Photorealistic first-person POV of a white male doctor in his early sixties, standing at the foot of a gynecology exam table and looking down between the patient's raised legs. Bright clinical exam room, fluorescents, exam lamp, white walls, steel cabinets, glove tray, rolling stool, privacy curtain. No text, no logos. In the foreground, his open white lab coat, button-down shirt, and slacks are visible at the bottom of the frame. Pants unzipped only at the fly. An abnormally large erect cock, extremely thick and heavily veined, protrudes from the open zipper and is buried deep in her pussy, her entrance stretched wide around the massive shaft, only the base still visible outside. Realistic skin and veins. His hands are not prominent. Beyond him, a late-40s woman in high lithotomy. Classic padded U-shaped heel-cup stirrups cradle her ankles from underneath, feet raised well above the table, knees bent and spread wide. Hips at the edge of the padded table. Long straight blonde hair on the pillow. Confused, uncertain face, brows knit, mouth slightly parted, as if she does not know what to do. Sensible makeup, expensive necklace and bracelets. Pale hospital gown bunched at her waist, chest covered, hands on her stomach. Sharp focus on the penetration and her pelvis, clinical color.