McKenna’s Insurance Exam

It all started in my senior year of high school, shortly after my 18th birthday.

I was alone in the house, as my parents had gone out.

Bored, I began looking through the book shelves.

“Women’s Health: A Nursing Guide”

I froze. I somehow felt compelled to look.

And there towards the middle of the book, I saw it.

A series of drawings of a woman, spread open in stirrups getting a pelvic exam from male doctor.

However, before I had more opportunity to contemplate it, I heard my parents’ car in the driveway.

I quickly closed the book, put it back in the book shelf, and quickly picked up another book and sat down in the chair with it just as my parents came through the door.

Those images have stayed with me since that time.

I tried pre-med in college, but found my talents lay in other fields of endeavor.

I achieved great academic, professional, and financial success, even founding and becoming the CEO of my own company, but deep inside there was this pull created by my memories of those drawings in my mom’s book.

The full exposure, the embarrassment, yet at the same time the complete social acceptability of the whole thing aroused intense feelings in me.

This continued for many years, and then the best thing in my life happened to me.

I married McKenna.

She is everything I could have ever wanted in a woman. She is beautiful enough to be a model. Her face with her red hair, alabaster skin, and piercing blue eyes is stunning.

Sometimes if she is reading or working on the computer, I find myself almost hypnotized just staring at her face.

And she has a great body to match. She is into fitness and her body is just the right mix of hard muscle and soft curves.

Oh, and she loves cooking and is really good at it!

However, the quality I appreciate the most is how she loves me and would do anything for me.

She would let me go to all her doctor exams, but, initially did not know how much that turned me on seeing her get examined (though to be honest, my position, and the sheet actually blocked a lot of my view).

One day I found the courage to tell her that I found watching her exams exciting.

She never mentioned anything, but then, out of the blue, at one of her exams, she told the nurse that she did not want the sheet as it blocked her view and made it feel like she was not in control of her exam!

My view of her exam got much better!

My heart would pound as I watched the male doctor touching and squeezing her breasts. And then he would pull out the stirrups with a loud clanking sound. My wife would willingly scoot herself down and open herself up to his (and my) gaze as her most private womanly parts were all on display. Then he would touch her genitalia and put his fingers in her vagina!

My wife, despite having such a wonderful body, is actually a modest and shy person. I knew she did not enjoy these exams, and in fact was very embarrassed by them. However, she knew I enjoyed them and so she did them for me.

But still I wanted more. I wanted an even more thorough and embarrassing exam for my wife.

Yet I also wanted it to be discreet and safe.

Eventually, I found someone – a real doctor with a wonderful imagination who understood my interest.

“Has your wife had any recent minor trauma such as a fall or anything like that left her sore?” he asked me.

“Well, recently, when we were flying cross-country, we hit some air turbulence and afterward she complained of some back and neck pain,” I replied.

“How is she now?”

“Well, I got her some heating pads and sent her to some massage therapy and she is all better now.”

“Perfect. Listen closely, here is our plan.”

Together we made a plan.

I was to take my wife to a business conference where I was a presenter. We were to stay in a 5 star hotel. I would receive a phone call purportedly from my insurance company, and I was to make sure my wife could hear my end of the conversation. We would then set up for him to visit our hotel room the next day to do the exam.

A few weeks later, my wife and I were staying at a 5 star hotel for a business conference when I got a phone call. My wife was in the room and could hear my side of the conversion.

“Hello.”

“Ok.”

“What?”

“I am about to make a very important business presentation the day after tomorrow. That will be impossible.”

“Lose my insurance coverage? Listen, I have been with your company for years. Isn’t there anything you can do for me?”

“Thank you very much. I appreciate you doing it for me.”

I saw my wife looking quizzically at me.

“Can you believe it, McKenna? It was our company’s insurance underwriter. When you hurt your back and neck on the airplane, I filed a claim for them to pay for your heating pad and massage therapy. They called me and told me that this changed their risk profile for you and they needed to do a more thorough evaluation. They said you needed to go to one of their approved physicians for the re-eval. But there aren’t any in this area”

“Oh, no. What about your business presentation this week?” my wife asked me.

“I told them that, and they said that since I had been a loyal customer for such a long time, they would send someone out tomorrow.”

“I am glad it is working out.”

“Yeah me too. Insurance is already such a large expense for us, and if we had to find a new company in this economic situation, we would end up paying a lot more. It could affect the viability of our business.”

As I said before, my wife loves me and would do anything for me. I knew she would do what the insurance doctor asked her.

That night I could hardly sleep. It was like trying to fall asleep on Christmas Eve! Except, it would not be me but the doctor who would be unwrapping and seeing the most wonderful of presents!

The next morning there was a knock on the hotel door.

My wife went to the door and opened it to let in a man wearing a white coat.

“Hello, I am Dr. Braxton and I work with your insurance company.”

“And you must be McKenna?” he said looking at my wife.

She nodded.

“We have been expecting you, please come in.”

He stepped in and then called through the open door into the hotel hallway.

“You can bring it in here, Paul.”

At that, a young hotel bellman came in carrying a large suitcase.

“I just have some supplies here with me and I am also required to have a third-party witness for my examinations. I hope you understand. The nice thing about these high end hotels is that people can be expected to be discreet. Paul here agreed to help with my things and serve as a witness. He understands the HIPAA requirements, so you don’t have to worry.”

My wife and I nodded. I could see my wife, who was already wondering what the examination would entail, seemed nervous about having the young bellman watch everything.

Dr. Braxton then turned to me.

“Bob, our policy is that these examinations must be audio and video recorded. The person you spoke with yesterday told me that you were aware of this requirement and that you agreed to do the recording?”

I nodded. “I will record with my phone.”

“Excellent.”

“Now, also the policy is that once the examination starts, until it ends, the examinee needs to be recorded by Bob and witnessed by me and Paul the entire time. So if there is anything you want to do privately before we start, now is the time to do it, McKenna.”

McKenna blushed a little and asked to use the restroom before we started.

She went into the bathroom in the room and closed the door.

A minute later we heard a flush and she came out.

She seemed a little embarrassed. She seemed especially nervous about the presence of the bellman, but did not say anything.

While she had been in the bathroom, Dr. Braxton had had Paul open the suitcase and had taken some medical supplies.

“Ok, we will start now. Bob, do you have plenty of storage and battery charge on your phone?” I nodded.

“Are you all set McKenna? Once we start we cannot interrupt?”

She nodded.

Dr. Braxton motioned for her to sit on the bed.

“Paul, you understand you are to witness everything. That means you must at all times be proactive in trying to see everything I am doing with McKenna. In addition, as per HIPAA, you are not to discuss anything that occurs in this room with anyone outside of it. Do you understand?”

“Yes, sir.”

“3. 2. 1. Go!” he said, looking at me. I started recording.

“Hi, I am Dr. Braxton, and I am here at the behest of your insurance company.”

“The company is at the forefront of innovation in the insurance industry. Many people think that insurance companies make money by just subtracting premiums from payouts. However, that is not the case. Insurance companies actually make money, by taking premiums, investing them, and then using that to pay the payouts. By carefully knowing and managing risk, an insurance company can keep the correct amount invested and the correct cash on hand to cover payouts. By investing in precisely knowing risks, the company can keep insurance premiums much lower than other companies which are much less precise with their risks.”

“That is why, when there was concern for neck/back injury, it triggered our automated audit systems to require that a full neurological evaluation be given with a focus on things that could increase risk for neurological problems in the future.”

“I will take a thorough medical history, and conduct a detailed examination.”

“You are free at any time to refuse to answer a question or refuse a test or examination. However, be aware, that if you do that, the company will not be able to ascertain risk as precisely as we like, and it will result in the cancellation of your company’s policy. However, be assured that all information gleaned from this advance will be used for our general risk models and will not cause an increase in your premiums. Does that make sense?”

Dr. Braxton then proceeded to take a thorough medical history.

He was far more detailed than any of the doctors we had seen as part of her routine medical care.

He inquired about the injury and where specifically she had pain and any associated symptoms and things she did that made it better or worse.

Then he moved on to her general medical history asking about previous illnesses, surgeries, allergies, medications, and pregnancies and births.

He even asked about tobacco, alcohol, and drug use and about sexual activity.

McKenna seemed embarrassed answering some of these questions, especially in front of the young bellman, but knowing that this was vital to me and our company, she went through with it.

I watched her as she sat on the bed.

She had just the right amount of makeup to highlight her features without looking painted. She was wearing a casual dress, with a pearl necklace and matching pearl earrings.

She looked the picture of understated elegance.

If the medical history was this thorough, what would the exam be like!

I could feel the anticipation building inside me.

“Now we will start the examination.”

My ears perked up.

I could see McKenna becoming more nervous.

“We will start with the Mini Mental Status Exam.”

He then proceeded to ask various questions about the date and location, and had her do some simple drawings and memory tests.

“Very good. Now for your cranial nerve exam.”

“Please cover your right eye, and look at my nose.’

Once she had done that, he held up different numbers of fingers just at the edge of where her peripheral vision should be and had her tell him how many.

“Excellent.”

“Now, McKenna, without moving your head, follow my finger with your eyes.”

My wife moved her eyes to follow his fingers.

“Now, I am going to check your facial sensation. Tell me if both sides feel the same.”

He then lightly touched several areas on her face, comparing the left and right.

“Now, I am going to use pinpricks to check your sensation. Don’t worry, this won’t hurt.”

He then took out a new safety pin, opened it up, and lightly touched those same areas.

“Good. Now smile real big for me.”

“Excellent, now wrinkle your forehead.”

“Good, now puff out your cheeks.”

She did all those as requested.

“Now open your mouth, and say ‘ah'”

“I am going to touch the back of your throat to test your gag reflex.”

He gently touched one side and then the other with a long q-tip eliciting gag responses.

He then touched the side of her face.

“Keep me from turning your head.”

“Now the other way,” he said as he moved the other side of her face.

Then he put both hands on her shoulders.

“Now shrug your shoulders.”

“Perfect. Now stick out your tongue and move it from side to side.”

She did that.

I thought she looked so cute with her tongue sticking out.

“Excellent McKenna.”

“Everything so far seems healthy and normal with your mental state and cranial nerves.”

“Now I need to do a motor exam. And for that I need to visualize your body more fully.”

“McKenna, could you please please stand up and disrobe down to your underwear for me?”

She looked at me.

I just nodded, indicating that she needed to go along with what the insurance doctor was ordering.

She blushed a little, and slowly began to unbutton the buttons along the front of her dress.

Soon the entire dress was unbuttoned. McKenna took a quick look at Paul, and then at me.

Blushing once again, she slid the dress off her shoulders.

It slid down revealing her smooth body.

She was wearing matching black bra and panties.

Even though they covered probably more than most beach bikinis, she looked embarrassed and shy.

“McKenna, I want you to walk back and forth across the room so I can check your gait.”

With me recording her, my wife walked back and forth across the room. Her breasts and bottom jiggled slightly with each step.

“Very good. Now have a seat on the bed,” Dr. Braxton ordered.

“I am going to test your motor function.”

“Raise your arms against my hand,” he said as he pushed downward on her arms.

“Good, now pull me towards you,” he said, holding her hands.

“Now push me away.”

“Now squeeze my fingers as tight as you can,” he said, placing two of his fingers in her hand.

“Now spread your fingers apart and don’t let me push them together.”

Then he moved to her legs.

“Pull your knee up,” he said, pushing on her right knee.

Then he repeated it with the left knee.

“Straighten out your right leg, and don’t let me bend it”

“Now the other one.”

“Now pull your foot up, and don’t let me push it down.”

“Good, now push down with your foot like you are pushing the gas.”

“Excellent. Your motor exam is normal.”

“I am now going to check your reflexes.”

Dr. Braxton took his hammer and tapped on her arms, followed by her knees, and then her ankles.

He then scraped the back of the hammer along the bottom of her feet.

McKenna giggled as he did that.

“Ok, reflexes are normal. I am now going to check your sensation.”

“First light touch.”

He then proceeded to lightly touch his fingers along her arms and hands, her belly, thighs, legs and feet.

“Good, now pinprick.”

He repeated the same, but now using a new safety pin.

“Now, I need to do a breast exam. Please remove your bra for me?”

“What?!?” McKenna exclaimed.

“In women, breast cancer is responsible for a lot of brain and spine lesions. Thus, since you had back and neck pain, as part of the comprehensive evaluation, it is necessary to also do a full breast exam,” Dr. Braxton explained.

McKenna looked at Paul, and then at me with questioning eyes.

I nodded, indicating that she should go ahead.

As my wife reached her arms behind her to undo the clasp of the bra, I could feel my heart pounding in my chest anticipating the first exposure of her private parts to these men whom we had just met.

I looked over at Paul, the bellman. He looked mesmerized as he watched McKenna fumble with the bra snap.

McKenna unsnapped the bra and I saw the cups go slack. They slid forward exposing more and more of her white breast, and then the light pink areolas and then the darker pink nipples!

I saw that her nipples seemed to be harder than normal. Maybe it was the air conditioner, or else the fact they were being exposed to multiple strangers.

“Thank you McKenna. Now I am going to visually inspect your breasts. Please raise your hands above your head.”

She did as ordered, which caused her breasts to lift up and her nipples to point straight at us.

“Now, put your hands on your hips and flex your chest muscles.”

She again followed his instructions.

“Very good. Now lie back on the bed with your arms over your head. I am going to palpate for any masses.”

McKenna lay back as ordered, her position flattening her breasts against her chest. I noticed how prominent her nipples looked.

Dr. Baxton rubbed his hands together to warm them up and moved in close.

“I am going to examine the lymph nodes in the axilla or underarm first,” he explained.

He pushed with his hands into one underarm and then the next. McKenna seemed ticklish and jerked a little when he did that causing her breasts to wobble sexily.

“Now I am going to palpate the breast tissue.”

As his hand moved towards my wife’s breasts, I found I was holding my breath.

He gently touched her right breast and began to systematically explore up and down the entire breast. At the end, he pushed all around her nipple, and even squeezed the nipple a bit looking for any discharge. He then repeated the same with the other breast.

“Now I have one more visual assessment of your breasts. Stand up for me. Put your hands on your hips and lean forward.”

I swallowed hard as I saw her breasts dangling freely.

I saw Paul staring intently. He certainly was making sure to pay attention to all the proceedings!

“Very good, now I want you to go ahead and lean all the way down and try to touch your toes so I can assess your back for any scoliosis.”

He looked at her for a moment.

“McKenna, if it is ok, I need to move your underwear down to be able to visualize your intergluteal cleft for symmetry. May I?

She nodded.

Dr. Braxton then gently grasped the sides of her underwear and slowly pulled them down to the top of her thighs, exposing her bottom completely.

I heard Paul gasp beside me. This was his lucky day, and I am sure beat his usual job of moving luggage for people!

Dr. Braxton then pushed along her spine and then pushed the dimples above her bottom.

“Ok. McKenna. You can stand up straight now. For the next part, go ahead and step out of your underwear, and lie down on your back on the bed.

My wife had just stood up, and was about to pull up her panties, before it registered that Dr. Braxton was asking her to take off her panties.

She shot me a quick look to see if I was ok with how things were going. Again I nodded. She quickly pulled them down her legs then off, and went and lay down on the bed as ordered.

I saw she was trying to avoid looking at Paul.

I was her husband, and Dr. Braxton was a medical professional so it was somewhat normalized in her mind to be exposed to us. However, for a non-medical person such as the bellman to be seeing her like this, greatly increased her embarrassment! However, she knew that this was required and did not want to do anything to jeopardize our business.

Dr. Braxton took a few more supplies out of his suitcase and came over.

Based on her previous exams, she had an idea of what would be next.

She lay down on the bed, blushing slightly, with her thighs slightly together.

This concealed most of her genitals from view, but did nothing to hide her red bush!

I could see Paul look appreciatively at her hairy pubes.

“McKenna, scoot down to the edge of the bed, and let your knees fall completely open.”

This is always my favorite moment of the exams that McKenna has. The moment when she has to completely expose herself to the doctor. No matter how many times she has done this before, she always blushes for this part. And now was no different, as she turned a bright shade of red and reluctantly spread her legs exposing her genitals completely to everyone in the room!

Dr. Braxton put on a new pair of gloves.

“McKenna, I am just going to check your genital sensation and some sacral spinal reflexes now.”

He then began to gently touch along her labia majora asking if she felt that ok. He then moved to the inner labia, then along her clitoral hood. He even pulled back her hood, and gently touched the head of her clitoris.

Then he spread her labia open and touched inside her vagina.

He then inserted two fingers into her vagina.

“I want to test your pubococcygeus muscle. It is the muscle associated with Kegel exercises. Can you please bear down and tighten your vagina around my fingers?”

My wife did that.

“Excellent. Now I am going to check your bulbocavernosus reflex. There are two ways to check it, and I will check it both ways today.”

“The reflex should result in your anal sphincter contracting. First I will check it by applying pressure on your clitoris,” he explained.

“To assess your anal sphincter contraction, I will now introduce a finger into your rectum,” he told her as he lubed up his left index finger and slowly inserted that into her rectum.

“Ok, now for the test.”

He then gently squeezed her clitoris with his right hand.

I saw her bottom spasm down, and I knew her anus squeezed his finger hard.

“Perfect, healthy reponse.”

He then removed his finger from her bottom and took off his gloves and threw them away.

“Please stay in that position, McKenna. We are almost done.”

“I am now going to catheterize your urinary bladder to measure your post-void residual volume.”

He then went to his suitcase and took out a Foley catheter kit.

He opened it and put it next to my wife.

He then went and put on sterile gloves, and came back and stood next to my wife.

“I am now going to introduce a tube into your bladder to check how much urine is left after you have voided. It may feel a little strange, but it should not be painful. Ok?”

She nodded.

“Just to verify, you have no iodine allergies?”

She nodded.

He opened up the iodine swab packets. He then opened up the lubricant packet and lubricated the end of the catheter. He carefully connected the catheter to the container. He then took a saline syringe and tested the bulb at the end of the catheter by inflating and then deflating through the port on the catheter to make sure everything worked.

“I am going to clean the area around your urethra, McKenna,” he explained.

Using his left hand, he spread her labia open, exposing her clitoris. He then gently applied upward pressure until her little urethra was fully visible.

“Cold and wet,” he warned as he took the iodine swabs and cleaned around her urethra and her labia.

He then took the catheter and gently inserted it into her urethra.

McKenna gave a little start initially but then relaxed.

He slowly fed the catheter into her, and then finally, took the saline syringe and inflated the bulb.

“The other way to check the bulbocavernosus reflex, is to gently tug on a foley catheter. I will do that now.”

He gently tugged, and again we saw her anus contract.

“Everything is normal,” he said.

He then took the urine container attached to the catheter and put it down off the bed.

“This will help the urine flow into the container.”

We waited a moment for the urine to finish flowing through the tubing.

“Ok, I am going to take it out now. You may feel a strange sensation, but it should not be painful.”

He used the empty syringe to deflate the balloon on the catheter.

Then he soaked some cotton balls in the Foley kit with the saline.

He then gently spread McKenna’s labia open again.

“Deep breath. 1. 2. 3,” he said as he quickly pulled it out.

He then wiped her with the wet cotton balls to remove the iodine.

“You will probably want to take a bath and wash yourself thoroughly. The iodine can be irritating if left on for too long,” he advised.

He then measured the urine in the container.

“25mL. Well within normal limits.”

He turned to my wife and me.

“You can go ahead and stand up now, McKenna.”

My wife gratefully got out of her awkward exposed position and stood up.

I think she thought the exam was over.

The next question told her that it wasn’t over yet.

“McKenna, have you ever had an enema?”

“What… yes… why?” stammered my shocked wife.

“McKenna, I need to give you an enema. This is not so much for your bowels as for forming an objective measure of your sphincter tone. What we have found is that rather than relying on a subjective measure of sphincter tone and trying to correlate that with outcomes, a functional test of checking whether the person can retain a Fleet’s enema for 5 minutes in the standing position without any anal leaking gives a much more objective measure and better correlates with long term neurological outcomes,” he explained.

Her face had a look of horror on it as she heard Dr. Braxton explain.

She turned to me with a plaintive cry, “Babe?!?”

“Now honey, let him do his job,” I encouraged her.

She stood there for a moment, but her love for me overcame her reluctance.

“Ok,” she said simply.

“McKenna, please get up on the bed on your hands and knees,” Dr. Braxton ordered.

My wife climbed up on the bed, and kneeled down, her legs together.

“Please move your knees to shoulder width, McKenna,” Dr. Braxton followed up.

Blushing once more, my wife did as he ordered.

This opened her up and now and once again revealed her labia to all in the room.

But Dr. Braxton wasn’t done yet.

He took a Fleet’s enema from his suitcase.

“Please, put your chest down on the bed, and reach back with your hands and spread your buttocks for me,” he ordered.

McKenna slowly lowered herself onto the bed so her weight was now resting on her chest. She reached behind her and spread her buttocks as ordered.

This fully exposed in glorious detail, her dark pink anus, which, of course, was captured in high definition by my phone’s camera for the video.

He put on gloves and applied lubricant to the end of the enema nozzle.

He then took the lubricated nozzle and gently inserted it in her anus. She let out a little gasp as the plastic eased up inside her.

He then squeezed the bottle to give the enema.

“That’s done, McKenna,” he said, taking out the nozzle.

He took off his gloves and set a timer on his watch.

“Please stand up, McKenna.”

My wife let go of her bottom and awkwardly got up from the bed.

“Please do your best to retain the enema until the timer goes off,” he instructed.

McKenna stood there in the middle of the room, completely naked.

After about 1 minute, she could really feel the enema, and I saw her clench her bottom as tightly as she could.

She was also shifting her weight from foot to foot, desperately trying to keep the enema inside.

I think she was so focussed on retaining the enema, that she kind of forgot her embarrassment momentarily, and she was now kind of hopping in place a little causing her breasts to jiggle. This whole time, her bottom was tightly clenched.

Finally, as soon as the watch beeped, she ran to the bathroom.

“McKenna, leave the door open. We need to observe you at all times,” Dr. Braxton called out as we hurried behind her.

We all followed her into the bathroom as she quickly plopped herself down on the toilet seat.

We heard the initial rush of gas and fluid as she relieved her bowels.

With her bowels having had a little relief, she became more aware of us.

She looked at us watching her in the bathroom and blushed the deepest red I have ever seen.

For McKenna, this was the height of mortification. Even though we have been married more than 10 years and have shared everything, still everytime she has to poop, she always closes not only the door in the master bathroom for the toilet, but also the door to the larger bathroom itself. Only behind these two locked doors will she poop in peace.

And now, here she was pooping in front of not only me, but also two strange men!

She looked as if she was finished and wanted to get up.

“Just wait a few more minutes, McKenna. Many times, once the initial urgency is relieved, it can feel like your bowels are empty, when, in fact, there is a lot more left.”

Sure enough, a minute later, we heard her a loud fart followed by a plop in the toilet.

She hung her head, unable to look at any of us.

After about five more minutes, she was finally done.

With a red face she wiped herself and stood up.

Dr. Baxter, took a look at the toilet before flushing it.

“You did an excellent job of retaining everything. Your sphincter tone and control are excellent, indicating the lower spinal segments are all functioning correctly.”

“This concludes my examination. Everything is healthy and normal. McKenna, you may get dressed now after you wash your hands. Bob, please send me the video recording so I can reference it as I write up my findings.”

He then walked out of the bathroom and back into the main area of the hotel room.

“Paul, I want to thank you for taking time from your busy schedule to assist in my examination. Please sign here to attest that you witnessed the exam,” he said, giving him some forms to sign.

He then packed up his equipment back into the suitcase.

Paul took his suitcase and opened the door of the hotel room.

By this time, McKenna had washed her hands and had come out of the bathroom, still naked.

“Thank you Bob and McKenna for your cooperation. On behalf of the insurance company, we look forward to continuing to do business with you.”

With that, he walked out the door letting it close behind him.