I looked at the guy standing beside my desk, then I looked at the medical records on the screen, then I looked back at the guy. He was five foot ten, maybe a little over, dark hair, dark eyes, the kind of dark, dark stubble that has turned into a five o'clock shadow almost before he's put the razor down. Would I say stocky, or would I say muscular? A bit of both, maybe. And would I say, a bit, well, twitchy? He was wearing jeans, and a T-shirt which rode up just a little to show dark hair over a flat stomach. I told him to sit down.

'OK, Peter' I said, 'the records say you've been with this practice for nearly five years and this is your first visit. So what can we do for you?'

'Two things,' he said. 'First, I need a sort of, kind of a standard health-check.'

I raised my eyebrows.

'Life Insurance,' he said. 'They're asking for a doctor's signature that I'm not going to fall down dead tomorrow.'

'We can do that. It will cost you £95 plus any extra tests you want, like cholesterol, liver function, that sort of thing.'

'Not on the NHS?'

'Sorry, not for insurance.'

'Oh, well.' He didn’t look surprised. He didn't say anything else, though.

'There were two things?'

He took a deep breath. Then he let it out and looked embarrassed. 'It’s a bit awkward.'

I'd been right. He was twitchy. I have a smooth line for this. 'I'm a doctor, Peter. Don't think of me as a guy. Think of me as a really clever white coat. Especially, don't think of me like your old man. Now, why are you here?'

He took another deep breath and this time he spoke, in a bit of a rush. 'I need to be circumcised.'

Well, I thought, I'll be the judge of that.

'Need? Very, very few guys need to be circumcised.'

He looked me in the eye. 'I think so. And it's funny you mentioned my old man. In a way, I want to be like him.'

'He's circumcised?'

'He was.'

'Ah.'

'That's not why, not really. But it sort of…' He went quiet.

'Gives you permission?'

He dropped his eyes. Now, understand me, I am a doctor. These days we don't actually swear the Hippocratic Oath, but we know what it is. It says First of all, do no harm. And we, or at least all the good doctors I know, try to live up to that. This is not always easy.

'OK, Peter. I think that means I have to see what you're talking about. Please get on the couch and lower your pants so I can examine you.'

And he did. And I did. And how can I put this. Like I said, I am a doctor. There was nothing there that was a surprise. And I'm not supposed to be other than professionally interested. But among his dark and curly pubic hair were a pair of substantial balls, and lying over them one of the most beautiful cocks I have ever seen. Let's not say big, that's a bit ordinary. Let's say fine. Any guy would be proud of it. Oh, dear, those aren't very professional words, are they? And was I imagining it, or was his cock stirring, just a little, the head just pressing behind the little rosebud at the tip of the foreskin.

Still, I wasn't going to touch it, was I? I certainly was not.

'Can you pull your skin back for me? Now a little further?' It slipped back easily over the edge of the glans, it ran back a long, long way, the frenulum was there but it didn't catch until the skin had gone back as far as it could.

'This may be a little embarrassing, Peter. I need to see how it works when you have an erection.'

'Doctor,' he said, 'you wouldn't be the first man to see me with a hard-on.'

'All the same. I shall turn round and if you can, well, do the magic?' And I turned away.

'You can look now.' And I did, oh, yes, I did. Of course it was just as I expected. His foreskin had gaped a little and now revealed just the tip of his glans and the meatus.

'Now retract it, please.' And yes, it still went all the way back.

'Peter,' I said. 'Please don't misunderstand me, but from a purely medical point of view, your penis is, well, perfect as it is. I don't understand why you want to be circumcised.'

'Need. Not want, need'

I looked at him. 'You do understand, really understand, what circumcision means?'

He lay there on the couch, his foreskin still retracted. Each time I said the word, his eyes flashed and out of the corner of my eye I thought his erection grew harder.

'Oh, yes,' he said.

'Very well then. There's stuff I have to say. Maybe you know it already,but I'm a doctor and I have to say it anyhow.'

'OK, say it.'

'All right. There are guys who need to be circumcised. Medically need it. They have a phimosis, a really tight foreskin that hurts them. Or worse, a paraphimosis that traps the skin behind the glans and maybe cuts off the blood supply and they could lose it forever. You don't have either of those.'

'I know.'

'Your frenulum, that's the little bit of connecting skin that gets tight when you're right back, sometimes we take that out, but you don't need it.'

'That's not it.'

'There isn't something, well, religious about this? Because if there is, I'm sorry, but we don't handle that here.'

'No,' he said. 'Nothing like that.'

'And this isn't some part of a scene, is it? We don't handle that here, either.'

'No.'

'Well then, I don't understand. If I agreed to circumcise you, I'd need to explain some things first. Circumcision, even if it's done carefully, takes away some of the nerve endings. Your penis would never be quite as sensitive. And the ones that remain, the ones that were inside the foreskin, they would dry up and become less sensitive, too.'

'Guys have told me that. Circumcised guys.'

'Also, your glans will dry out. At the moment it's maybe the most sensitive part of your body. I picked up a metal probe and touched his exposed glans just at the corona. He gave a little cry. 'I think that says I'm right. It stays moist under the foreskin. It would never again be as sensitive as it is now.'

He took a deep breath and didn't say anything. I think he was concentrating on not just cumming there on my couch.

'Also,' I said, 'we only do one kind of circumcision here. Maybe you've read on the net about how you tell your doctor how you want it to look. Well, not here. When I perform a circumcision, I go for the gold standard. I take as much foreskin as I can, I strip out the frenulum and you get a very clear, dark scar, quite far back on the shaft. It's a nice mark, I call it the ring of confidence, and it makes it very obvious you were circumcised as an adult. So does the colour of the glans. It never goes the colour the other circumcised guys have, the ones who were done at birth. The guys at the gym will see that. Some of them at least will know what it means.'

He gave a little moan. 'You have to stop,' he said. 'I know all that, and it's making me want it even more.'

'Right,' I said. 'Get your pants back on.' I turned back to my desk as he tried to put it away without hurting himself.

'You can't do it now?'

'No. First, there's stuff to prepare, a consent form to fill in, admin stuff.' I fiddled with the computer. 'Besides, I need to give you twenty-four hours to think it over. There's an appointment here at four o'clock tomorrow.'

And he was there, as I had known he would be. I prepped him carefully. He lay under the paper sheet. You have no idea how defenceless a penis looks when you have lifted it through the hole cut in the sheet and it is all you can see. I picked up the needle to put in the anaesthetic.

'Can't you do it without?'

'No,' I said. 'I can't take the risk of you moving when I make the incision. This has to be a good result. Now, before I put it in, I need to be quite sure you've thought about this thoroughly.'

'I've thought about nothing else.'

'All the things I told you? All the disadvantages? All the reasons against?'

'All of them. Some of them are the reasons I want it.'

'Well, just a couple of other things. First, when your glans is permanently bare, I said it will lose sensitivity, and it will. But for a week or so, maybe even longer it will still be highly sensitive, especially the corona. It will sometimes give you an erection in your pants. The edge will rub and maybe a very fine layer of the skin of the glans will flake off. You have no idea how itchy that will be or how horny it will make you feel.' Then he looks at me, 'I suppose you did masturbate last night?'

'No. I've had the last one with a skin.'

'Hmm. I think you are in for quite a bad time. Because, second, no sex, any kind, until the itching has gone. That will be hard, you'll want it a lot, but not even with lube. You'll need the lube later, when you're fit to start a sex life again. Like I said, you'll be gold-standard tight.'

'How long? Till I can?'

'A month? I don't know. Let me tell you what I'm going to do. I'm going to put in the anaesthetic, then I'll mark up your penis where I shall make the cuts.'

I put in the needle. Three injections give you a ring-block.

I pulled his foreskin back and picked up the pen. Because his foreskin was really loose I could keep the whole of the inner foreskin and a little more. I marked him. Then I held the inner skin steady and pulled the shaft skin forward and over itself till it met the mark and I marked him again. The inner skin was paler than the outer and it would show beautifully. The scar would be almost exactly at the halfway point of his shaft. I made him look, so he would know what was going to happen.

'Could it be tighter? Please?'

'You don't want it tighter,' I said. 'It'll pull your balls forward as it is. Any tighter and it will hurt when you get a hard-on.'

'Yes,' he said. 'Tighter.'

'Right. If it's what you want.'

'Not want. Need.' He was almost whispering. 'I need to know I am really circumcised.'

'Oh you'll know that,' I said. 'Every time you take it out for a leak, every time you have sex, every time you take a shower at the gym, every time you see your penis, you will know you've had a real circumcision.'

And I picked up the scalpel, and slipped the hard, sharp point of it under his soft, soft skin.