Chapter 1: Patient Zero

Until recently, I had an ordinary, run-of-the-mill pediatrics practice — cuts, coughs, ear aches — all the usual problems that parents take kids to the doctor’s for, whether they need it or not. Lately, my practice has become more teens and early teens, so lots of school exams and sports physicals, and of course, skin and complexion problems. Plus the usual issues surrounding sexual issues, including the matter of birth control. As a result, while I still see children of all ages, it seems like my patient list has moved more toward the 14-and-up age group

I’m in my mid-thirties, and I’ve had my own practice since I completed my pediatric residency at Riverside Hospital. My nurse and office manager is Kim — Kimberly — 30 or early 30s, attractive, “solid,” but in an athletic way. About 5’ 9”, she’d been a “star” on her high school soccer team and good enough to make the varsity squad her last three years in college.

Let me explain the title of this chapter. “Patient zero” is a term from medical epidemiology. It is used to refer to the person — the patient — who is the very first known case of a particular disease or condition.

For me — for us — “patient zero” was a 14-year-old girl, a patient for the past two or three years, here for a routine physical, and during the course of my exam mentioned that she’d been having some “unusual sensations” “down there” (those are my words — she just said “feeling funny”).

Of course, my nurse/assistant, Kim, is present for all such examinations, including this one.

I was performing a more-or-less routine pelvic exam when she became ‘agitated,’ and before I knew it, she was having a very obvious orgasm, even grabbing my wrist, either to stop me, or to keep me from taking my hand away.

I couldn’t think of anything else to do, so I let her finish and stepped out into the hall to allow her to dress. Thirty seconds later, her face flushed, she rushed past me and out of the office without a single word.

I didn’t see Kim, but that wasn’t unusual. I thought she might be in the records “room” (which is a glorified closet — or maybe not so glorified). I opened the door and went in, and there was Kim, sitting on the rolling stool, skirt up, fingering herself like crazy. She was too far gone to stop herself, so I stepped back out to let her finish in privacy and give her some time to compose herself.

She came out a few minutes later, smoothing her skirt, her face still flushed. I asked if she was OK and she said yes. The funny thing was, she didn’t seem the least bit embarrassed — by what she’d been doing, or by the fact that I had walked in on her while she was doing it. But then, I thought that nurses are probably more practical about bodily matters than most people. Still, her nonchalance surprised me.

This patient was our last of the day. Still a bit disconcerted — OK, shaky — from the whole experience, I said to Kim, “I don’t know about you, but I think that after that I could use a drink. How about you?”

Kim immediately replied, “Me, too.” We both had our own cars, so we arranged to meet at Scarpino’s, a bar-restaurant about a mile from the office.

We took a booth in the bar area and ordered our drinks. I requested my usual old fashioned, but Kim surprised me by asking the waitress for a vodka martini — surprising, because I never thought of Kim as much of a drinker. Maybe the experience back at the office got to her more than she let on.

Fortunately, the place wasn’t busy yet and our drinks arrived quickly.

We help up our glasses. “Bottoms-up!” and took our first sips — long ones.

I was going to say something, but Kim beat me to it.

“That was a first, wasn’t it?”

I admitted that it was, indeed, “a first,” but then for some reason — perhaps to mitigate the serious nature of the incident — I added, “ ... at least, with a patient!” And then I realized the total inappropriateness of that remark, but before I could attempt to apologize, Kim raised her eyes and looked at me over her martini glass. She smirked. Yes, she’d caught my inappropriate quip — and no, she wasn’t offended by it.

She let me squirm for a moment, but then she took pity on me. “No, I don’t know that I’ve ever had that happen with a patient.” Then she added, “But I’ve heard stories about things like that,” she paused to take another sip of her mart, “ ... and not just once, either.” She took another sip — she was making some serious progress on her drink. “Still, that really caught me by surprise.”

Another sip, then looking up at me again she said, “I was also surprised at the effect it had on me. I guess you figured that out when you found me the the records closet.”

So now it’s out in the open, fair game for conversation. In fact, under the circumstances it would be downright bizarre if we didn’t discuss it.

“Well, I apologize for ... for you having to see that. I...”

“Apologize? What the hell for? That’s the hottest thing that’s happened in my life in two years.”

“So, ... Kim ... you’re not angry...?”

“Hell, no!” Then, “What I want to know is, what were you thinking ... when you realized what was happening?” She took another sip of her martini and waited for me to answer.

I’d asked myself that very same question.

“I’m not sure I can answer that. The one thing I remember thinking is, ‘What’s the professional thing to do now?’ like there was something they’d taught us in med school about this sort of thing and maybe I’d missed class that day or something.”

Kim laughed — a laugh of genuine amusement, but also, slightly sympathetic to my predicament. When she did that, I felt somewhat easier about going on.

“So I guess it was mainly the total surprise, and what I wanted to do most was to contain the ‘damage’ from her ... her squirting, then maybe to spare both of us from any extra embarrassment...

“Although to tell the truth, she didn’t seem real embarrassed.” I smiled, took a drink of my old fashioned. “I guess there were some other things she was feeling right then that were a whole lot stronger than embarrassment.”

Kim responded with an insinuating, “You got that right.”

I was surprised by the casual — almost humorous — way Kim seemed to be taking the whole thing. And that included this conversation of ours. She went on.

“So, did it get you excited?” Another sip, another smirk over the rim of her glass.

“Not then, at least. I think I was just so surprised, and so concerned with doing the right ‘professional’ thing that nothing else was on my mind.”

And then Kim finally brought it into the open.

“And how about after, when you found me in the records closet...,” she could have stopped right there — but she didn’t, “ ... frigging myself like crazy?”

I could feel myself start to blush, and it didn’t stop when she added, “And yes — I had an orgasm, and it was a big one.”

Now I was sure my face was glowing red — not a figure of speech. Kim was obviously taking pleasure in my discomfort, the discomfort that she had caused — was still causing.

And by then Kim had snagged the waitress and told her that we were probably ready for another round. After the waitress walked off, she said, “It didn’t bother me, you know? That you caught me like that — that you saw me that way.”

The cocktail waitress was already back with our drinks — I guess she and the bartender had been keeping an eye on us. Kim immediately picked up hers and took a long sip. She set the glass down and looked at me for a few moments. “In fact, I think I wanted you to.”

That was a jolt. I tried to hide my embarrassment — and my confusion — by taking a long drink from the glass the waitress had just handed me. I had to say something here.

“Are you sure?” Of course she’s sure, you idiot — she just said it, didn’t she? “But ... why? I mean ... why ... would you want someone ... want me ... to... interrupt you when you were doing ... when you were having ... that?”

She smiled again and took another sip of her martini — a small one this time. “I’ve wondered about that, y’know. And the best answer I can come up with is that seeing her like that, and seeing her cumming...,” yes, Kim used the “c” word, “ ... seeing her cumming like that got me so turned on that I needed to share it with someone.” Another sip, looking at me. “Does that make any sense?”

If that’s the way she felt, who am I to argue? “Yeah, I guess so. Yeah.”

We both paused, to let things sink in, I guess. Then you knew she had to ask.

“Did it turn you on, Rick? When you saw me inn the closet, and realized what I was doing — did it turn you on?’

And that’s what I had been wrestling with, and what I had been hiding — hiding from myself, mostly. She’d been so open and honest with me, there’s no way I could lie about it.

“Not when ... when I walked in on you. But afterwards, when I got back to the office, yeah, I realized that there was a pretty noticeable bulge in my pants.”

She continued looking at me, and that look said, “And...?”

“Okay, yes, I might have ... okay, I did give myself a few squeezes.”

“And, ... did you make yourself cum?”

“No, I didn’t...

“But I thought about it...”

Kim smiled, like she just accomplished something, or maybe like she’d won an argument. She set down her glass and reached across the table and took my hand and held it for what seemed like ages. Then she looked into my eyes. And that look seemed to say, “An understanding?”

Yes — yes, Kim and I now shared something — an ‘understanding,’ if you would.

As if we were on the verge of finalizing our “discussion,” she asked, “So, ... what do we do the next time — the next time something like what happened this afternoon happens again?” A final sip of her martini. “And, Rick — it will happen again, trust me.”

“I don’t know — I’m not sure what we should do. Should we — should I try to avoid situations like this?”

“You’re a pediatrician with young female patients, Rick — I don’t think you can avoid those kinds of situations.”

“So, are there things we can do to ... I don’t know... discourage things like that from happening?”

Kim looked at me, a long, serious look.

“I don’t think either of us want to discourage things like that, do we, Rick?”

Kim and I didn’t go home together.

As it turned out, and consistent with the technical definition of the term, our own “Patient Zero” was to be just the first of many.

It was about 10 days later that Kim mentioned we had a new patient coming in that afternoon. “The strange thing is, she wanted to be sure to be your last patient for the day. In fact, she was pretty adamant about it.” We looked at each other, like “What’s that about?” and shrugged.

4:15 came, and because this girl was a new patient, Kim had set aside 45 minutes for the visit. In fact, the patient — “Emily” — arrived at four o’clock. She apologized if she’d come too early, but Kim reassured her that it was not a problem. “In fact, usually it’s the other way around and patients arrive late.” Thus reassured, Kim led Emily into the examining room.

Kim proceeded with all the usual pre-examination questions for a new patient, but after those were finished Kim came and got me and told me our patient was ready. I took the chart that Kim handed me, and we went into the examining room.

I won’t describe Emily to you, first, because I can scarcely picture her after all these years, and frankly, it really doesn’t matter.

I greeted her and introduced myself, and she smiled and extended her hand for me to shake. She didn’t strike me as a being shy, but when I asked her why she came today she kind of stumbled, like she was having trouble finding the right words to say what she wanted. Finally, she looked like she’d made some kind of a decision.

“My friend — Ruthann — she’s been seeing you for years...” And that’s when things started to fall into place for me — and for Kim. Because Ruthann (I won’t mention her last name, of course) was the patient who ... who had the orgasm when I was examining her, the one that Kim and I had our conversation about afterward.

“Anyhow, Ruthann says that you ... that you’re a real good doctor...,” and stopped. She looked down and lowered her voice, so soft that I almost couldn’t hear her. “Ruthann said that you made her feel real good last time ... at her examination...” She kept her gaze on the floor and waited for ... to see if we understood what she was trying to communicate.

Yes, we understood. Emily’s message was pretty clear — virtually unmistakable, in fact. Kim and I looked at each other. This might the moment of — “truth” didn’t even come close to it. This was when we would decide whether we’d ... how far we’d be willing to go ... This decision could change the nature of our practice — maybe even our lives.

Kim looked at me, and somehow she saw it. I looked at her, and I saw it in her eyes. The implied “Yes.”

I turned to Emily.

“Yes, your friend Ruthann was here last week.” I decided to take things a little farther, to see if we were really on the same wavelength. “She’s one of Nurse Kim’s and my favorite patients...”

Then Kim broke in, “In fact, we had a very — successful — visit with Ruthann the last time.” She paused to let Emily digest the words, and their possible meaning. “Doctor and I think that Ruthann left her appointment feeling very good.” Then, the challenge.

“Emily — do you want to feel good, the way Ruthann did...?”

It was now Emily’s chance — to confirm, or to deny.

“Yes!” And then realizing how she’d sounded, she said in a calmer voice, “I mean yes, that’s what I was hoping — I mean, thinking — when I made the appointment for today.”

Kim and I looked each other, the slightest of smiles passing between us.

Then I thought of one other thing.

“Oh, Emily — one more thing — would you like Nurse Kim to be here with us during the examination?” Of course I would insist that Kim be present during any exam like this, no matter what the circumstances. But I wanted to hear what Emily’s answer would be.

Again, with far more enthusiasm than she probably intended, she answered, “Oh, yes!” and once again, she had to dial her enthusiasm down a couple of notches. “I mean, Ruthann said that Nurse Kim is a very good nurse — and really pretty, too.”

Kim and I looked at each other, surprised. We hadn’t expected that little insight, and it opened up the question of what other possibilities there might be with young Emily.

I reached under the cabinet and took out a folded package. “Okay, Emily, in that case, why don’t you put this gown on and we’ll get to your examination. I can step out of the room while you undress and into the gown, or I can stay here and Nurse Kim can put up this screen. That way, you’ll have some privacy when you change.”

She seemed to think about the choice for a moment before saying, “It’s alright if you stay.” Then, perhaps realizing how that sounded, she said, “I mean, the screen’s fine.”

Another bit of information — Emily wanted me to be in the room when she was undressing. Another smile between Kim and me.

Kim moved the screen in front of the exam table and I heard the sounds of clothes coming off. “What should I do with my clothes?”

You can burn them, you teasing little minx.

“You can lay them over the chair there, or you can toss them over the screen.” She opted for hanging them on the screen. And then,