The Fun of Performing Rectal Exams

Kendra Campbell -- This past week I have been rotating in the Accidents and Emergency (A&E) department at the local hospital. I think I’ve had more fun this week than I’ve had in all the other weeks combined. Our attending physician is absolutely amazing. The A&E department at this hospital is at times pretty chaotic. There are patients literally everywhere. The nurses (or sisters, as they are called here) are always trying to keep up, but there is always a constant flow of patients. Usually, there are only three med students following around the physician, but due to a scheduling conflict, they had to assign six students to this one physician. In the midst of all the chaos and confusion, our doctor remains completely calm and manages to teach us quite a bit in the process.

On the first day of my rotation, I was already writing notes in patients’ charts, writing orders, and even writing scripts (with his signature as well). Okay, so this might sound pretty lame to all of you, but this is the first time I’ve ever actually written a script! It was so much fun!

By the second day, we were interviewing all the patients and performing exams on them. The physician would leave us alone and return a little while later for our report. Then we’d tell him our proposed diagnosis, and usually we were right on. It made me think that I actually might know a thing or two.

The most interesting part of the second day was a 78-year old man with BPH. He was very friendly and smiled at all three of us med students as we filed in the room. The next thing I knew, our doctor was asking us all if we had performed a rectal exam yet. “Only on the model,” we all replied. “Well,” he said, “today is your lucky day!” I was so excited that I almost started shaking. I gloved up, applied the lube, and performed the exam. Afterwards, the other two students also took a shot. Luckily, our patient was more than willing to allow us the opportunity to learn (amazing!).

After we performed the rectal exam, it was time to change his urinary catheter. I guessed the right number, so the doctor gave me the responsibility. This was the first time I’d ever performed a procedure that required sterile gloves, and I stumbled a bit getting them on. I removed the old catheter, inserted the new one, and inflated the bladder, all with instructions from the doctor. After it was all over, I stepped back and admired my work! I was incredibly proud of this quite miniscule accomplishment.

Today was just as much fun as the first two days, and I have learned that I absolutely love A&E. I feel more like a doctor now than I ever have before. I can’t believe that I can actually diagnose patients correctly and come up with treatment plans. I’ve come a long way since my first days of med school. But there is one thing that hasn’t changed, and that’s my giddy excitement over learning the little things. Many people consider performing rectal exams to be scut work that’s given to med students as a sort of rite of passage. But I don’t mind performing them in the least. I’m actually thrilled and enthused to have the opportunity to perform one. Now, I know this might seem silly and ignorant to many of you seasoned med students and physicians out there, but I don’t care. I like getting excited about seemingly insignificant or boring tasks. It’s what makes life fun and interesting. People all too frequently lose the childlike excitement with their jobs and their lives, because they stop seeing the importance of things, and they just mindlessly float (half asleep) through life.

It reminds me of a sign I once read: “You don’t become old and stop playing in playgrounds. You become old BECAUSE you stop playing in playgrounds.” So, here’s to never getting tired of performing rectal exams!