**Super gross chapter warning!**

I don't normally like to go for the shock factor, but sometimes we see stuff that makes even us -- healthcare professionals that deal with blood and piss daily -- grossed out.

Fournier's gangrene (don't Google it).

A man is admitted with scrotal swelling, noted by nursing home staff. He's got quite advanced dementia so hasn't been able to tell them where anything hurts. I only met him on the urology grand round today. He's MRSA-positive so he's been getting some pretty hardcore antibiotics -- meropenem and vancomycin. It's basically industrial bleach in terms of antibiotic power, needed for the monster that is MRSA.

The urologists examine his wound today. They undid his nappy and peered at his nether regions. Then one placed his (gloved) hand on the penis and lifted it to get a better look at the scrotum and...

The scrotum just... peels off the perineum (the area between the legs), exposing raw flesh.

I fought against a gag. The man is crying from pain.

The urologists nod. "Healing. Good." (Urologists don't tend to be folks of many words.)

They ask the nurses to give the man some painkillers and move onto the next patient.