Wow. I know that in such cases of morbid obesity there was a genetic component, but have never really looked into it. Your comment is basically a health paper in and of itself. Thanks. By the by I was impressed with the completely professional manner in which all nine of us treated the patient. Although I'll admit that we did have a general debrief afterwards that mainly involved the words, "F**K me! That was a big one" and "Yes, I did see you subtly trying to avoid being urinated on". But of course, that is our secret stress relief skill - black humour.