Watching a penis get surgically removed isn’t anything like you’d expect.

Sure, it’s terrifying, and bloody, and it makes you want to brush a hand against your own crotch, just to make sure it’s still there. But the worst part about watching a penis get guillotined from its owner is that it takes so damn long.

We imagined it coming off in one brutal slice, like a John Wayne Bobbitt castration. But that’s not what happens at all. It comes off in pieces, one little chunk of flesh and muscle at a time. TheIt’s like cutting away the brown parts of an apple with a knife. You take a slice here, a slice there, seeing how much of the apple you can salvage.

Dr. Gregory Bales, M.D., a urologist and surgeon at the University of Chicago who invited me to witness a penectomy—the medical term for surgical penile amputation—likes the analogy.

“That’s exactly right,” he says. “It’s like a rotted piece of fruit. You could just throw the fruit away. But if you want to keep the fruit—and this patient really, really wants to keep his fruit —you want to minimize the tissue loss.”

He pauses and looks at the patient, who is lying on the operating table, his legs in stirrups, peacefully sedated.

Bales grabs the man’s penis, examining it from every angle, his expression somber. “I don’t think there’s a lot of healthy tissue to work with here,” he says.

The smell is staggering. Like a tube sock filled with mayonnaise that was left on a Florida parking lot for the summer.

Up close—and yes, we were allowed to watch everything, the entire excruciating four-hour procedure, within arm’s reach of the action—the patient’s penis is grey and disfigured. If Gollum from Lord of the Rings had a penis, this is probably what it looked like.

You know your penis is in bad shape when even your penis surgeons are grimacing and covering their noses.

Joe and Jake, the resident assistants for today’s procedure, are no strangers to the gross things that can happen to a human body, and even they can’t believe this guy’s penis.

They’re especially surprised when they cut into it and it doesn’t bleed. All penises bleed—if you cut into a healthy penis, it should bleed like a geyser of viscous fluid—but when Joe and Jake slice off the head of the patient’s penis, nothing appears from the wound but a dust cloud.

Eric Spitznagel

“Is this for real?” Jake asks. “That is not normal. His penis is fetid. How does that even happen?”

How indeed? When you watch a man’s favorite organ—and let’s admit it, it’s our favorite organ—get slowly sliced away into nothing, you realize just how vulnerable these pieces of flesh dangling between our legs really are.

If you’re a reasonable person, you want more information. How can you make sure something like this never happens to you, where your penis falls into such a sad state of disrepair that the only possible medical solution is to the chop the damn thing off?

There isn’t always an easy explanation. This patient is uncircumcised and has a condition caused phimosis, in which his foreskin doesn’t fully retract behind his glans penis.

That alone could be treatable, but he also didn’t have the best hygiene, and a few too many missed showers led to genital infections, which led to a fungal infection caused by Rhizopus, the same fungi you’d find on bread mold.

He decided not to have it checked out by a doctor, and by the time he finally made an appointment, it was too late.

“His penis is literally being eaten away,” says Bales, the only one in the surgical room not recoiling in horror.

As the team cuts away increasingly large chunks of his rotting penis, leaving a morbid pile of ashen globs on the patient’s belly, they finally hit pay dirt. Blood starts pumping out of the lump of tissue that used to be a penis.

One squirt shoots so far that some of us instinctively duck, even though the blood only hits a few forearms.

“The poor guy had a pretty bad understanding about what was happening to him,” says Joe, as he hacks away at penis meat.

“We talked him through what was involved in the surgery, and he was like, ‘Am I going to have sex after this?’ I was like, ‘Are you kidding me, dude? You’re not going to have any sex again.’”

For such a long surgery, it’s amazingly tense. Partly because you’re always on alert for spurting penis blood. (Nobody wants to be on the receiving end of a castration facial.)

And partly because, when you watch a man lose his penis, it makes you think. “That could be me.”

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You realize just how vulnerable these pieces of flesh dangling between our legs really are. They can be cut apart as easily as a child slices through PlayDoh with a plastic fork.

But more than that, you realize that penises don’t always get into trouble for the outrageous reasons we like to believe. The men who lose their penises are not always the morons who took wild risks and don’t deserve our sympathy.

They aren’t always the guys who rammed a rusty nail down their urethra, or tried to holster loaded guns into their pants, or thought, “I wonder if I should stick my dick in this mineral ice.”

They aren’t always the guys who humped farm equipment or penetrated park benches or cactuses or shampoo bottles and are then surprised by the consequences. Sometimes they’re the guys who didn’t make a doctor’s appointment soon enough, or didn’t realize that a soapy washcloth to the nuts could make a world of difference.

“It’s the little things, the things that are most common, that can be the most dangerous,” Bales says. “I guess that’s why it happens so often. Guys aren’t thinking, ‘This is something I should be careful about.’ It’s the behavior you think won’t end badly that usually end badly.”

The first part of the surgery is almost over. What used to be a penis now looks like, well, nothing really. It’s just splayed tissue, resembling nothing that could’ve feasibly once been used for sexual penetration.

The surgeons move on to the next stage, trying to determine where they’ll be creating the patient’s new urethra.

“How’s this?” Joe asks, poking at a soft spot on the lower part of his testicles.

“That’s really low,” Jake says. “You can’t pee out of your ballsack.”

“It has to be that low,” Joe says. “Otherwise, when he tries to pee, he’ll just spurt all over his feet.”

Bales shakes his head. “It’s really tragic,” he says.

“For the rest of his life, he’s going to pee like a girl. He’ll have to sit to pee. And if he had responded sooner, if he had recognized this was a problem, it would have been a hundred times better.”

“He would have at least had a chance of saving his penis,” Bales continues. “But that’s how guys are. They don’t want to go in and have the doctor give them bad news. But you wait too long—”

He pauses, and picks up the mangled flesh that used to be his patient’s penis.

“And this could happen.”

(This story appeared, in a slightly different form, in the November 2016 issue of Men’s Health.)

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