For some, peeing in a cup seems like an easy task. For Tom Smith of Pike County, Georgia, the request was right up there with being asked to move something with his mind. Smith suffers from paruresis, a phobia of peeing around strangers. When his employers at Caterpillar Inc. asked him to undergo a spot drug test, Smith froze. After three hours and 40 ounces of water, Smith offered to give a hair sample. Caterpillar chose to fire him for refusing to take the test.

Steven Soifer, president of the International Paruresis Association, says Smith's condition isn't quite as uncommon as one might expect, and he's often contacted by people with similar predicaments.

"It's in every situation you can imagine," Soifer says, "schools, prison probation, pre-employment testing and employment testing."

Despite the growing attention being paid to the condition, the Caterpillar people were unforgiving, refusing to comment beyond citing U.S. Department of Transport drug test collection guidelines.

» Scott Saxon