The knock comes after 10 minutes but I keep her waiting. Eventually she is instructed to enter. She is trained well enough to present herself accordingly. I proceed to inspect the rest of her uniform. On top of her underwear she has a white long maid's coat, fastened up to the collar, a regulation uniform belt and court shoes. Her seems still appear straight so I'm pleased.
It's been a few months since her last treatment so I decide to start with an initial medical. She is directed over to the medical bench where her pulse is taken, blood pressure checked, heart rate and rhythm checked. Her pulse shows a tachycardia, I want to find the reason for this. I suspect it's sub clinical and totally psychological but continue with the observations to rule out a physical cause. I adjust her corselette to give me access to her chest wall. Passing the stethoscope over her chest she takes large deep breaths, the stethoscope is cold. I know this as I keep it deliberately cold. She shivers. Her chest is auscultated and palpated. The findings show no dullness, no crepes, no wheezes, just a slight dypsnoea which may be related to her psychological state at this time. She knows this is the final stage in her transformation.
Next I make her lie flat on the bed to continue her examination. I check her for signs of jaundice, anaemia and circulation problems and I'm happy that no abnormalities are detected. I move onto her abdominal examination. Firstly checking for signs of striae, scarring or any visual abnormalities. None present, I move onto palpation of the 9 regions of her abdomen. Firstly with a light palpation, then deep palpation. No tenderness or masses were detected so I now move onto listening for bowel sounds. All present I continue to palpate for her bladder, it's full. I'm very pleased about that. I intend to make good use of her full bladder and take control.
I now inform her that I intend to do a full and thorough genital examination. I can see she feels uncomfortable about this. I show no compassion, it needs to be done thoroughly to establish the correct course of medical treatment required. I instruct her we need to remove the harness and butt plug for the time-being. Snapping on new gloves I see her eyes flash and watch me. I move the bed sheet up over her abdomen to expose her genitalia, whilst I arrange the sheeting to cause her arms to be pinned tightly to her sides. Again there is evidence of erectile tissue still functioning. I ignore this in the first instance while I proceed to do a manual examination of her perineum. No lumps, no bumps and nothing untoward so far. I then continue to examine the shrivelled up former testes. As I manipulate them through my fingers I'm checking again for any lumps, bumps, any adhesion, any hardening of tissue. I'm pleased to note nothing in either testicle causes me concern. She remains perfectly still throughout while I dispassionately begin to exam the former penile tissue. Checking the shaft, the circulation, checking again for lumps or bumps. I then roll back the foreskin and examine the head of the penis, the frenulum and the opening to the urethra. There is some clear discharge present unsurprisingly. This needs attended to and gives me an indication of where the problem may be coming from. Genital exam concluded, I move onto her lower limb circulation. She has strong healthy femoral, popliteal and pedal pulses.
Lastly I need to do a rectal examination. I let her watch again as I glove, then double glove. Snapping on the latex has her pulse increasing and her face flushing. I'm unconcerned as I instruct her to turn onto her left side, and bend her knees up to her chest as much as is comfortable. She does this in silence as I move to the position the overhead examination light. I need to put some light on the subject as I examine her externally initially. No signs of any varicosity, I lube my gloved finger and proceed to enter her rectum. I instruct her to relax as much as she can. Easier said than done and I can feel her sphincter tighten. I know this is not pleasant but I tell her it's necessary. I need to get a good digital examination of the prostatic tissue still present and this is the best way to gauge that. I continue on, eventually I manage to digitally enter her and examine in full the prostate. Again, no lumps, bumps or hardening of the tissue. However, it is larger than expected, especially after the last treatment should have shrunk it back quite significantly. Again, this helps with deciding the treatment required.