Lending a hand

July 10, 2003 11:36 AM

Since we're being morbid today, how 'bout a dose of Body Identity Integrity Disorder? People with this disorder really, really want to amputate part of their own body. Here's a first-person account from a so-called wannabe, a story about a doctor who used to perform amputations of healthy limbs for BIID patients, and the article in today's Slate about a new documentary. A couple of these sites raise an interesting question: why do psychiatric disorders seem to come and go with the times?
posted by LittleMissCranky (34 comments total)

I've always been certain that my left hand is plotting to kill me. One of these days, I'll be driving along, and it will strike....veering me into oncoming traffic.

Until that day comes, it's still useful to the rest of me.
posted by graventy at 11:49 AM on July 10, 2003

Does this include anybody who ever wanted to cut off his hands after hitting "Post"?
posted by wendell at 11:50 AM on July 10, 2003

I mean, besides me?
posted by wendell at 11:51 AM on July 10, 2003

Why don't these people amputate their friggin' heads and raise the average IQ a point or two...
posted by Dark Messiah at 12:04 PM on July 10, 2003

Any doctor who performs an amputation on a healthy limb ought to have his or her license revoked.
posted by orange swan at 12:07 PM on July 10, 2003

Whatever happend to that guy on the net who was going show himself cutting off his own foot on his webcam?
posted by Akuinnen at 12:34 PM on July 10, 2003

http://www.cutoffmyfeet.com/

Found the site, looks like he didn't do it.
posted by Akuinnen at 12:37 PM on July 10, 2003

Does this remind anyone of Geek Love? It's a twisted little book, but a great read.

I don't know what to make of this disorder. I'd definitely say that these people should not be allowed to amputate their healthy limbs. There must be some other way to deal with this as a mental illness, perhaps talk therapy or drugs. To allow these people to believe that the amputations allow them to 'be themselves' in the same way as transgendered people do is dangerous and outside of medical convention. I can't conceive any connection between the two procedures. Simply put: these people are sick. The 'doctor' link in the post left me shaking my head in sadness for these people who's mental illnesses are being pandered to, rather then cured.
posted by elwoodwiles at 12:42 PM on July 10, 2003

On one hand, this sort of freaks me out.

On the other hand, though, it could be seen as a kind of extreme body modification--where is the line drawn between okay body mod and not-okay body mod? Do we, as individuals, have a right to decide how our own bodies look, or should there be a limit--and if there is a limit, who will enforce it? Is my desire to stretch my earlobes an illness in the same way as someone else's desire to not have a left foot? Are they merely points on a continuum or two completely different things? I don't think there are any easy answers.

As an aside, Geek Love deals with this subject, kind of.
posted by eilatan at 12:44 PM on July 10, 2003

I remember this news item from a few years back - it made the e-mail rounds at the time: Murder Case Centers on Amputation Festish.

The question of why maladies seem to go in and out of vogue is an interesting one. We don't see all that much in the way of St. Vitus Dance today - perhaps some of our more common modern maladies will one day become more obscure.

I recall hearing about this book a number of years ago: Hystories: Hysterical Epidemics and Modern Media. I remember that it provoked a fair amount of controversy and it sounded interesting to me, but I nver read it. The author makes the case that these syndromes often reflect the anxieties of the age.

Today, hysterical epidemics are not spread by viruses or vapors but by stories, narratives Showalter calls hystories that are created "in the interaction of troubled patients and sympathetic therapists ... circulated through self-help books, articles in newspapers and magazines, TV talk shows, popular films, the Internet, even literary criticism."
posted by madamjujujive at 12:46 PM on July 10, 2003

I don't see why these people should not be allowed to do whatever they want to their own bodies. If it is their highest desire to amputate their own leg and they will not be a burden to anyone else by doing so, then I see no reason why they couldn't. Legislate a mandatory waiting period if you want to make sure it's not a passing phase - otherwise, come on. We're all adults here.
posted by widdershins at 12:48 PM on July 10, 2003

As just mentioned, this seems like a case of "do whatever the hell you like to your own body so long as it doesn't harm anyone else" to me.

Which leads to a case of "what about the mental anguish friends and family have to endure?", which leads to a case of "does the potential for friends and family to become upset trump the right of the individual to do whatever the hell they want to their own body?", which puts us back pretty much where we started.

Personally, I don't see the mental anguish of others as a sufficient reason to restrict individual freedom (in general as well as in this specific instance).
posted by amery at 12:55 PM on July 10, 2003

Very cool links, madamj - interesting that Furth is featured in yours as well as misscranky's. Hmm...
posted by widdershins at 12:58 PM on July 10, 2003

my disgusting little tales of polyps, warts, and 8 pound tumours

I used to restore antique cars, especially Volkswagons, and I worked with quite a bit of toxic stuff, including auto paint.

One day, I noticed a little polyp-like thing in my armpit. It was red and about 1/2 a centimeter long, with a rounded bulb at the end. It was sore. This was before the advent of the internet - and I was too neurotic to make a trip to the library for research. I didn't have health care. Later, I read that doctors will sometimes remove a painfull hemorhhoid by putting tight rubber band around the base. This cuts off circulation to the offending protrusion, and it dies and falls off. Now I imagine they use lasers to remove such things.

But I didn't know of the rubber band method at the time and, as the polyp-thing gradually got bigger and bigger and sorer and sorer, I became more and more disturbed until, one evening, I just snipped it off at the base with a nail clipper. That hurt. It bled for hours while I was asleep, then finally stopped and I woke to find that my sheets were covered with blood stains. The disturbing polyp thing never came back.



Does this qualify me for the disorder?



Also, I once had a huge wart on the bottom of my right foot and would have to periodically shave down the callous which formed around the wart, in order to be able to walk normally. Otherwise, the pressure was painfull.

In my early twenties, I spent several months in Mexico. The wart didn't like the climate, I suppose, for it just dried up there and fell off, never to come back. It is fully gone - I rarely think of it, and it never comes to haunt me in dreams.


Meanwhile, my wife's Doberman-German Shepherd crossbreed dog, who is technically dead almost because she's lived so far beyond the usual expected range of her breed, developed an enourmous tumour on her side. It tested to be benign, and so we didn't have it removed, partly because the vet suggested that surgery was risky.

It started small, and grew over the course of three or four years and eventually my wife and I could no longer remember the dog without the tumour or when the tumour was small. It eventually was as big as a large grapefruit, but much heavier. When she walked, sometimes the tumour would catch on doorways. She dog didn't seem to care. The tumour seemed insensate.

When guests saw it, they would get disturbed. The tumour grew and grew, and grew some more until it was so heavy that she could no longer get up without assistance.

We talked to the vet. His opinion had changed, partly because the dog had already outlasted his expectations by a year and was going strong - except for the huge tumour.

We opted for surgery. It was a stunning $600 success and the vet - using laser surgery - sliced out the big tumour and several others, including a nasty rectal tumour which wasn't benign, and a polyp like thing on her head which sometimes bled a little and marred her beauty.

After the surgery, the vet said - "The big tumour took a lot more work to take out than I thought. It was incredibly well attached, with lots of blood vessels, and I had to make such a huge triangular incision to do the removal that I was thinking 'How the hell am I going to close this dog back up? Not what you want to hear from your vet!'

But he did close her up. Not completely though - where the three incisions on her side came together, there was a hole - for aeration and drainage. It opened up a little several days after the surgery, as the stitches pulled out a little. The hole was about as wide as a standard book of matches, about 1 3/4" wide and high. You could look right in.

Regardless, she healed perfectly and the hole closed up. Now, her fur has almost all grown back. We did not keep the huge tumour. It weighed about eight pounds, said the vet. She's become quite trim and active, like a new dog...sort of. I wonder if the she even remembers the tumour now.
posted by troutfishing at 1:03 PM on July 10, 2003

Meanwhile, maybe the people with "Body Integrity Disorder" are receiving, displaced somewhat in time, the Transhumanist or even Extropian zeitgeist of the mid part of the 21st Century, when humans start to replace and modify parts of their bodies wholesale until they are barely recognizable as human. Maybe the BID people feel compelled to cut off bits of themselves because they are unconsciously yearning for machine bits, for prosthetics which are superior to the amputated flesh and blood parts.

But maybe they are just loony.
posted by troutfishing at 1:12 PM on July 10, 2003

On one hand, this sort of freaks me out.

I really expected you to say your other hand was severed.
posted by me3dia at 1:24 PM on July 10, 2003

"What is your problem this time, Jeff?"
"I've got too many legs!"

Fans of "Coupling" might remember this.
posted by Civil_Disobedient at 1:29 PM on July 10, 2003

I am sooo tempted to link to delmoi's picture in the yahoo picture-theme thread as a response to Civil_Disobedient's comment above. But I'll restrain myself. Barely.
posted by widdershins at 1:35 PM on July 10, 2003

One side of me agrees that you should be able to do whatever you want to your body. Then there's another part that questions whether one should be allowed to go from "perfectly healthy" to handicapped by choice. Hell if I'm going to give up a decent parking spot to some lunatic that decided to cut off his/her own legs.

Also, do the urges of the disorder go away after you've cut something off... or is like getting a tattoo - once you get one, you can't stop and have to get more?
posted by Witty at 1:49 PM on July 10, 2003

Ah, there it is.
posted by MrMoonPie at 1:50 PM on July 10, 2003

Interesting comments, everyone. This issue seems to have found a split in my thinking, as usually I'm pretty libertarian about peoples' decisions about their bodies. Piercing, tattoos, stretched earlobes etc don't bother me in any way, but this is just too far. I said earlier that this is an illness because I cannot conceive of a healthy mind coming to this idea and actually going through with it. From the links it almost sounds like some weird variant of obsessive compulsive disorder, these people simply can't stop thinking about their limbs and the only way to move on is to remove the limb. They need therapy, not surgery. Passing laws to prevent this wouldn't, in my opinion, be attempts to legislate morality, but further enforcement of medical ethics. No doctor should be legally able to amputate healthy limbs just in the same way they aren't allowed to do unnecessary surgeries in general.
posted by elwoodwiles at 2:04 PM on July 10, 2003

elwood: No doctor should be legally able to amputate healthy limbs just in the same way they aren't allowed to do unnecessary surgeries in general.

Boob jobs, nose jobs, facelifts?
posted by trharlan at 2:09 PM on July 10, 2003

Civil_Disobedient, your comment reminded me of this site that is about people who want even more limbs. (nsfw) Maybe there is some type of synergy possible here?
posted by madamjujujive at 2:14 PM on July 10, 2003

troutfishing, i'm not sure whether to say thanks or too much input! maybe both.

reminds me of the clive barker short story "body politic", where the guy's hands plot to take over the world and start by cutting themselves off his body. against his wishes, of course. the left one's the leader (naturally).

the last scene in the story is in a cell block where all the unfortunate prisoners' hands have severed themselves and are walking around on their own.

creepy.
posted by gottabefunky at 2:25 PM on July 10, 2003

trharlan, good point. This is an interesting issue. I have a very knee-jerk rejection of this idea that doesn't jive with many of my opinions. I'm having trouble conceiving healthy minds making these kinds of choices.
posted by elwoodwiles at 2:26 PM on July 10, 2003

I said earlier that this is an illness because I cannot conceive of a healthy mind coming to this idea and actually going through with it.

But is that fair? What if you have a completely normal, healthy person who wants to cut off their leg? That is, with the sole exception of their desire to cut off their leg, they are totally balanced and cool?

People do some pretty crazy things without being considered crazy; the steady march of body mod impulses over the years seems like testament to the inevitable acceptance of more extreme fads. Not to say this is a fad, but it seems to be on the same continuum, if pretty much at the end point of it.

I guess I think it's possible for someone to want to do this without being out of their mind. I sure as hell wouldn't want to go there -- I practically shit a brick in the 7th grade when I chipped a tooth -- but if I can get along with people who have holes poked in their faces and ink stabbed into their dermis, I can accept someone hacking off a leg.
posted by cortex at 4:08 PM on July 10, 2003

We got into a lot of these "what should you never do to your body?" issues on the tongue-forking thread...
posted by soyjoy at 8:02 PM on July 10, 2003

I don't think a mere talk therapy will work

I don't know the details, but my hunch is that his is a far more serious and fundamental problem with the neurological system than legitimate suicidal concerns (which I imagine might be related to a "legitimate" desire to amputate, were such a thing to exist, which I doubt)

Read up on neurology, for the layman perhaps some books by Oliver Sacks

I myself do not know the science intimately but there have long been cases where patients insisted that a body part of theirs was in fact someone else's, leading easily perhaps to the desire to amputate.

This is no mere "I feel bad today" or "i feel high" or some sort of attention seeking; this is a disorder along the lines of being able to write coherently but read nothing; being able to see but unable to consciously comprehend it, causing such patients to report themselves blind; being unable to form new memories, becoming stuck in time, and constantly being unable to explain your present circumstances; being unable to hold trains of thought at all, literally "out of sight, out of mind", while not realizing your condition

- stuff like that ^^
posted by firestorm at 8:42 PM on July 10, 2003

re: cortex about someone wanting to cut off their leg meanwhile seeming cool and balanced - this is often the case with those patients who cannot acknowledge body parts as their own.

This is the case with patients who have no memories after a certain year, none at all, stuck in time they r, time travelling they r, and often they have no idea of their condition.

Many cases exist of relatively contained brain damage, where the patients are quite 'normal' and 'balanced', and sometimes the patient is not aware at all
posted by firestorm at 8:46 PM on July 10, 2003

there is a dualism here, but not of mind and body, because the mind is dependent on the brain. You must realize that these kinds of symptoms are part of an illness, and a very serious illness, and that there are people who may seem perfectly balanced but are very ill. Although some people may be tempted to preach tolerance of the entire spectrum of human thought and behavior, there is fundamentally a division between normal and illness, and that just because these people want to do such and such a thing doesn't mean that in the interest of individual freedom they should, as a very real illness is impacting them and their thought processes, a disease of the brain, that cannot be discounted to personal quirkiness.

The danger is to discount it as personal quirkiness; to assume that everyone is capable at all times of deciding for themselves.

The real dualism is the normalcy and the illness, how people normal in other respects can be gravely ill in another.

I find it fascinating that the conscious mind can exist in such states; fascinating to see that people can seem normal and yet have some very important things missing.
posted by firestorm at 8:56 PM on July 10, 2003

Aha - I was lazy - we were in Oliver Sacks land and I didn't notice. Now it all all makes sense, and I'm sorry to have made fun of the people with the disorder. Now excuse me, I have to go find my wife........no, errr, I mean my hat so I can go walk the dog.


gottabefunky - Isn't it good to share?
posted by troutfishing at 9:41 PM on July 10, 2003

stuck in time they r, time travelling they r,

Strong in the Force, this one is.
posted by kindall at 11:23 PM on July 10, 2003

Interesting that people mention Oliver Sacks, but not the stories from his book that are most to the point: the man who kept falling out of bed, because: (1) his 'proprioceptive (I'm mis-spelling that, but it's 11:25pm here, please excuse me) self-image', the mental map a person has of their own body, did not include his leg; (2) although he could move it and feel with it, he didn't know where it was without looking, or feel that it was 'part of him'; (3) while in bed his leg felt to him like 'something alien', like a huge caterpillar or something nestled up against his body; (4) so, he would throw it out, and follow it down.
posted by aeschenkarnos at 6:31 AM on July 11, 2003

aeschenkarnos - as I said, "Now excuse me, I have to go find my wife........no, errr, I mean my hat so I can go walk the dog.........."

Here is my favorite Oliver Sacks story, much better than the tale of the man who mistook his wife for a hat:

"In the mid-eighties, Sacks studied the reaction of people with aphasia as they watched a televised speech by the former-actor-turned-president. Despite being unable to grasp the skillful politician's words, the patients were convulsed in laughter.
 
"One cannot lie to an aphasiac," Dr. Sacks noted. "He cannot grasp your words, and so cannot be deceived by them; but what he grasps, he grasps with infallible precision, namely the expression that goes with the words, that total spontaneous, involuntary expressiveness which can never be simulated or faked, as words alone can, all too easily."
 
So, why did those patients with aphasia cackle at Reagan's speech?
 
"It was the grimaces, the histrionics, the false gestures and, above all, the false tones and cadences of the voice which rang false for these wordless but immensely sensitive patients," explained Sacks.
 
Conversely, Sacks remarked on a woman with tonal agnosia who was also watching the address-stony-faced. Emily D., a former English teacher and poet, was deprived of any emotional reaction to the speech but was able to judge it in the opposite way the patients with aphasia did. Her response? "He does not speak good prose," Emily D. told Sacks. "His word-use is improper. Either he is brain-damaged or he has something to conceal."
 
"We normals," concluded Dr. Sacks, "aided, doubtless, by our wish to be fooled, were indeed well and truly fooled. And so cunningly was deceptive word-use combined with deceptive tone, that only the brain-damaged remained intact, undeceived." ( anecdote courtesy of )
posted by troutfishing at 9:01 AM on July 11, 2003