I feel her abdomen. “Do you go to the bathroom regularly?” I ask. “Yes,” she replies. “Tell the doctor you sometimes have pain,” her husband intervenes. It’s time to push things a little further. “Yes, it’s true. It happens to me sometimes. It’s not real pain. It’s more of a nuisance.” “It would be a good idea to take a look at your anus to see if everything is okay. Fissures and hemorrhoids are easily treated if caught early,” I pronounce professionally. She looks at me, already dreading what I’ll say. Take off your panties and kneel on the examination table. Then lean forward and support yourself on your elbows.”