Title: The Gynecologic Examination

Keywords: MF, tort, gyno, medical, humil

Author: SubSophie

Summary: A chapter from the textbook of twisted gynecology for
the evil gynecologist describing how to perform a gynecologic
examination to cause the most distress, discomfort, humiliation
and pain.



THE GYNECOLOGIC EXAMINATION

In this chapter we shall cover the conduct of the gynecologic
examination from the introductory words to the patient through to
its conclusion. This is a very important part of the
gynecologist's work and it is vital that it is conducted
according to the correct protocol.


Patient preparation

The examination of the female external genitalia is never a
pleasant process for any woman and most approach it with some
degree of trepidation. The reasons are not too difficult to
understand given the very private and intimate nature of the part
of the body being examined and the fact that the examiner is
almost always male. A woman is only really comfortable with her
lover seeing her vulva, and even then usually only when her
inhibitions have been reduced by sexual arousal. It is important
for the gynecologist to capitalize on this anxiety and
embarrassment and make the examination as unpleasant and
humiliating as possible. This can be started with the doctor's
opening remarks.

From the moment the patient enters the consulting room it is
important to instil a sense of apprehension and anxiety in the
patient. If it is her first visit to the gynecologist, she will
be especially nervous and tense. Tell her right away that there
will be no chaperon present and that a comprehensive and invasive
investigation will have to be made. It is important to maintain a
stern a threatening expression at all times and to avoid smiling
or offering any encouraging or supporting words. You should also
explain that what you have to do will be uncomfortable and
painful for her.

Once the scene has been set, the patient must be asked to
undress. Rather than merely removing her undergarments (which
allows her to maintain some dignity and modesty) she must be
instructed to undress completely. Do not provide her with a
screen for this purpose, she should be allowed no other option
than to undress in front of you. As she does so, you should
comment adversely on her appearance by mocking her fashion sense,
make up etc. Once she is completely naked, you should look her up
and down in a derisory fashion and make insulting and offensive
comments about her body. Women are acutely sensitive to this sort
of treatment and it is therefore a highly effective way of
upsetting her. It is especially important to comment on her
breasts (too small, too flaccid) and her pubic area (ugly, too
hairy etc). It is also a good idea to laugh at her as you do so.
She should then be told to mount the examining table and position
herself with her legs in the stirrups exposing her genital area. She
should be securely fastened to the table at her ankles, legs, wrists
and waist. If she protests, you should explain that it is a hospital 
regulation that patients be restrained during examination to prevent
them falling off the table.

Once she is in position on the table, it is worth opening the
door to the examining room and leaving it open. This has the
effect of reducing her sense of security and privacy even further
and sends a clear message that her modesty and rights are of no
importance. This is especially effective if your consulting room
is in a busy hospital or university medical centre as there will
be a constant flow of people passing the doorway. Ideally, the
examining table should be oriented with its foot towards the
doorway to allow any passer by a clear view of the patient's
vulva without even needing to enter the room.

At this point, you should inform her that you are going to make a
phone call or a cup of coffee and leave the room. She must be
told to remain in position until you return. This is most
upsetting for the patient as she is now completely naked and in a
very exposed and vulnerable position with the door open and no
one else in the room. She will be extremely anxious in case
anyone should enter the room during your absence. If possible, it
is well worth informing the non-medical male staff in the
hospital (porters, electricians, chefs, cleaners etc) that your
office is open to them at any time should they wish to drop in
and see any of your patients. Such an invitation is usually
accepted enthusiastically.


Instrumentation

It is important to lay out every instruments you have on a
trolley in full view of the patient. Even if you only intend to
use a small number of them. A clinical trolley stacked with a
large number of gleaming, surgical instruments is a fearsome and
intimidating sight for a young, naked woman whose sexual organs
are vulnerable and exposed.

The choice of speculum size is important. This should always be
one or two sizes larger than would normally be considered
appropriate in order to be as uncomfortable as possible when
inserted. In addition, a four blade retractor should always be
available as this is able to produce much more dilation of the
vagina than a normal speculum. A range of probes, seekers,
needles and scalpels should also form part of the instrument set,
as should alligator clip electrodes and a high voltage stimulator
capable of delivering a variety of waveforms. A diathermy or
electrocautery system should also be available for precise
burning procedures. Alternatively, a soldering iron will suffice
for this purpose.


Procedure

You should start the examination by close inspection of the
external genitalia. Part the labia and inspect the vestibule and
vaginal introitus. As you do so, be sure to comment on the
offensive smell emanating from the patient's vulva, even if (as
is usually the case) there is none. You should criticise her poor
personal hygiene and tell her how unpleasant she has made the
examination for you. This is extremely humiliating for the
patient, all the more so because virtually every woman will have
scrupulously washed her entire vulval area prior to the
examination precisely to avoid such comments. Her sense of
injustice and indignation will greatly add to her overall
discomfort.

You should also take numerous photographs of every part of her
body with a macro medical camera. Do not ask her permission
before you do so. If she questions the necessity for the
photographs, assure her that there is no medical justification
whatsoever, but that you have a personal collection of them at
home for use as masturbatory aids and to share with your drinking
buddies. You might also intimate to her that they will be posted
online clearly identified by her name, address and place of work.
At this point you might also like to shout out to the corridor to
summon anyone who might care to look at the patient or take their
own photographs on their mobile phones.

Insert a speculum into the patient's vagina without prior warning
or explanation. Ensure that it is as cold as possible (immersing
it in a bowl of iced water beforehand is recommended) and make
sure it is much too large for her (as above). You will have
difficulty inserting it, partly because of its size and partly as
a result of the involuntary contraction of her vaginal sphincter
caused by the cold metal. In order to overcome this difficulty
simply push harder until the resistance of her vagina gives way.
As you should do so you should express your exasperation and
impatience. Open the speculum as fully as possible ignoring any
cries of discomfort from the patient. If you have one available,
a four bladed retractor is to be preferred as it can produce
extreme dilation well beyond what is comfortable or natural for
the patient.

As you inspect the interior of her vagina, you should express
grave concerns to her about the condition of her internal organs
suggesting that severe problems exist which will need major
surgical correction. It is worth inserting a very large sized
sound into her cervix and pushing it well into her uterus as this
is acutely uncomfortable and distressing. Similarly, her urethra
should be thoroughly probed and stretched with over-sized
instruments.

It is now time to concentrate on the most important area of the
patient's genitals; the clitoris. The exquisite sensitivity of
this tiny organ makes it an ideal candidate for harsh treatment.
It should be explained to the patient that you have found some
clinical signs of disease which indicate immediate treatment
which will be extremely painful for her. If she requests pain
relief or anesthesia, explain that you have no anesthetist on
duty, so she will just have to be brave.

Start by retracting the prepuce to expose the glans. You should
then scrape the surface of the glans with a seeker or blunt
needle. This is sure to produce a protest from the patient, but
you should persist in jabbing and scratching the tender tissue.
The glans should then be firmly gripped with a pair of artery
forceps which are then tightened to the furthest notch. This will
produce extreme compression of the clitoris which will become
quite white and bloodless as a result. Releasing the forceps
after a minute or so will produce even more pain as the blood
supply is restored. You should then attach an alligator clip to
the clitoris (connected to the positive terminal of the
stimulator) and another to her labium majora (connected to the
negative terminal). Power up the unit and deliver a spupramaximal
stimulus to the clitoris using a variety of different waveforms
to vary the effect. Generally a sawtooth wave is the most painful
and voltages of several hundred volts should be applied. After
electrocuting her clitoris for several minutes after which she
will be in very considerable pain, you should proceed to insert
needles into her clitoris. These can also be attached to the
electrical supply for a much better flow of current which reaches
all the nerve endings inside the organ itself. Finally, the
electrocautery probe (or soldering iron) should be applied to the
clitoris to produce second or third degree burns and eventually
painful blistering. This should ensure that the patient suffers
considerable discomfort for several days afterwards.
Clearly the individual practitioner will be able to devise his
own set of favourite procedures, but the above serve as a good
introduction to the subject and a reliable basic set of
techniques to ensure that your patient will have an extremely
painful, humiliating and distressing experience.