeah. 628 00:41:11,550 --> 00:41:12,529 Very good. 629 00:41:12,530 --> 00:41:18,510 Oh, wow. And how the o -ring of the ant is, you know. 630 00:41:19,490 --> 00:41:21,850 Oh, that's very nice. 631 00:41:22,330 --> 00:41:23,930 It's hugging you. 632 00:41:25,650 --> 00:41:26,790 That's exactly right. 633 00:41:31,250 --> 00:41:34,610 There you go. 634 00:41:37,050 --> 00:41:38,610 Now, I'm going to help you with this. 635 00:41:41,770 --> 00:41:48,690 I'm going to help you with this by motioning back and forth 636 00:41:48,690 --> 00:41:51,870 myself, just to give you an idea of where you need to be. 637 00:41:55,070 --> 00:41:56,070 Beautiful. 638 00:41:57,730 --> 00:41:59,090 That is very nice. 639 00:42:01,250 --> 00:42:04,230 You're getting the hang of it. I really have a lot of respect for how quickly 640 00:42:04,230 --> 00:42:05,230 you're learning. 641 00:42:06,850 --> 00:42:07,850 Perfect. 642 00:42:11,650 --> 00:42:12,870 Repetition is very important. 643 00:42:13,210 --> 00:42:15,450 So you go ahead and do as many as you can. 644 00:42:20,390 --> 00:42:21,390 That's great. 645 00:42:22,030 --> 00:42:23,150 Yeah, keep doing that. 646 00:42:25,970 --> 00:42:26,970 Again, 647 00:42:28,490 --> 00:42:30,710 you're reaching as far as you can. 648 00:42:32,630 --> 00:42:33,630 That's very deep. 649 00:42:34,210 --> 00:42:35,710 That is very, very deep. 650 00:42:43,440 --> 00:42:45,880 Now, are you getting a thorough idea? 651 00:42:46,260 --> 00:42:52,600 I want you to sense with your cock all the surfaces that you're touching 652 00:42:52,600 --> 00:42:57,160 by stroking back and forth. Oh, yes. 653 00:42:57,760 --> 00:43:02,180 Before we determine a proper course of treatment, if any is necessary. 654 00:43:06,640 --> 00:43:10,080 No need for suppository or thermometers just yet? 655 00:43:10,280 --> 00:43:11,280 Not just yet. 656 00:43:14,120 --> 00:43:16,440 But this internal massage is doing wonders. 657 00:43:16,700 --> 00:43:18,940 I mean, it's already loosening everything up. 658 00:43:21,840 --> 00:43:22,840 Oh, 659 00:43:24,380 --> 00:43:25,380 now see, that's great. 660 00:43:26,060 --> 00:43:30,220 Now there is a pressure point behind the female anatomy and sexual reproductive 661 00:43:30,220 --> 00:43:31,220 organs. 662 00:43:31,920 --> 00:43:36,820 Oh, that is just going to make your patient so, so giddy with you. 663 00:43:37,360 --> 00:43:41,000 And you were just tapping on that nerve for me. I appreciate that. 664 00:43:44,240 --> 00:43:46,320 You really are an overachiever, aren't you, Doctor? 665 00:43:46,620 --> 00:43:47,880 Well, hold on one second, please. 666 00:43:52,060 --> 00:43:54,720 This is great. 667 00:44:01,060 --> 00:44:06,400 We're just going to keep repeating that same manner. 668 00:44:11,950 --> 00:44:13,890 You've determined with absolute certainty. 669 00:44:14,390 --> 00:44:15,110 Oh, 670 00:44:15,110 --> 00:44:24,770 you 671 00:44:24,770 --> 00:44:29,490 are nailing it. 672 00:44:30,090 --> 00:44:32,970 Oh, your technique is just sort of perfect. 673 00:44:33,450 --> 00:44:36,730 Oh, my goodness. 674 00:44:39,750 --> 00:44:41,130 Oh, very nice. 675 00:44:44,490 --> 00:44:46,250 because there's a thousand that needs to happen. 676 00:44:46,650 --> 00:44:50,950 But I'll tell you what, we can definitely approach a different angle. 677 00:44:51,650 --> 00:44:52,650 Yes. 678 00:44:55,630 --> 00:45:01,950 Now, I'm going to need your support here because my 679 00:45:01,950 --> 00:45:06,070 breaths are very heavy and you don't want to hurt my back further than when 680 00:45:06,070 --> 00:45:07,670 already been hurt, right? 681 00:45:09,450 --> 00:45:12,430 Oh, my. 682 00:45:13,050 --> 00:45:14,050 Oh, yeah. 683 00:45:14,960 --> 00:45:19,500 This is by far the most effective technique, short of the last one that 684 00:45:19,500 --> 00:45:20,500 going to do. 685 00:45:21,780 --> 00:45:22,780 See, 686 00:45:25,500 --> 00:45:27,360 this is highly effective. 687 00:45:27,900 --> 00:45:33,420 You are really, really penetrating deep and you're getting a much clearer view. 688 00:45:47,180 --> 00:45:50,600 Man, I'm actually impressed by how strong your cock is right now. 689 00:45:52,400 --> 00:45:55,880 Most students don't make it this far into the tutoring session with me. 690 00:45:56,100 --> 00:45:59,320 Really? Oh, man. You are really something. 691 00:46:00,060 --> 00:46:04,980 Your stamina and your strength is not like anything I've ever seen before. 692 00:46:07,100 --> 00:46:09,680 Oh, yeah. 693 00:46:10,540 --> 00:46:13,900 I've been breathing this entire time. 694 00:46:32,299 --> 00:46:35,100 Thank you. 695 00:46:35,300 --> 00:46:38,860 Yes. Oh, yeah. 696 00:48:07,570 --> 00:48:12,550 extra final measure of investigation is going to be necessary. 697 00:48:13,990 --> 00:48:20,550 Well, there is one or two positions that 698 00:48:20,550 --> 00:48:25,470 are going to be essential. 699 00:48:25,970 --> 00:48:27,050 Absolutely essential. 700 00:48:27,450 --> 00:48:33,710 So I think by now we are going to need you to 701 00:48:33,710 --> 00:48:36,230 administer your recommendation. 702 00:48:37,700 --> 00:48:43,340 And whatever course of treatment you are ready to provide. 703 00:48:51,320 --> 00:48:52,138 Oh, 704 00:48:52,140 --> 00:48:59,000 that's nice. 705 00:48:59,740 --> 00:49:01,620 You want to take it nice and easy. 706 00:49:06,800 --> 00:49:11,020 Yeah, this is the angle. It hides nothing. 707 00:49:11,300 --> 00:49:13,960 There are going to be no questions left after this. 708 00:49:19,060 --> 00:49:19,779 Oh, 709 00:49:19,780 --> 00:49:30,860 yeah. 710 00:49:32,940 --> 00:49:34,560 Homeopathic medicine is the best. 711 00:49:35,180 --> 00:49:36,980 Of course, the treatment for the body. 712 00:49:37,260 --> 00:49:39,940 Oh, I agree with you on this one. 713 00:49:40,180 --> 00:49:44,460 Of course, you'll make a lot more money if you just do what all the medicinal 714 00:49:44,460 --> 00:49:51,020 companies tell you to do, but naturally the... Well, it comes and goes, but 715 00:49:51,020 --> 00:49:55,140 this is... Oh, it definitely comes and goes. 716 00:49:56,120 --> 00:50:00,380 Oh, yeah. 717 00:50:01,740 --> 00:50:07,280 If you can find a way to... treat this inflammation without including any 718 00:50:07,280 --> 00:50:14,220 narcotic or chemical, that would be the safest, and it tends to 719 00:50:14,220 --> 00:50:15,700 be the most effective course of treatment. 720 00:50:19,020 --> 00:50:20,480 And leave costly? 721 00:50:21,100 --> 00:50:22,420 Sometimes even free. 722 00:51:28,330 --> 00:51:29,169 stitch effort. 723 00:51:29,170 --> 00:51:34,390 Yeah. And if you can manage to get that treatment all the way into that back 724 00:51:34,390 --> 00:51:35,910 area, I think it would be alright. 725 00:51:37,830 --> 00:51:44,750 I think I have an idea. It may not be from the same position, but 726 00:51:44,750 --> 00:51:48,230 I think we can go for that last stitch effort. Oh, that's wonderful, because I 727 00:51:48,230 --> 00:51:52,650 would really like to get on with what I need to do today. 728 00:52:12,330 --> 00:52:13,330 Nice and deep. 729 00:52:14,470 --> 00:52:18,170 I want it to be really deep. Make sure you get the treatment all the way in 730 00:52:18,170 --> 00:52:19,170 there. 731 00:52:24,310 --> 00:52:25,310 That's perfect. 732 00:52:28,210 --> 00:52:29,770 I feel good at this. 733 00:52:30,050 --> 00:52:31,870 Can you tell me you haven't done this before? 734 00:53:02,220 --> 00:53:03,380 Nice and hard. 735 00:53:04,180 --> 00:53:05,180 You can do it. 736 00:53:06,320 --> 00:53:08,180 You can give it to me hard. 737 00:53:10,780 --> 00:53:11,780 I'm getting close. 738 00:53:17,320 --> 00:53:18,320 I'm coming. 739 00:53:51,150 --> 00:53:52,150 started 10 minutes ago. 740 00:53:52,470 --> 00:53:58,270 Oh, I'm not worried about it. I'll eat that now. I won't be on my way. Tell 741 00:53:58,350 --> 00:53:59,350 Smith I said hi. 742 00:53:59,490 --> 00:54:00,490 Oh, I said hi. 743 00:54:00,550 --> 00:54:01,348 Thank you. 744 00:54:01,350 --> 00:54:02,350 Cranky old bitch. 56828

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