The Urologist's Female Assistant

My phone rang with what I recognized as Dr. McGinnis' number. The same Dr. McGinnis whose assistant (and daughter, as it turned out) couldn't seem to leave my foreskin alone. Especially when she thought she had half a chance at slicing it off of me.

Over several months, I'd gotten used to Liz's efforts. The threat seemed worthwhile to endure, as it usually came with an masterfully extracted ejaculation, sometimes two. But what I didn't expect this time was a phone call directly from Liz. She typically waited for me to approach her mother's office before making a move.

"Hey, I don't know if you knew this, but my mom is an adjunct professor at the medical school," Liz announced, in her usual, cheery voice, "and she's kind of a 'penis guru' they bring every so often to show the students around male genitals. Anyway, she remembers your foreskin, and wants to know if you'd be willing to serve as an anatomical model on Circumcision Day."

"I don't want a circumcision, Liz."

"You don't have to get one, not this time anyway. We just need you to lie still while the medical students examine your uncircumcised penis. It pays $75 and I'll buy you lunch."

"Will you be present for this examination?"

Silence, then I recognized the sound of Liz inhaling through pursed lips.

"Wouldn't miss it for anything."

I arranged the day off from work, and met Liz at the hospital cafeteria, across from the medical school.

We took our seats amid the bustle of dozens of doctors, nurses, medical students, and staff in their white lab coats and scrubs. I noticed Liz had chosen a burrito for lunch, which she ate with a fork and knife, looking up at me intently before slicing off another bite. I took her hint.

"So, Liz, how did you get to be so enthused about circumcision?"

She chewed slowly, as if reminiscing.

"Mom always talked about her work at home," she said. "Dad seemed uncomfortable about it, but eventually he learned to join in with a question or comment. He didn't seem engaged, though. I, on the other hand, would press her for details."

"Like what?"

"Like, she told me about testicular cancer, and how the only remedy was to cut the testicle off," Liz said, popping a grape into her mouth. "She said the men always had trouble coming to terms with that until she told them if they delayed, they might lose both testicles and their penis. Then they'd listen to her.

"Later, when I started grade school and ran up against my first playground bully, I threatened to cut his testicles off myself. That got me in a little trouble with the teacher."

"Did the bully back down?"

"Kind of, indirectly. Over the next few weeks, I'd take random opportunities to make eye contact with him, then do this," she made a scissor motion with her fingers, "and he'd get all bug-eyed, then look away."

"And ever since..."

"Yeah. I get off threatening guys' genitals," she shrugged. "Guess we each have our thing, right?"

"I suppose. Have you ever carried out one of your threats?"

Liz smiled coyly and took a swig of her tea.

"You could say, indirectly," she said. "You should know here's another component to your visit today besides the modeling."

"Oh?"

"I'll show you. Done?"

We bussed our table, set the trays on a counter, and left the cafeteria.

Liz led me down a hall, through a door, and into a small room with a full-sized glass wall. Through the glass, we could observe a class in progress.

At the head of the room stood Dr. McGinnis, using a laser pointer on a wall-sized illustration of an intact penis.

"... the inner lining of the foreskin, which is membrane, not skin."

As she continued pointing to details on the graphic, about a dozen students took notes on paper or touch-screen tablets. The mix was roughly 50-50 male/female. Liz leaned over and whispered.

"They can't see us in here. It's a one-way mirror. I don't think they can hear us, either."

We took seats facing the glass. Then she laid her hand on my sweatpants and gently separated my penis from my scrotum, where it had been resting.

"The foreskin got a reputation during World War II, when U.S. military doctors noticed their Jewish recruits were a lot less likely to show up with syphilis and gonorrhea. Unfortunately, no effort was made to test this thesis by controlling for the number of sexual partners or for contact with prostitutes," Dr. McGinnis sighed slightly. "And when they returned to civilian practice, these doctors assumed they could reduce the prevalence of STIs by eliminating foreskins. Thus, the wholesale circumcision of infant boys began."

Liz slid her hand under my waistband, navigated to my penis, and squeezed the growing bulb of my glans through the foreskin. She rode her fingers over the corona repeatedly, milking my penis until it filled to erection.

"The practice peaked in the 1960s," Dr. McGinnis continued, "with 85-90 percent of newborn American boys undergoing circumcision. This continued despite no clinical evidence of any effect on STI transmission.

"In the meantime, our European counterparts circumcised virtually none of their boys. Their STI prevalence is virtually the same as ours, including HIV. So there's been a lot of surgery undertaken with no measurable benefit, let alone diagnoses."

Students began to interrupt her with questions.

"Doctor, what about cleanliness? Doesn't a foreskin produce smegma?"

"Smegma accumulates in the genital mucous membranes of males and females, and it's a beneficial substance, with antibacterial and antiviral properties. It's water-soluble, so it rinses away easily," she paused, then addressed the group. "Do you know any men or women from Europe or Latin America?"

About a third of the students raised their hands.

"Ever heard them talk about smegma?"

Silence. Liz tightened her grip on my erection, slipping her other hand into her scrub pants. Then someone asked another question.

"So if circumcision has no health benefits, why do so many parents request it?"

"There's been no polling on this," Dr. McGinnis replied, "but in my experience, it's usually the circumcised father behind the request. Some claim they want their son to identify with his father, but there's no clinical basis for believing a son would be affected either way."

"Do uncircumcised males ejaculate quicker?"

The question everyone was thinking, but no one dared to ask until this guy. A round of snickers ensued. Dr. McGinnis handled it deftly.

"If anyone can find evidence of that, or how one can predict how an infant's sex life is going to play out, I'm open to learning."

At that, Liz began a slow, rhythmic pinching of my glans through the foreskin, which made my leg jump each time. Her nuzzling my ear made me wonder if I'd be the first premature-ejaculation statistic reported to Dr. McGinnis.

"Doctor, if a boy is born with phimosis, shouldn't it be addressed earlier rather than later?"

"Phimosis cannot be reliably diagnosed until the late teens," Dr. McGinnis said. "At birth, the inner foreskin is bonded to the glans by synechia, the same tissue bonding the nail to the nail bed. This adherence is sometimes mistaken for phimosis. It will resolve itself within a few years.

"Phimosis is a rare condition, regardless. We'll cover that in the live exam later."

At that, Dr. McGinnis stepped aside to introduce a video.

"The infant circumcision we were going to observe today was cancelled. What you're about to see is an adult circumcision from my practice."

Liz slid down in her seat. I could see the bulge of her hand in her pants moving side-to-side, slowly. She pulled my foreskin out to the end and pinched it.

On the screen, I recognized the setting from the videos Liz had directed me to online. However, this one lacked the production value I'd seen on YouTube. In fact, it looked rather crudely edited. It didn't me take long to realize Liz had taken her mother's recordings and added titles, captions, and polish to make them more appealing online.

The monitor delivered this up-close circumcision to the class in 1080p detail. Liz leaned over to whisper in my ear.

"I remember this guy. He was in our clinic for a bump on his testicle that turned out to be nothing. And nothing was wrong with his foreskin; I inspected it myself. When I told him we needed a subject for this video, he volunteered." I could feel her breath on my neck. "I guess I can be persuasive that way."

As the video continued, Liz tugged at my penis sporadically, but getting to her own orgasm took most of her attention. The scent of her free-flowing vaginal moisture rose between us. She whimpered and shook as the stitching began, then slumped in her seat.

The students continued their questioning.

"Why did this patient elect a circumcision?

"He said he'd been persuaded that a circumcised penis would make him more attractive. I'm not sure where he got that idea, though. The only poll ever taken on the subject found that American women familiar with intact penises preferred them 9-to-1. And I'm unaware of any pageant he could enter."

Again, laughter. I noticed one of the women looking around at her colleagues, then raising her hand.

"Stefania?"

"Yes," she said, in a vaguely European accent, "I was wondering how many of the guys here are circumcised?"

The room fell silent. Dr. McGinnis looked around, indicating she thought it was a fair question. Gradually, every man raised his hand.

"Not unusual in this cohort," Dr. McGinnis broke the silence. "As long as infant circumcision remains legal without a diagnosis, you all have the ethics to consider."

At that, Liz slipped her hands out of her pants and mine.

"We have to go, now. This way."

She rose and led me out of the room. We walked across a hallway and into an empty surgical prep room.

"This one's not in use," she said, turning the lock behind her.

"I need to get you ready for your examination. Can't have you in there with a drooling hard-on, and you remember what happened the last time my mom handled your penis," she said, tugging at my pants as soon as I got up on the table.

"Okay," she whispered, beholding my erection. She eased her hand under my scrotum and lifted it slightly, rolling my testicles one over the other and back.

"So full," she said, looking up to meet my eyes, "I bet I got you so charged up in there, you're about to burst, huh?"

"I do need to ejaculate pretty bad."

"You've already started with all this precum. I'll pump the rest out of you."

She let my testicles fall, and took my erection in hand. She worked it slowly at first, watching as the foreskin stretched out then peeled off the glans. She gradually stepped up the pace, resting her other hand on my shoulder just like she did in our first appointment. My skin made a snapping sound as it popped off the glans.

"I kept you in there a little too long," she said, meeting my eyes again. "Think you can squirt for me pretty quick?"

I shrugged. Liz released my shoulder, slipped her hand into her panties, then teased my nose with her fingers. The intense smell of her warm vulva filled my nostrils. My erection flared.

"Come on, cum for me," she urged, jerking my penis harder. I could feel her breath in my ear. She glanced up at the clock.

It took less than a minute of Liz tugging at my penis for me to feel a pull deep in my groin that signaled an impending ejaculation. Liz sensed it too, and stepped to the side, flailing away as my semen burst in high, white arcs over the floor. She squeezed out the last of it, then gathered some paper towels from a dispenser. She grabbed my penis and wiped my meatus abruptly, making me jump. Then she fished a foil pack out of her pocket.

"Aloe vera," she said, gesturing at my foreskin. "Cool your foreskin off so it's not all red when they come to inspect you."

I opened the packet and swabbed the gel onto my glans and inner foreskin while Liz mopped up the splatters of semen on the floor. She wrapped the empty packet in the used towels and dropped them in a trash can.

"They're probably done by now," she said. "Get your pants on."

We left the room at a fast pace, taking an elevated walkway across the street and into the medical college. Liz led me up a flight of stairs to a door, where she stopped abruptly.

"This is where the students will step up, one-by-one, and examine your foreskin. They're required to handle it, to skin it back, roll it forward, and they're expected to ask my mom questions.

"Try not to get aroused. You'll embarrass me," she said, then she leaned into the door.

The teaching room resembled an exam room but with considerably more floor space. Liz gestured toward a table covered with a fitted sheet, then toward a white armoire. I slipped my clothes off, hung them in the armoire, and lay down on the table. To my surprise, it felt warm. Then Liz handed me a light blanket.

"Okay, here's how it will go. There's a circumcised guy in the next room," she gestured toward a side door, "and they will examine him first. It's a before/after comparison, so after him they'll come in to examine you ... your penis, specifically. Your uncircumcised penis." She looked at my genitals, squinted, and shook her head.

"After my mom demonstrates how your foreskin works, each student will step forward, one at a time, and skin your penis up and down. They'll identify your frenulum, your inner foreskin, your acroposthion. Some will have questions, but they're only allowed to ask my mom. You have to keep quiet the whole time. Got it?"

I nodded.

"And they're not all female, so you can close your eyes if you don't want to know who's touching you. That'll also help you and the students relax."

She looked at the door.

"If you do this right, you might get invited back," she said, reaching out to tug my foreskin sharply, "to the operating room. Then you can get promoted to the room next to this one." She winked, let my penis go, then left through the side door.

I lay staring at the ceiling in silence until shuffling in the next room caught my attention. I heard Dr. McGinnis' voice through the wall. It remained muffled until the door came slightly open. Then I recognized Liz's sneaker propping it there. She wanted me to hear the whole examination.

"... patient was circumcised at birth, which means 21 years ago. The scar line has faded, but the color contrast between the inner and outer foreskin remains apparent. Okay, one at a time, now."

I heard more shuffling as the students moved to take turns examining the man's penis.

"Okay, frenulum? Or a remnant of it," a female voice asked, "and the raphe, leading toward the scrotum."

Then I noticed Liz's eye appear in the crack of the door frame. She winked again.

"My guess," Dr. McGinnis' voice interrupted, "is this was a Plastibell circumcision. These typically leave little of the frenulum intact. The plastic clamp remains in place while the cut heals, so potential damage from gauze adhering to the incision site is eliminated."

After each student had a turn to examine the patient, a rustle indicated they were about to change rooms. Liz opened the door for them.

Dr. McGinnis led the group. She took up a position next to my shoulder and smiled warmly at me. The students seemed busy donning fresh gloves, and writing on their tablets and pads.

"This is a recent patient of mine," she said to the students, who filled the space around me but didn't make eye contact. "He presented 16 weeks ago with adult phimosis. By following a stretching regimen, assisted with topical steroid cream, the patient was able to relax his foreskin enough for full retraction. According to two independent studies, phimosis can be resolved without surgery in 96 percent of cases."

With that, she lifted the blanket, exposing me from the ribs down.

"Please identify the acroposthion, raphe, and coronal ridge. Then retract and identify the preputial band, cingulus, and frenulum. Note the condition of the meatus in contrast to the circumcised model's. Also, see if you can detect any signs of the remediated phimosis."

I closed my eyes as Liz suggested, trying to guess whether a male or female was handling my penis.

The first one seemed to have first-hand foreskin knowledge, as I felt the confident tug of someone who knew how to handle a prepuce. Then the voice gave her away.

"Acroposthion, raphe, coronal ridge," she said slowly, lifting my penis up, then peeling the foreskin open. "Preputial band, cingulus, frenulum.

"The meatus," she said, pinching the end of my glans so firmly that my leg twitched, "appears ... fuller, and more relaxed than the circumcised patient's."

Dr. McGinnis explained how most circumcised males experience a narrowing of the meatus, the urethral opening, in the years following circumcision. The condition, meatal stenosis, can become so severe as to restrict the flow of urine. Typically, she said, the remedy is to reopen the meatus with a scalpel.

As she spoke, the student continued holding my glans between thumb and forefinger, occasionally rolling it slightly. I cracked one eyelid enough to make out a slender blonde. She glanced briefly up at me, then back at my penis. I felt a pulse at the base of my pelvis. This could mean trouble.

Fortunately, Dr. McGinnis wrapped up her explanation just then, and the blonde tugged my foreskin shut. A male student took her place, and I closed my eyes to minimize the experience of another man touching my genitals.

It wasn't so bad, actually. I just went to my happy place and willed myself to ignore him, along with the next half-dozen student-doctors who stepped up to open, manipulate, and close my foreskin one at a time. I sneaked a look to the side once, and noticed Liz behind one of the students, biting her lip.

The one named Stefania came last and took longer than the others. She pulled my foreskin straight out to the limit, then rolled it back over the glans and leaned in close to examine the inner surface.

"Doctor, I see nothing unusual that I would attribute to the phimosis. Are there any remaining symptoms?"

"No," Dr. McGinnis said. "We were able to resolve the problem with no ill effects. Thank you for remembering to check that."

Dr. McGinnis resumed her narrative.

"Now, this patient," Dr. McGinnis said, stepping closer to my mid-section, "is rare in his cohort, having not received a circumcision at birth. Probably 90 percent of those born in his time were circumcised. How many of you have seen an intact penis at this age?"

I cracked my eyes just enough to see no hands rise.

"It's important for you to witness how a healthy, whole penis develops," Dr. McGinnis said, snapping on a pair of gloves.

She expertly lifted my glans, slid the foreskin down, and pointed with her other hand.

"This frenulum—see how it ties the foreskin to the body of the penis just below the glans?" she said, and the students leaned in for a close look. "Some are actually attached to the glans itself. Nothing unhealthy about that, but the attachment to the glans can break during intercourse, leading some to make an emergency room visit. In such cases there is no need to intervene. Just instruct them to apply an antibacterial or other sanitary moisturizer as you would with any other freshly exposed membrane. The frenulum will not reattach.

"The frenulum and the ridged band are the most densely enervated parts of the male body. More nerve endings per square inch than any other surface. There is evidence that stimulation of the frenulum triggers ejaculation. Circumcised males have to make up for the loss, often by engaging in aggressive, abrasive intercourse."

At that, I spotted one of the female students' mouths fall open, as if she'd been hit with a sudden realization. The rest remained silent, fixed on the sight of Dr. McGinnis pinching and stretching my frenulum. One of the men spoke up.