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straight into the bladder. It is an infection risk, as bugs can creep up it, but sometimes you have to weigh up the benefits against the risks. In Mr Groom’s case, the risk was of him being incontinent in bed as he might not get a urine bottle in place in time. Urine is very good at breaking down skin, and Mr Groom did not need sores around his inner thighs, buttocks or scrotum. I tried to make this case.
    I wasn’t alone in thinking that it should be left in; all the nursing staff agreed. But the doctor didn’t even budge when the charge nurse stepped in, and so the catheter was taken out.
    The next day Mr Groom began to have some problems.
    As predicted, he was not managing with a urine bottle.
    Even after the previous day’s shower, the smell coming from Mr Groom’s lower regions was getting bad again.
    Michelle was the nurse assigned to Mr Groom this shift, so it was up to her to deal with Dr Grey, but I was by her side when she confronted him.
    ‘Can we put another catheter in?’ Michelle asked. The doctor hesitated a moment, then looked at me, almost for confirmation. I nodded my head, and Dr Grey consented.
    Of course, Dr Grey was not going to replace the catheter, because that was the nurse’s job, and so that fell upon my friend Michelle.
    I have known Michelle from my training days; she is a pretty blonde with a ready smile, a quick wit and a habit of over-dramatising things. Off she went with catheter in hand and the faithful rubber gloves. She came back from Mr Groom’s room 15 minutes later.
    ‘Can you lend a hand?’ she asked me, a blush touching her cheeks. ‘I’m having a bit of trouble.’
    Trouble? There shouldn’t be any trouble; he’d already had a catheter so there shouldn’t be any obstruction.
    ‘Sure, but what sort of trouble are you having?’ I replied.
    ‘I can’t find it,’ she told me.
    ‘Find what exactly? The right equipment or the right size catheter?’
    Michelle’s face went red.
    ‘No . . . I can’t find his penis.’
    With this statement, Michelle began to giggle. I walked back with her to Mr Groom’s room to see if I could sort things out.
    ‘What’s the matter, doc?’ Mr Groom asked me as I walked in the room.
    Mr Groom couldn’t see what was going on because he was lying almost flat and his stomach was in the way.
    I didn’t know what to say. I couldn’t tell him that Michelle was unable to find his penis.
    ‘Nothing’s wrong,’ I lied. ‘Michelle just needs an extra pair of hands.’
    I quickly put on some gloves and got down to business.
    The penis wasn’t there – there was absolutely no sign of it. Mr Groom was so overweight his penis seemed to have been sucked up into his belly. There wasn’t even any sign of a scrotum. I glanced at Michelle who was redder than a beetroot and refusing to make eye contact with either me or the patient.
    ‘Can you try pushing a bit over here?’ I instructed Michelle, as we tried to coerce the thing out, by pushing on his bladder while I dug my fingers into the crevice where his penis should be.
    ‘Hold this bit for me,’ I instructed Michelle, as she used one hand to hold back his stomach.
    No matter how hard we tried we couldn’t find the penis.
    ‘What’s the problem, doc?’ Mr Groom asked me again.
    He didn’t sound worried, just curious. It’s just as well he couldn’t see past the roundness of his belly because he couldn’t see either my or Michelle’s face. Michelle looked like she was having a spasm – her shoulders were shaking from trying to repress a dose of the giggles. I felt like slapping her, not just because it was so inappropriate, but because it was infectious. Nothing in my training had prepared me for this. But I was not going to let Michelle contaminate me.
    I had to answer Mr Groom, but my mind struggled to come up with an answer that would not take away any last remaining shreds of dignity that we had not already stripped. I finally settled on a reply.
    ‘How do you usually