STANDARD
OF CARE
“Read it.” Dr. Bloom tossed the patient’s chart to Oliver.
Oliver caught the folder and managed to keep the papers it held from falling out. He fumbled it open and read aloud. “Patient is a thirty-six-year-old woman. Chief complaint: Anorgasmia. Health history unremarkable. Patient remains inorgasmic despite counseling on self-stimulation. No organic cause of sexual dysfunction is apparent.”
“Look,” Dr. Bloom said, “as you all know, the medical board has recently rescinded the prohibition against sexual contact with patients in specific circumstances such as this one. However, the hands-on therapy you’ll be learning to perform today is cutting edge. These cases are going to be scrutinized carefully, so proceed with the utmost discretion. At a minimum, always be accompanied by a female staff person.” He indicated the nurse at his side, a tall woman whose scrubs were covered with cartoons of chimpanzees eating bananas. She nodded. “And be careful to document everything.” He lifted the surgical mask from around his neck and tied it so it covered the lower half of his face. He pulled gloves out of his pocket and snapped them over his hands, then went into the patient’s room, followed by the nurse.
All the residents tied their masks over their faces, including Oliver, although he wondered why it was necessary. He gloved up and followed Dr. Bloom into the examining room.
Inside, a woman lay with her feet in stirrups, wearing a pale-green hospital gown. As the residents encircled her, she looked steadily at the ceiling. Her breasts rose and fell. Oliver focused on her face, not on the little tents her nipples made in the thin cotton covering them. He checked the chart again to make sure of her name. “Vanessa?”
She turned big eyes toward him and nodded.
He glanced at the chart again, and then back at her face. “It says here that you’re seeking treatment because you’ve never been able to have an orgasm. Is that right?”
“Yes. At least I don’t think I have. They said you have an experimental treatment that might help me.” Her voice was low, sexy. Almost like a smoker’s rasp, but she didn’t smell like smoke, didn’t have the telltale lines around her lips.
“It’s not exactly experimental,” he said. “I’m going to use a vibrator, along with some verbal instructions. It’s now the standard of care in cases like yours.”
She looked disappointed. “It won’t work. I already tried a vibrator. It didn’t do a thing for me.”
Oliver cleared his throat. “I understand. That’s what it says in your chart. But some women need the doctor’s touch, at first. If I can bring you to orgasm here, today, then I should be able to teach you to do it on your own, or with a partner. I’m going to remove your gown now, if that’s okay.” He untied the strings from around her neck and she raised her arms so he could lift the gown from her body. Her nipples were small, pink, puckered. Goose bumps stood up on her thighs, and she was shivering.
Oliver wondered whether she was cold or nervous. He moved so that he was standing between her legs. The nurse plugged in the vibrator and handed it to him. He was acutely aware of the gaze of the other residents. They all stood perfectly still, watching him from above their masks. He raised the vibrator, and located the ON/OFF switch and speed control. He’d observed a doctor perform this therapy before, but this was his first time. He tried to keep his hand steady.
Vanessa’s eyes got even bigger and she tried to scoot back from the edge of the table. “You’re not going to stick that in me? It’s too big!”
“No, no, this is a wand-type vibrator. I’ll just be using it on the outside of your body.” How did she not know that? he thought. Surely her therapist had explained how to use a vibrator? It doesn’t matter now. Concentrate. Oliver brushed the curls back from her pubic mound so he could more easily see her vulva. Her clitoris was small, deeply hooded, almost hidden in her pink lips. He turned the vibrator on LOW and pressed it gently against her.
“Oh,” she said. Her face took on a look of wary concentration.
Dr. Bloom pushed his way between the two men to Oliver’s right. He addressed the residents as if Vanessa wasn’t in the room. “You don’t want to rush things at this point. Watch the patient. Wait until she habituates to the sensation. You want her to relax enough to begin to get bored.” Sure enough, as if on cue, Vanessa’s legs released open and she looked around the room.
Dr. Bloom nodded to Oliver. “Now’s the time to increase the intensity.”
Oliver switched the vibrator to high and pressed it firmly against Vanessa’s vulva. She began to pant. She wrapped her arms across her chest, squishing her breasts. “I can’t stay relaxed,” she said.
Ignoring her statement, Dr. Bloom addressed the residents. “Part of the problem is that these women have often been told, ‘Just relax, and it’ll happen.’ But orgasm isn’t brought on by relaxation. It requires rhythmic muscular tension.” He raised his voice to address Vanessa. “You just hang in there, young lady. Won’t be long now.”
A bead of sweat dripped from Oliver’s forehead onto his mask and an erection was growing inside his scrubs. He was glad that they were all wearing plastic aprons so no one could see the lump in his crotch. He wanted to touch Vanessa’s nipples, which were now bulging between her fingers as she clutched at her breasts. He wanted to rub himself against her bare buttocks, where they protruded off the end of the table. He peeked furtively at the other residents, wondering if their dicks were hard, too. Then he pushed the thought out of his mind and pressed the vibrator more firmly against Vanessa’s clitoris.
“The patient is showing all the signs of impending orgasm,” Dr. Bloom said. “Her respiratory rate has increased. She’s exhibiting the characteristic involuntary large-muscle contractions. Note the sex flush on her upper chest, forehead and cheeks. The breasts have increased in size and the nipples are erect. The vaginal lips have reddened and become enlarged as well, due to vasodilation. You can observe them moistening.”
Vanessa’s eyes were closed and her breath made small rhythmic sounds. “Oh, oh, oh.” She squirmed. Is she trying to get away from the sensation? Or trying to press herself closer to it? Oliver wasn’t sure. Suddenly her eyes flew open and looked straight into his. “Oh fuck!” she screamed. “I’m coming. I’m coming!” She grabbed his wrist and pulled his hand, with the vibrator, hard against her vulva. Her back arched and her head rolled from side to side.
Just as suddenly, she pulled his hand away from her body and sat straight up on the hospital bed. She threw both arms around Oliver and hugged him, laughing and pressing her face into his chest. “It worked! I can’t believe it. Doctor, I could kiss you!” Her feet were still splayed in the stirrups, high up next to her ears. As she pressed her breasts against him, Oliver looked around, surprised and embarrassed. He patted her nude back awkwardly. The vibrator still buzzed away in his other hand.
After a few moments, Vanessa lay back with both hands behind her head and sighed. “That was amazing.” Oliver switched the vibrator off and handed it back to the nurse.
“Well done,” Dr. Bloom said. “Now, how many of you have erections?” The residents looked around sheepishly. One by one, they slowly raised their hands. Oliver raised his as well. “Exactly. So do I. Now, the new protocols state that it is acceptable to have intercourse with the patient, as long as the patient consents and the treatment is deemed therapeutically desirable.” He raised his voice again. “Vanessa?”
“Yes, doctor?”
“Following the therapy you just received, we expect that you should be able to have orgasms on your own in the future, by using a vibrator. However, many women are not satisfied with this outcome. They don’t consider the treatment a success unless they are able to orgasm with a partner. For most women, it’s much easier to orgasm during intercourse if they have recently orgasmed from direct stimulation. Do you understand?”
“Yes, doctor.”
“Then, with your consent, we will proceed to part two of the therapy.”
“Yes, Dr. Bloom.”
Dr. Bloom turned to Oliver. “You may proceed.”
Oliver hadn’t been expecting this. “What should I…I mean how should I…”
Dr. Bloom said impatiently, “Well, don’t just stand there, young man! You’re a doctor.”
Oliver looked to Vanessa for guidance, but she was still lying on the narrow bed with her arms behind her head, waiting with an attitude of relaxed expectation. He untied his scrub pants, pulled out his erect penis and rolled a condom onto it. “Lube,” he said. He held out his hand, and the nurse squirted a dollop onto his fingers. He massaged it onto the head of his cock, and then smeared the rest onto Vanessa’s labia. He slipped gloved fingers inside her. She sighed and her eyelids half closed. Everything about her felt soft and open.
He spread her lips with his fingers and slid his cock into her cunt. It slipped in easily and her snug, warm walls surrounded him. He pushed all the way in, so his hip bones pressed against the firm muscles of her buttocks that bulged over the end of the table. He stood there for a moment, not moving, inserted all the way to the root of his cock. She was wiggling against him, trying to rock her hips up and down, but not really able to because of the table and the stirrups and her ass suspended out in the air. She looked so pretty, struggling like that, with that pleading look on her face. He started to stroke in and out of her. She moaned and closed her eyes.
“At this point,” Dr. Bloom said, “you could apply the vibrator again.” He paused. “On second thought, I don’t believe you’ll need it. Digital stimulation should suffice.”
Oliver took Vanessa’s hand and placed it on her cunt. He positioned her fingers on each side of her clitoris and used his thumb to set them moving rhythmically back and forth. A look of amazed understanding came over Vanessa’s face and she began to rub herself vigorously. She made little yips and cries and the pink flush spread across her chest and cheeks again.
“A little nipple stimulation would not be out of order, doctors,” Dr. Bloom said. The two residents nearest Vanessa’s head jumped guiltily and each gingerly pinched a nipple. Oliver stroked his erection into her harder and faster. Vanessa screamed and her cunt gripped him. That was it. He was coming along with her, grasping on to her shapely thighs and inhaling her salty scent.
When the intensity of the pleasure receded, Oliver slowly pulled out. His fellow residents were softly clapping their gloved hands. A few of them whistled. Vanessa smiled shyly.
As he walked toward the sink, Dr. Bloom clapped Oliver on the shoulder. “Well done,” Dr. Bloom said. “You’ll make a fine erotologist.”