Chapter 2

CASE FILES - PERSONAL NOTES - PATIENT 20 - DAY 1 (CONTINUED)

I put a gentle hand on her chest, just above her small breasts, and looked down into her eyes. “It will be alright, I promise. I won’t hurt you. Please try to remain calm, okay?” Again she hesitated before nodding. “I’m going to start with a breast examination. Alright?” Another nod.

I really DID have to determine if she was healthy, especially considering her previous environment, and so I performed a normal B.E., using the flats of the fingers on both hands, first on the left breast, then on the right. They were, as I’ve already mentioned, small, but fluid and elastic. There were no lumps. Her breath deepened, and her nipples became engorged, growing in length and girth to more than twice their flaccid dimensions, while the breasts themselves increased in size by almost a third.

“How are you doing, Ann?”

She swallowed heavily. “Okay.”

I pressed my palms into her shoulders, her arms, her sides and waist (discovering she was ticklish), and finally her legs. She couldn’t hear me breathe a determined sigh as I prepared myself to look at what I really wanted to see, seating myself on a small stool. Her pubic hair was thick and, as I soon discovered, matted with sexual secretions. She jerked slightly as I used my fingertips to smooth it aside and spread her vaginal lips wide. And there it was. No doubt about it. A healthy, intact, 19-year-old annular hymen. I wouldn’t have called it perfect, but it would most certainly do for my purposes.

I went back to her left side and stood where she could see me. “I need to draw some blood now, okay, Ann?”

Again, she swallowed heavily, then nodded silently. I prepared the syringe and vials, swabbed her inner arm, which I had twisted toward me in its cuff, warned her to hold still, and carefully slid the needle into a prominent vein. She didn’t react, only stared up at the ceiling; and I drew five vials quickly before withdrawing the syringe. “Just one more,” I warned her quietly, and I injected her with a moderate dose of diazepam in the same vein.

She took a ragged breath. “Am I okay?” she asked plaintively. “Am I going to be able to help the babies?”

I laid a gentle hand on her shoulders and smiled down at her. “Yes, I think so. I just have to analyze one or two samples. Just in case, I need to leave you on the table. Will you be okay here for awhile?”

She had broken into a huge smile when I answered yes to her question, but it slipped a little as she said: “Um ... ub ... yesss.” I used a thumb and forefinger to pull her left eye open. The pupil was dilated and wavering.

“You seem very tired, Ann. You’ve had a traumatic day. I think you’re going to fall asleep when I leave you here, but that’s perfectly alright. Just go to sleep, okay?”

“Um ... okaaay.”

I put the vials of blood into a small refrigerator, then I walked back to my apartment and picked up my cell phone before returning to her. Her head had lolled to the left, her eyes closed, her breathing deep and even, and saliva had pooled slightly in the corner of her open mouth. Back between her legs, I used a pair of medical scissors to trim her pubic hair. Carefully, I used a small, shallow speculum to spread only her vaginal lips, and I examined her more carefully. Her vagina was smaller than normal, and shiny with excretion, which exuded the odor of her excitement. The clitoral shaft was deep and pronounced, the hood short, and the clitoris itself fat and extended. It was also low-set ... or at least, it was lower than most women I had had the opportunity to examine. Keep in mind that I am a psychiatrist, and while I am an interned MD, this was definitely NOT my field of expertise. Still, I realized she was very fortunate in this regard. The odds are about 70% that a woman will go a lifetime failing to reach orgasm during coitus because her clitoris is too far removed from her vaginal opening. Young Ann here was built for pleasure during intercourse. I took great care in lining up my shot before snapping the picture with my phone. I texted it to Ardly.

Thirty seconds later, my cell rang. “What exactly am I looking at here?” he asked, excitement coloring his voice. “Is it what I THINK it is?”

“What you are looking at, Ardly, is the only picture of your future wife that I will send you before I deliver her to you in twelve weeks. It is also a picture of a female hymen ... one of the most misunderstood parts of the human anatomy, even though it is also one the most revered. Most men don’t know where it is ... or even what it is, for that matter. For as long as there have been doctors, there have been men like you who have asked them to guarantee a woman’s virginity. Well, hang onto your hat, old boy, as I reveal a one thousand year-old secret. It can’t be done. Not with total certainty, medically speaking.

“The hymen is literally the entrance to the vagina. And it’s always there ... even after a woman has sex. In fact, following the birth of a first child, there are, at the very least, remnants of it visible; and it’s the best way for gynecologists to make reference to all things around and in the vaginal cavity. Measurements, for various types of prolapse and other things, are always taken from the hymen.

“Normally, it’s about one and a half centimeters below the outer vaginal lips, but that varies quite a bit. Most of them are ‘annular,’ like the one in the picture I sent you. That is, there is a single opening in the center of a flexible membrane. The diameter of the hole varies among women, and the opening actually increases in size as a woman gets older ... even after she stops physically growing. On average, it’s about one millimeter for each year of age; and that follows here, as well. Ann’s opening is almost exactly two centimeters.”

“Her name is Ann?” Ardly interrupted. “And she’s twenty years old?”

“Shut up, man. I’m waxing eloquent, here. The hymen is often very flexible. And so, if a man’s erect penis is particularly thin, no matter how long it is, it might simply stretch the hymen without breaking it. That can lead to a lot of pain during intercourse, by the way. And, it doesn’t actually break, of course. It tears. Sometimes, depending on the capillary network in the tissue, there might be excessive bleeding when that occurs ... or there may be no bleeding at all. In point of fact, the majority of cases of bleeding in ‘first time’ sex are due to abrasion from lack of lubrication.

“The REAL problem with the hymen comes into play during childbirth. Most women’s hymens are still pretty much intact prior to first births, with the exception of one or two tears. Doctors frequently have to perform a hymenotomy, and cut the hymen to more easily allow the child to pass.

“And so, let me sum it all up. A virgin can tear her hymen without having sex because the tissue is delicate and very close to the surface. The old adage about the girl and the bicycle seat is not only true, it happens quite often. She could tear the tissue due to the sloppy insertion of a tampon, or during masturbation. But, even without an intact hymen, such a girl is still technically a virgin ... that is, she has never had sexual relations before. And, like I said previously, a woman can experience sexual penetration without significantly damaging the hymen ... though there is no way she can know beforehand that it will NOT tear. And, believe it or not, there are plastic surgeons that specialize in repairing the hymen so that devious women can fool prospective husbands.

“Can I give you my advice concerning the determination of whether or not a woman is a virgin? Just ask her. If you trust her enough to marry her, then that’s probably the most effective way to tell. However, you wanted my medical expertise in the matter, and so I’ve provided it, the same way doctors have done for centuries. Now, go online and type ‘pictures of the female hymen’ into your browser. You will find pictures just like the one I sent you under ‘annular’ and ‘intact.’ Ann has irritated hers in the past, probably with tampons, and she has confessed to frequent masturbation. However, the tissue itself is whole and untorn. And ... most importantly in my book ... she SAYS that she has never been with a man; and I believe her. I am confident that I will have her ready according to your specifications in three months. Will you be able to obtain the title to the building by then?”

“Already in progress,” he answered. “In fact, if you’d like, you can start renovating the place.” He paused. “Can’t you send me a picture of her face?”

“No. I am sure that a man of your means could easily hire someone who would get you a clandestine photograph of the girl, but if you did that, I would be greatly disappointed in you. It’s only three months. Let me do my job. Good afternoon.” And I disconnected the call.

Feeling rather pleased with myself, I removed the speculum, leg straps and stirrups, then extended the table so that she could stretch out full length. Finally, I removed the rest of the straps and gently shook her awake. Though groggy, she allowed me to sit her up on the edge of the table. “Here, take these,” I told her, and put three pills in her open palm while handing her a bottle of water.

She was still weak from the drug I had administered, and it took her a few seconds to focus. “Um ... What are they?”

“The small white one is estrogen and the capsule is progesterone. If you put those together in the proper dosage, you’d have a common birth control pill, but I’m regulating them separately. The other one is domperidone. You’ll keep taking that, even when I take you off of the other two. In a couple weeks, I’ll start you on prolactin.”

She stared at them. “These will make me have milk?”

“It’s part of the process, yes.”

She smiled to herself, popped them into her mouth and washed them down with a sip from the water bottle.

“Ann, I’m going to be giving you a lot drugs over the course of the next few months. You’ve told me that you trust me, and so I don’t expect you to question me every time I hand you a pill. Just take them. Agreed?”

For a moment, it looked like she might cry. “I’m sorry, doctor. Yes, of course. I’ll do whatever you say.”

I laid a gentle hand on her bare shoulder in compassion, but this only seemed to reminder her that she was naked. She shivered and crossed her arms over her chest. “Put your hands down at your sides, Ann. We’re not through here yet.”

She complied immediately and whispered “I’m sorry, doctor” again.

I picked up a device from a side table. It had to be plugged in, and while I had already made sure it would reach, the cord had become tangled and I had to deal with that for several seconds. I laid it on the exam table next to her. “This is a breast pump. We’re going to start out with very brief sessions and work up gradually. You will do the procedure yourself, every four hours ... including at least one in the middle of the night. You’ll have an alarm clock to set for that.” I moved very close to her, and she appeared nervous, but she didn’t shy away. “Before you begin, you will need to prepare yourself. Massage your breast like this.” I used the flats of the fingers of both hands to knead her left breast above and below, and then again from the sides. She issued an “OH!” but didn’t move as I worked the pliable gland.

“Next,” I continued, “you will need to engorge the nipple. Use your thumb and forefinger, like this.” I rolled her left nipple between my digits, then pinched and pulled it, and she gasped heavily and issued a small moaned. Immediately, her nipple reacted as it had done during the breast exam, lengthening and thickening succinctly. I let go of her. “Now ... let’s see you do the other one.”

By this time, she was blushing heavily, and even her chest was a rosy pink. She took a deep breath, swallowed, and began massaging her right breast as I had instructed, then pinched her nipple, which really didn’t need it, as it was already fully engorged. “Like that?”

“Yes.” I picked up the breast pump. This model had a smallish glass catch container below a clear plastic cushioned suction cuff. Believe it or not, they came in sizes ... or at least this one did ... and I had attached the smallest one, hoping it would mold itself properly to her breast. “Here’s the switch,” I told her, pointing. I turned it on, and it began humming rhythmically, then I put it to her left breast, and was surprised when it leapt out of my hand with a “Shlurp!” sound as it adhered snugly to her breast. I wasn’t nearly as surprised as she was, though.

She jumped about an inch upward with an “Eeek!” and then an “Oh!” I had dropped the thing entirely, and we both stared at the contraption, which had attached itself firmly to her. “Oh!” she exclaimed again. “It ... it really sucks hard!”

I was trying desperately to maintain an air of professionalism, but failed in that as I groped the small electronic controls on the side of the thing. I found one small sliding switch that was positioned all the way to the right of its track, and I slid it all the way to the left. “Is that any better?” I asked.

She nodded. We were silent for long seconds, and she finally commented: “It doesn’t just suck. It’s really sort of a ... um ... suck suck suck. Know what I mean?”

“Yes,” I commented, nodding. “It’s modulating pressure. It’s mimicking the sucking of a baby.”

She kept staring at it, and slowly, a sort of dreamy smile formed on her lips. I had her switch it off, then made her fit it to her other breast and start it again, making sure she understood the process completely. After several minutes, I turned it off, unplugged it, wound its cord around it to better consolidate it, and set it aside. Finally, I held out her bathrobe by the shoulders for her, and she slid off the table and allowed me to put it on her lithe body. She knotted the belt around her waist and stood looking up at me with a mixture of supplication and ... something else. She reminded me of a dog that had just been “rescued” from the pound, gazing up at its new owner with a look of unsure-yet-hopeful admiration.

“Follow me, Ann,” I told her, leading the way out of the exam room and down the narrow hallway to my office. I heard padding bare footsteps behind me, and I turned back to her once when she apparently stumbled, but she seemed okay. She was obviously still being affected by the tranquilizer, and every now and then, she reached out to steady herself with a hand against a wall. I led her to my desk chair and sat her down facing the computer monitor. This was going to be the tricky part. I had prepared myself for this and I’d practiced a little, but I wasn’t entirely sure I was going to be able to pull it off. Her attention immediately locked onto the screen, which was split into four parts, each containing a different type of spinning spiral.

“This is the modification thing, isn’t it?” she asked quietly. “This is where you try to change me.”

“This is where I put you to sleep, Ann. Just focus and listen to me. You’re going to find it very pleasant, I promise you. I just want you to relax, and I want you to look at whatever you find the most interesting. Now ... please take a deep breath ... yes, that was perfect. Do it again, please. Very good. Relax completely, now.” I let her stare for a long thirty seconds, and I was relatively sure she had focused on the spiral in the lower left portion of the screen. I tapped a few keys on the keyboard, and the screen shifted ... seemingly zooming in on that presentation and then splitting into four new portions, each giving a different spiral based on that one.

She jumped a little and said: “OH!” but continued to stare at the screen.

“That’s going to happen again, Ann. Several times, in fact, until we find the spiral that is perfect for you. Relax again for me, please. Take another deep breath and relax, even more than you were before. Yes, that’s it. Perfect. You see, every person is attracted to different things ... different movements ... different patterns ... different repetitions ... and speeds. And I intend to find the one that is ... perfect for you ... for your mind.” By now I was certain that she had locked onto the spiral in the upper left, and I tapped the keyboard again. Once more, the screen shifted, then exploded into a screen of four more spirals.

“Oh, wow,” she exclaimed softly. She hadn’t jumped this time.

“Take another deep breath, and relax even more than before. Very good. I want you completely relaxed now. Soon ... very soon ... we are going to find the pattern that is perfect for you. No one else but you. It will be yours ... and yours alone. And when that happens ... when we find your perfect pattern ... one that’s meant just for you ... then I’ll be able to put you to sleep. Now ... it would be best ... if you concentrated only on what I am saying ... listen only to me ... and let everything else ... just fade away.”