If you read my other story, "The Fishing Trip," then you are familiar with my first exposure to incest. At that time of my youth I had no regrets, even though I was well aware of the moral taboos associated with incest. I was sure that what had happened between my sister and myself was a rare and unusual event. I actually thought my experience to be almost unique in the world. It would be years before I would later learn just how untrue this was.
SOAP is an acronym describing the methodology of documenting patient examinations during a hospital or clinical visit. Before becoming a psychiatrist, before being an allergy/immunologist, I performed a six-month rotation during my internship as a physician in the emergency room of a major medical center. In plain language, I was an ER doctor. SOAP stands for Subjective, Objective, Assessment, and Plan. The following is an actual medical transcript that I dictated and was typed by a medical transcriptionist back in the mid-'70s:
S: 14 y/o WF presented to the ER with C.C. of vaginal bleeding x 36h. Pt. states that she had sexual intercourse for the first time and was worried because the bleeding has not lessened and is ongoing.
O: HEENT WNL, chest clear to auscultation, heart RRR, Abd S NT ND. Ext. genitilia slightly inflamed. Pelvic exam shows 2cm superficial laceration running laterally parallel to the vaginal canal. Significant trauma to hymenal folds shows recent tearing, probably secondary to sexual penetration. The hymen appears lacerated at the 10, 3, 5, and 7 o'clock positions. The tear at the 10 o'clock position extends into the vaginal wall past the mucosa and appears to be the primary contributor for bleeding. Some signs of early granulation present, bleeding appears to be moderate oozing without any arterial or serious venous component.
A: Primary dx: Ruptured hymen secondary to intercourse.
Secondary dx: Soft tissue inflammation extending to vaginal introitus.
Warnings for S&S of infection.
Recommend sexual abstention x1 week.
And now, here is the rest of the story...
I introduced myself to the young girl as Dr. Sterling. She told me her name was Emily. Emily was a plain girl, not ugly, but not especially beautiful. Just one of millions of other nondescript young girls that live in this country. If you met her, you would probably think, "She's a nice girl." And that would be the end of it. But Emily had a secret. And in the 1970s, as well as today, Emily's secret would by many be considered sick and demented.
"Well young lady," I said, "What brings you in here today."
"I'm bleeding ... down below ... and it won't stop," she replied, "It's been going on for two days now,"
Emily was very very nervous, almost to the point of tears. It was obvious that she was scared to be in the emergency room. She sat at the exam table wearing a light blue disposable paper gown which fastened in the back. Her hands were clenched together in front of her and she didn't look me in the eyes at all when she spoke. Emily's hair was dark brown and hung to her shoulders. Her skin was very pale, almost white. She had no tan lines anywhere, suggesting that she rarely spent time outdoors or in the sun. After looking in her ears, and eyes, and mouth, and listening to her breath sounds, I folded the gown down to her waist and listened to her heart. It was beating quite quickly. Almost a hundred beats a minute.
Her breasts were very well developed for a 14 year old girl. They were round, soft, and warm, and hung symmetrically on both sides of her frame. About the size of a large grapefruits, each was suspended firmly, without stretch marks. Her nipples were overly large and not well defined. I mean the centers came to a sharp point, but rather than the pencil eraser types you read about all the time on this website, her's were darker in the center, and then faded in color as they spread out across her chest. The nipples were almost 2 inches each in diameter, and if it wasn't for the contrast to her pale skin, you would never be able to tell where they began or ended.
After listening to her heart and examining her breasts, I had her lay back and palpated her abdomen and asked her about her menstrual history.
"I started my periods a couple of years ago," she said, "And they are regular for a couple of days each month."
"But..." she added, "That has nothing to do with why I'm bleeding."
"Ohh?" I asked, "You know why you are bleeding then?"
"Yes!!!" she exclaimed shakily.
Emily then started to cry. Actually controlled sobbing would be a more accurate description. I handed her some tissues and waited for her to continue after composing herself.
"I had sexual intercourse the day before yesterday," she stated, "It was my first time."
Peggy, my chaperone and nurse aide was standing behind Emily. She gave me a kind of quirky smile and rolled her eyes, suggesting one of those, "oh boy, here we go again..." looks. I smiled back at Peggy in full understanding. And then I compassionately took Emily's hand and asked her if she wanted to talk about it.
In all actuality, I already knew all I needed to know to complete my examination. I didn't need to know more, and wasn't really all that interested in her newly discovered sex life ... but before I could continue, Emily smiled at me, and squeezed my hand. She then told me her story ... everything in its entirety and in great detail. This is what she told me to the best I can remember it...
"It's really hot in our house," she started, "And we don't have air conditioning."
"But I guess I'm getting ahead of myself, she continued. You see, mom and dad sleep downstairs. Our house actually used to be a barn about a hundred years ago. The upstairs is what the loft used to be. It is divided into two halves with the stairway separating the halves. One big open area, which is separated by a heavy curtain on a rod so my brother and I can each have our privacy.
But in the summer, it really gets hot with the curtain pulled. I have a fan in my window and Johnny has a fan in his window. If we both have the fans blowing in, they kind of cancel each other and we don't get much breeze from them. Since our loft only has two windows, one on my side and one on his, we found that if we opened the curtain and set one fan for blowing out and one for blowing in, then we could get a good cross breeze that makes it tolerable to sleep.
Except that doesn't work much when it's 95 outside like it was a couple of nights ago. And it was raining outside. It was so humid that I was sweating to death upstairs. Johnny had pulled the curtain and had the fan blowing in while mine blew out, but the rain was being sucked in so we changed the direction of the fans. It didn't help, mine started sucking in rain. It was raining so hard we actually had to turn off the fans so they wouldn't short circuit from rain hitting the motors. We just lay there in absolute darkness, with it thundering and pouring outside, sweating to death.
I eventually took off my nightgown and lied there naked to get cool. It helped some, but not much. Being so late at night, and with the storm, it was pitch black upstairs. But occasionally, when the lightning flashed, it lit up like it was daytime for a brief half-second. Across the room I could see Johnny atop his bed ... he was naked and whacking off. Johnny does that a lot these days. He didn't know it, but I've seen him playing with himself for a couple years now. He thinks I can't see him in the dark, and normally that's true ... but I can still hear him. And that night, the lightning flashed often enough that I could see him when it did.
That's when ... that's when..."
Emily started crying again. I tried to comfort her and said, "That's okay, you don't have to go on if you don't want to. Peggy can we get her a drink of water?"
Peggy stepped out for a second and came back in with a paper cup of cool water. Out of fashion for her, Peggy handed her the water and said, "It's okay honey, you'll be okay. Why don't you take a deep breath and then tell Dr. Sterling the rest of your story."
I looked at Peggy inquisitively and she gave me one of her 'hey, the story is starting to get good' looks. Emily had started to calm down at this point, downed her water and then continued...
"So," Emily continued, "I was hot and sweaty, and was starting to get kinda horny myself listening to Johnny. I actually started to rub myself a few time ... down below I mean ... and then stopped and simply got up off my bed and walked to the other end of the loft and stood next to Johnny."
"He was surprised when the lightning flashed again to find me standing next to him. He said to me ... Crap Emmy, what the hell?"
"I'm horny," I said.
"Well, what do you want me to do about it," he retorted?
"I don't know," I started, "What can you do about it?"
"Well, Johnny looked at me and scooched over in bed and told me to lie down. I did and we were side by side, naked I had no idea what was going to happen next. We just talked for a while. At first it was about the storm, then about the heat, and then I brought up that I saw him whacking off. He told me had to do it otherwise his balls filled up to the point where it felt that they could explode, and that it was dangerous to let them do that cause it could cause cancer."
"I didn't know that," she quickly added.
Peggy snickered at that point and I gave her a sharp look. Emily must have missed it because she went on with her story oblivious to Peggy holding her hand across her mouth to keep from laughing out loud. I was glad that Peggy was behind her out of her view.
.... There is more of this story ...