Happy amputee

February 3, 2007 1:37 AM

I won't be happy until I lose my legs"I was six when I first became aware of my desire to lose my legs. I don't remember what started it - there was no specific trigger. Most people want to change something about themselves, and the image I have of myself has always been one without legs" This woman has Apotemnophilia. She wants both her legs cut off, in fact she already had one. It's victimless - would YOU be willing to amputate a perfectly healthy limb?
posted by Baldons (97 comments total)

Yeah, victimless except for all that wasted medical attention.
posted by chrismear at 1:41 AM on February 3, 2007

Maybe they just want to enhance their bust?
posted by hal9k at 1:58 AM on February 3, 2007

Dr. Adder
posted by infini at 1:59 AM on February 3, 2007

Darling, you look FABulous. Have you lost height?
posted by hal9k at 2:09 AM on February 3, 2007 [2 favorites]

do these legs make my ass look fat?
posted by exlotuseater at 2:11 AM on February 3, 2007

I don't agree that helping these people get amputations is victimless; it seems to me the same sort of situation as giving a suicidial man a gun or a drunk friend his car keys. Helping a mentally ill person harm themselves isn't right.
posted by Mitrovarr at 2:24 AM on February 3, 2007

The suicidal man (or the wannabe amputee) wants to harm himself - that's victimless. The drunk friend doesn't want to harm himself - giving him his car keys would put his and other's people life in danger - THAT'S not victimless. You should be entitled to harm yourself. Besides, the woman feels much better now. That's not a simple problem.
posted by Baldons at 2:32 AM on February 3, 2007

Baldons: You should be entitled to harm yourself.

Only if you are of sound mind. I think it's fairly clear that people with this disorder are not.
posted by Mitrovarr at 2:34 AM on February 3, 2007

Many (deeply religious people, often) would think that NO ONE who wants to harm himself could be considered sane... that seems like a Catch-22. You can harm yourself if you're sane, but if you want to harm yourself you're surely not sane. Who decides?
posted by Baldons at 2:45 AM on February 3, 2007 [1 favorite]

Only if you are of sound mind. I think it's fairly clear that people with this disorder are not.
posted by Mitrovarr at 2:34 AM PST on February 3 [+]
[!]

How do we know they are not of sound mind? Other than the fact that we've labeled them as not having a sound mind?

The "victimlessness" of the procedure should be weighed against the likelihood of them attempting to remove the limbs themselves, which would obviously be a worse situation for everyone involved. If these people have felt as they do all their lives, then they're not exactly mentally unstable.
posted by mek at 2:50 AM on February 3, 2007

Well, it's very hard to define mental disorders, and even harder to define personality disorders (which this sounds like it might be.) However, I'd have to say that the reason this sounds pathological to me is that they are clearly highly driven to make what is clearly an illogical, harmful decision; what they want to do will obviously compromise their capabilities and their health, but they cannot offer any rational reasons to do it. The similarity between the different cases and the trends that emerge also suggests that there's some common pathology at work.

I think these people would be much better served if we could somehow reconcile their mental self-image with their intact bodies, than through surgical intervention.
posted by Mitrovarr at 2:59 AM on February 3, 2007

Indeed; one reason for society not to accomodate these people is that by becoming invalids they will cost society a lot of money.
So in that respect it's different from suicide.
posted by jouke at 3:06 AM on February 3, 2007

I wonder if surgical enhancements/reduction, that is the desire to have "normal" plastic surgery a less sever form of the same type of disorder.
posted by edgeways at 3:07 AM on February 3, 2007

edgeways: I wonder if surgical enhancements/reduction, that is the desire to have "normal" plastic surgery a less sever form of the same type of disorder.

Sometimes. There's a related disorder called Body Dysmorphic Disorder. However, I tend to think most cases aren't; most plastic surgery is not debilitating in the same way as an unnecessary amputation, and usually the people who seek it are hoping for semi-rational improvements - a better appearance and possible an improved social life. Also, they are not driven to such pathological extremes; a person who wants a nose job is unlikely to freeze it off if surgeons refuse to give it to them. If all the surgeons they went to agreed that they looked fine and didn't need surgery, they would likely accept it.
posted by Mitrovarr at 3:16 AM on February 3, 2007

You know, in the UK, "legless" has another meaning.
posted by fourcheesemac at 3:22 AM on February 3, 2007

I can't believe there's any argument here. If I want to lose a leg, let me lose my fucking leg. Who the hell are you to tell me I can't?

Not to trivialize, but "My Body, My Choice" should be every bit as applicable to a limb as it is to a intra-uterine growth you want removed. If I want to amputate the hair from the left and right sides of my head to produce a mohawk, do people have a problem with that, too?

(Obviously, amputees-by-choice should receive no public funding for wheelchairs, stump-care, etc. I'm sure they're okay with that.)
posted by skammer at 3:23 AM on February 3, 2007 [2 favorites]

skammer: I can't believe there's any argument here. If I want to lose a leg, let me lose my fucking leg. Who the hell are you to tell me I can't?

It's a social contract sort of thing. I agree with society stopping the mentally ill from harming themselves, because if I were to become mentally ill, I would want to be stopped from harming myself.
posted by Mitrovarr at 3:37 AM on February 3, 2007 [2 favorites]

It's a social contract sort of thing. I agree with society stopping the mentally ill from harming themselves, because if I were to become mentally ill, I would want to be stopped from harming myself.

These are people whose "body image" doesn't include certain limbs, and they want to correct that. Some men have a body image of being female, and they want to correct that. Are transsexuals mentally ill? Should society stop them from having surgery to cut off their penises and install breast implants?
posted by rifflesby at 3:47 AM on February 3, 2007

Let's put that hought in euthanasia: I agree with society non letting the terminally ill to end their suffer, because if I were to become terminally ill, I would not want to have my suffer ended.

It's an individual choice - you could leave that written and not interfere with other's choices, I would think. You can do as you wish - as does she.
posted by Baldons at 3:49 AM on February 3, 2007

If I want to amputate the hair from the left and right sides of my head to produce a mohawk, do people have a problem with that, too?

I was thinking similar thoughts: what about things we cut off regularly: hair, nails.

NB -- I cannot even fathom this kind of order/disorder. To be certain, I am of the opinion that people who live in situations where they might have to run a bit, hold off on this surgery until they are comfortably in safer climes.
posted by RubberHen at 3:49 AM on February 3, 2007

It's not victimless if we have to take care of you for the rest of your life.
posted by Blazecock Pileon at 3:54 AM on February 3, 2007

I feel seriously bad for her kids, that's a family secret that's gonna be damned hard to face. I suspect she's not in the least bit prepared to deal with their reactions when the time comes, as she sounds self-absorbed to the point of lacking empathy for her loved ones. Also, what Blazecock said.
posted by zarah at 4:05 AM on February 3, 2007

Should society stop them from having surgery to cut off their penises and install breast implants?

Nope. But you can't just waltz into a hospital and tell them you want a sex change. You have to undergo a couple of years worth of pre-op therapy (which allows them to screen the truly trans gendered from the plain old nut cases) before they'll even talk to you.

And, at the end of the day, the new woman will walk out of the hospital (figuratively speaking), needing no special transport, housing, or employment--they are no further burden on society.

I'm willing to shoulder a burden of those folks who have suffered involuntary loss of limb--but find it crass to have to do so for someone who does so electively.

I'd love to hear the perspective of an involuntary amputee to the idea of someone wanting a healthy limb removed.
posted by maxwelton at 4:08 AM on February 3, 2007

I saw this when it first went up. It was the "most-read" article on the Guardian site for days on end.

The parallel to gender transitioning is perfectly apt. The author is describing this as a change which fundamentally aligns her physical self with the mental self she's pictured (and valued) her whole life. Having known and worked alongside tons of genderqueer people in my former travels in LGBT activism and outreach, I'm already in favor of allowing that form of transitioning to be made more legal/accessible. Just because the concept of this one makes me feel seriously uneasy doesn't mean it's not legitimate or within her rights. I think people just object because they don't get it, and it gives them the creeps.

That said, yes, it should be privately paid for to whatever extent is possible; even if so, I think it will still trigger the same sort of "welfare-queens-with-Cadillacs" uproar as gender reassignment does from time to time in the public sphere ("Trannies getting your hard-earned tax dollars to fulfill their perverted wishes!" or whatever.)
posted by mykescipark at 4:14 AM on February 3, 2007

one reason for society not to accomodate these people is that by becoming invalids they will cost society a lot of money.

Oh please. Did you even read the article? The woman required extremely long (and thus expensive) hospital visits when she twice tried to amputate her own leg with dry ice and failed. Yet when she found a physician willing to finally actually perform the amputation, she immediately started getting better and feeling better, and wanted to leave as soon as possible after the procedure, not lingering around near death for months.

It's not victimless if we have to take care of you for the rest of your life.

I hate to inform you that we're not still in the early industrial revolution era, where the only jobs are lifting and carrying things for 10 hours a day. To assume that just because someone only has one leg they cannot make a decent living is ludicrous. How many readers of MetaFilter work in an office all damn day long sitting in front of a computer? And if you want to talk about cost, see above about failed attempts at self-amputations and long hospital stays.
posted by Rhomboid at 4:17 AM on February 3, 2007

I guess no one saw the irony in naming this year's Third Annual International BIID Meeting "Stepping Into The Future"? Or maybe the convention organizers just have a really dark sense of humor... either way, it's priceless.
posted by flapjax at midnite at 4:25 AM on February 3, 2007

I've heard Apotemnophilia described as a feeling very similar to those that have (unwillingly) lost a limb. The profound sense of something being incomplete with their bodies. It's not a conscious decision, they literally feel incomplete by, uh, being complete. I think that makes it easier for me to understand. How would I feel like if I lost an arm? Now, imagine that this same feeling was with you when you had that arm...

Thoroughly fascinating.
posted by slimepuppy at 4:36 AM on February 3, 2007

There's a documentary out there called "Whole" that traces the lives of several people who either want to lose a limb or have already lost one. It's interesting to hear their stories first-hand. I'm no psychiatrist, but these people don't sound insane. They live regular lives; they just don't happen to want limbs.
I've heard this condition compared in many ways to being transgendered: you exist in a body that you feel is wrong. As with the transgendered community, I feel like it's appropriate that we do not tell the patients that they are wrong for wanting to change their bodies, but rather allow them to make the change that suits their emotional state. Plenty of people have lost limbs and gone on to lead normal, healthy lives, and I think it's tough to argue against elective surgery in this area without somehow marginalizing amputees in general.
posted by Help, I can't stop talking! at 4:52 AM on February 3, 2007

I wonder if Arturo had anything to do with this.
posted by emmastory at 4:59 AM on February 3, 2007

Hey, can someone give me a hand?
posted by fourcheesemac at 5:19 AM on February 3, 2007

Removing legs without the benefit of modern surgical tools is would be difficult but not impossible. Did I ever tell you about the time I performed an appendectomy with a rusty sardine can? And once I was caught short without instrument one and removed a uterine tumor with my teeth.
posted by The Straightener at 5:22 AM on February 3, 2007 [1 favorite]

Sounds like a perfectly selfish way to destroy a marriage and a family to me.
posted by A189Nut at 5:46 AM on February 3, 2007

previously
it's a very interesting problem, partly because it's just so inscrutable. I mean, I guess lizard tongues or overpierced faces or whatever are pretty hard to relate to, but amputation is usually seen as a tragedy, so desperately wanting it really sits the wrong way for most people.

I understand the "it's a free country" argument, but if anyone I knew personally wanted to do this, I'd think they were crazy. Am I just not educated enough in difference to appreciate why this is just another quirk of personality? it's possible. Still, limbs are tools which are useful in navigating the world. Wanting more useful limbs makes sense, even if they would not be aesthetically an improvement. But wanting access to less of the world, wanting to limit your capacities, is hard to support with much enthusiasm.

On the other other hand, that could be considered an argument against homosexuality, limiting the likelihood of parenthood, and in order to get past that, society had (has) to get past the idea that the goal of love is the creation of children. So I suppose the key here would be to get past the idea that the goal of the body is to do things in the world. Perhaps it is just to provide a physical space for the mind, sitting in front of a screen or something.

at the end of the day, i'm not gonna fight against this, but I'm not gonna fight for it either. And I pretty much think people who want this are crazy; if I felt this desire I would certainly seek mental help first.
posted by mdn at 5:47 AM on February 3, 2007

Dr. Adder

Holy crap, I haven't thought about that book in years. Nice one. As for the subject at hand, well, I just can't seem to wrap my head around it. I just pretend I didn't read all those first hand accounts on BME and forget people like this even exist. It's easier that way.
posted by MikeMc at 6:28 AM on February 3, 2007

It's a good thing these people are living now, with all our advances in technology and understanding, and not a couple hundred years ago; how they would have survived then really beggars the imagination.
posted by breezeway at 6:37 AM on February 3, 2007

It seems perfectly clear that this is a brain disorder associated with the body map, and that any psychological cravings to have the limb removed have been gradually built up based on that biological disassociation. It is also very likely that this will be a fixable problem within a few years if it is not already. It would be irresponsible to not at least tell the woman that. Assuming this treatment was available, it would be just the same as giving someone extremely unpleasant electro-shock therapy in order to stop them feeling suicidal. They probably wouldn't want the therapy whilst they are ill, but they may well appreciate it later. I feel that this woman has probably become radicalised by people treating it like a psychiatric problem rather than a biological problem. She knows she isn't insane, and this makes her more bloodyminded to get rid of the thing rather than hold out for a 'cure'.

By the way, I would predict a comparable though considerably more complex misalignment is responsible in transgendered cases. Though if it was 'curable' I don't think we would be so sure of overruling their autonomy, given that society has become reasonably adjusted to gay people.

In the end, which is easier to adjust, the individual or the society they live in?
posted by leibniz at 6:39 AM on February 3, 2007

It's a social contract sort of thing. I agree with society stopping the mentally ill from harming themselves, because if I were to become mentally ill, I would want to be stopped from harming myself.

So how does that apply to people who don't feel that way?
posted by delmoi at 6:39 AM on February 3, 2007

I note the the wikipedia article doesn't have any medical references aside from a case study of a delusional individual and straightforward festishism. This means that BIID is about as legitimate as otherkin in the ol' scale of wikitruth.
posted by mobunited at 6:47 AM on February 3, 2007

Ever since I was 6 years old I have had the desire to have a Jumbo Jet growing out of my armpit.

After several attempts at hacking into air traffic control networks and luring planes to crash right into my arm pit I was finally allowed the operation on the NHS.

I have never felt so whole. Doing the housework with a plane coming out my armpit isn't a problem, although sometimes I do worry about the air hostesses getting all clogged up in my arm hair.

Some of you reading this will never understand. Perhaps in 50 years armpitplane syndrome will be as accepted as homosexuality is today.
posted by 0bvious at 7:07 AM on February 3, 2007 [1 favorite]

I really find these people fascinating. I actually have a half-finished script around here about a guy who wants to have his right leg amputated.

And I agree with leibniz that it more than likely has something to do with a messed up body map on the brain--same as with those with a phantom limb. However, I don't think we've solved the phantom limb "problem" (except for figuring out what causes it) so don't agree that a solution is a few years off.
posted by dobbs at 7:22 AM on February 3, 2007

"Susan Smith is a pseudonymn"

It's actually Eileen Smith.
posted by mr_crash_davis at 7:31 AM on February 3, 2007 [2 favorites]

Maybe she should have just gone to Iraq. Lots and lots of amputations going on over there.

I understand that this woman has a complex mental state that makes her want to do this to herself. But still, a part of me wants to send her to Walter Reed so she can proudly show off her new limbs to the kids there. I bet that'd cheer them up.
posted by Biblio at 8:06 AM on February 3, 2007

Question!

To my totally-untrained-mind - this, disorders like anorexia and bulimia, believing you are in the wrong gender and addiction to plastic surgery all seem related.

They're all feeling 'wrong' in the body you have. Some are not accepted by the general public and considered destructive (anorexia, plastic surgery addiction, needing to cut off a limb). Some are more accepted. (gender reassignment. Not anymore anyway. You're still doing major surgery.)

So what if doctors found out it was all one big related chemical disorder. That anorexics, people who want to hack off their leg/arm, people who want to trade in their boy parts for girl parts - all of that could be treated.

What then? Do you tell the gender assignment people. "Okay, for the last twenty years, we've said you're normal and healthy, but uh... no. no, not really. Here, Bob, have this pill, it'll make you stop wanting a vagina of your very own." while you're telling the other people "Here, have this pill, it'll make you want to stop cutting off your leg."

(I realize it would not be that easy. I'm summarizing treatment and medication into one pithy sentence for the sake of not writing a 900 word comment.)
posted by FritoKAL at 8:07 AM on February 3, 2007

Any doctor who perfoms this operation should have their license revoked, and should be shunned from the medical profession.

Since the time of Hippocrates, doctors have taken an oath to "do no harm." Any doctor who cuts off someone's perfectly good limbs because they're batshitinsane is definitely "doing harm."

This woman needs psychological help. Not missing limbs.
posted by Afroblanco at 8:08 AM on February 3, 2007 [2 favorites]

Send her to clear landmines in Cambodia.

win/win if she steps on one.
posted by the cuban at 8:33 AM on February 3, 2007 [1 favorite]

"Assuming this treatment was available, it would be just the same as giving someone extremely unpleasant electro-shock therapy in order to stop them feeling suicidal."

That may have been a very carefully included qualification ("extremely unpleasant"), but the impression the statement makes (or its implied assumptions) are incorrect.

A few years ago when I was extremely depressed, I was hospitalized and the doctor recommended electroconvulsive therapy. I didn't end up choosing to do it, but I learned a bit about it at the time. Turns out that it's a not a torturous therapy these days, although at one time it was. Nowadays they put the patient under anesthesia when they induce the seizure. It's also the case that no study has found any following brain damage or long-term damage to functioning (although in the short-term damage to memory is profound). And, finally and most importantly and astoundingly, the treatment is still by far the most effective treatment for depression with a success rate of greater than 80%!¹

I didn't just get this from biased sources—I called an old friend who is a PhD/MD (PhD in neuroanatomy). She'd had experience with it as a physician ("It's hard to argue against when you see firsthand its effectiveness at the hospital."), but also as a patient. Ironically, her personal experience was pretty bad; but that was the result of an serious error on the part of a technician.

Anyway, it's interesting that the One Flew Over the Cuckoo's Nest view of ECT persists. Frankly, that perception factored into my decision to not utilize it, in spite of what I had learned. Also, the stigma. But I think, in retrospect, I made the wrong decision.

1. All figures and absolute, unqualified assertions are covered under my blanket, universal qualification: "You can trust me on the essence of things, but always question my numbers."
posted by Ethereal Bligh at 8:34 AM on February 3, 2007

What if I didn't like my head?
posted by A189Nut at 8:42 AM on February 3, 2007

"Any doctor who cuts off someone's perfectly good limbs because they're batshitinsane is definitely "doing harm"

What about perfectly good penises for sex change surgery?

For some people, mental stability comes from some of the wildest things. Have faith in them, let them have it - or you'll risk to destabilise them even more, with pills, treatments and whatnot. Think of all the would-be transexuals, homosexuals, etc. who ended up in a mental institution because they lived in a time or place where that would be unacceptable and just plain "wrong".
posted by Baldons at 9:10 AM on February 3, 2007

What if someone said "I've always wanted to be blind". Would those of you supporting her still support her if she wanted her eyes permanently removed from their sockets?

What about someone who wanted to voluntarily make themselves deaf? Or remove their tongue and vocal chords to become permanently mute?

Would you still think this was just a "body image problem" and that it was victimless? The patient IS the victim, of their own delusions and mental incompetency. Have not any of you considered the fact that after the irreversible is done, she could, possibly, have a change of heart?

There is a fundamental difference between body modification and body destruction.

Voluntarily, and permanently, debilitating yourself is as clear a sign of mental illness as there ever possibly could be.

The woman needs a psychotherapist, not a surgeon.
posted by Ynoxas at 9:20 AM on February 3, 2007 [2 favorites]

I understand that this woman has a complex mental state that makes her want to do this to herself.

I understand that people say all kinds of crazy shit over email that may or may not resemble actual experiences and wonder if the aforementioned anonymous author is one of several sockpuppets of someone with a nice looking website. Note, for instance, that the BIID site reports her story as the only specific example of self "correction" in the FAQ. Also note that the site has no named BIID sufferers at all and none on the speaker's list of its international conference. There are, however, a number of fetishists interested in amputees and a built in attention market, and that many, many BIID references and sites seem to be connected to this (for example, only one youtube hit I could find tagged with BIID featured an actual BIID story; the rest are attractive amputees). The conflux of all of these things screams "internet-driven faux fringe group." While I'm sure there are people who actually have this problem, I am equally sure that this is being hugely amplified by the internet's ability to coddle wierd-ass bullshit.
posted by mobunited at 9:27 AM on February 3, 2007

It's actually Eileen Smith.

That's it, crash. Penalty box. Now.
posted by cortex at 9:40 AM on February 3, 2007

Susan Smith, great pick for a pseudonym, a woman who wouldn't be happy until her two own pieces of flesh and blood were amputated. By herself.

It does seem like extreme body modification, and I would prefer that these people not get any disability benefits at all. Not even a handicapped permit. I'm not a mind/body dualist, so I won't say that the mind has a different bodymap than reality. It's more that one chunk of meat has some ideas about the rest of the chunk of meat.

It definitely hits the big four: atypical, disturbing, maladaptive, and unjustifiable. I think we can accept atypical, in that the vast majority of the populace does not do it. Maladaptive, certainly ... they will be less capable in some aspect of their lives. Unjustifiable, in that they don't seem to have any reason besides "it doesn't feel right." And it's certainly disturbing to think about. Remember, this isn't someone who would be happy just not using those legs; I doubt she'd try to get nerve damage so they wouldn't work, she wants those suckers gone.

At this stage, it's probably more feasible to remove her legs than to fix whatever is wrong with her brainmap of her body, just as it seems more easy to do sexual reassignment surgery (even with the hush-hush, high incidence of post-op suicide). In the future, when science has more ability to rewire the brain, what will our choices be then?
posted by adipocere at 9:57 AM on February 3, 2007 [1 favorite]

Hmm. What are the chances she could *give away* some, uh, 'unneeded' parts to a Walter Reed patient? It's the only solution I can see that isn't evil or stupid in some sense.
posted by ransom_k_fern at 10:10 AM on February 3, 2007 [1 favorite]

I love a story with a happy ending.
posted by eperker at 11:04 AM on February 3, 2007

The following morning, and I'm still shocked by the outrage this is causing. Imprisoning doctors??? Let's look at one (hypothetical) example:

1.) Woman has leg she hates, lives in misery, constantly attempts dangerous self-amputations, perhaps suicide even. This sucks for her family as well, naturally.

2.) Doctor provides safe, sterile amputation.

3.) Cruising around in her shiny, new (self-purchased) wheelchair, woman lives the remainder of her life healthy and happy. And her family is happy because she's stopped bitching about her extra leg all the time. Win-win!

I would think there is a very valid argument that the "harm" caused by amputation (of a willing participant) is far outweighed by the harm that keeping the leg causes her mental well-being. I'm sure Hippocrates would understand.
posted by skammer at 11:11 AM on February 3, 2007 [1 favorite]

What about perfectly good penises for sex change surgery?

obcircumcision post:
What about perfectly good foreskins?
posted by PeterMcDermott at 11:21 AM on February 3, 2007

skammer, read the article. Shes not content, shes going crazy over still having that other leg. Who knows when she'll 'be happy.' Maybe no arms and no legs and no ears. Maybe then.

Random senseless violence to one's self (or others) is a legitimate sign of mental illness. A medical professional who helps a mentally ill person harm herself is in fact commiting harm himself.
posted by damn dirty ape at 12:09 PM on February 3, 2007

You should be entitled to harm yourself.

As long as you pay out of pocket for any modifications to your home, wheelchairs, crutches, anything else you need to accomodate your elective handicap, and the actual amputation and associated hospitalization, fine. Otherwise, you're just wrong—I shouldn't have to pay for you to remove that which shouldn't be removed.

This woman needs psychological help. Not missing limbs.

Indeed. I'm amazed that people think she doesn't need psychiatric help.
posted by oaf at 12:25 PM on February 3, 2007

I nursed one such case back in the mid 80s - most memorable. Staff gave her a wide berth through sheer necessity... such day-long persistent pleading and arm dragging nagging defies description. Oh yes, sane presentation at interview, sure... impeccably sane presentation when doctors appeared, sure. Manupulation's a powerful skill.

Her compliance with any psychiatric intervention? Nil, of course.

I learned then there were worse things than taking a dozen 2 year-olds on an 8 hour supermarket excursion. Had this woman leapt in despair from the ward balcony I swear I may have joined in public'ly thanking god then fought over completing the discharge summary.

Mark her words: "I always knew I would do it"... thing is she didn't do it, she didn't self-amputate, she manipulated surgical intervention, and will again. Mad as a cut snake I'd hasten to guess. I'd like to hear what the SOs have endured. Bereft of all energy, possibly.

I agree psychiatric help is appropriate, just difficult to administer... easier to amputate a perfectly good limb - no mean feat either.
posted by de at 1:50 PM on February 3, 2007

Asses.

Read about Kim, who underwent sex re-assignment at age 11.

Normal until Kim was twelve, and experienced the first signs of puberty. She was overcome by panic when her voice began to drop.

"Kim is a mentally well-developed child who appears happy and balanced. There is no doubt of the determined wish, that was already detectable since early childhood. It would have been very wrong to let Kim grow up to be a man. It is rare to have such a clear-cut case."

Some people are wired in such a way that they do not identify with the body they possess. It's as with a few of the limb transplant recipients: they can control the arm, but they don't feel like it's their's.

This woman should have the opportunity to undergo an intense psychological assessment, and only then protected against herself or provided a safe amputation. She shouldn't have to do crazy self-damaging things to get what she might need.
posted by five fresh fish at 2:24 PM on February 3, 2007

delmoi: So how does that apply to people who don't feel that way?

It has to apply to them, or it's meaningless. How many psychological disorders tweak the sufferer's brain in such a way as to make them think they are sane? A lot of them, maybe even most - and this includes some of the most destructive ones like paranoid schizophrenia.

I don't think it's any better for doctors to help a person amputate their legs to get a 'coherent body image' than it is to help a schizophrenic person cut off their hand because it's possessed by the devil. It's just a matter of one mental disorder being more overtly obvious.
posted by Mitrovarr at 2:25 PM on February 3, 2007

Oh Lordy... I've spent years trying to forget Geek Love. GOD I hated that book.
posted by miss lynnster at 2:58 PM on February 3, 2007

Might I add that my dad is an amputee... & I highly doubt he'd recommend the experience to anyone.
posted by miss lynnster at 3:01 PM on February 3, 2007

This woman should have the opportunity to undergo an intense psychological assessment, and only then protected against herself or provided a safe amputation. She shouldn't have to do crazy self-damaging things to get what she might need.

It sounds like she skipped the requisite several years of therapy and went straight to the self-damaging.
posted by oaf at 3:49 PM on February 3, 2007

Seems like there doesn't exist a highly effective treatment as yet. Drugs and cognitive therapy helped a little bit, but mostly just on the symptom (pretending to be an amputee) side which to me isn't much of a treatment (more like just telling little boys to splash cold water on their penises when they feel like masturbating).
posted by porpoise at 3:59 PM on February 3, 2007

Maybe she had a demonic possesion in her leg that she subconsciously knew about but consciously couldn't believe that so she instead thought of it as needing to feel complete.
posted by Burhanistan at 5:34 PM on February 3, 2007

I can be a bastard sometimes.
posted by Burhanistan at 5:35 PM on February 3, 2007

I still feel this is a lot closer to gender reassignment than to a schizophrenic chopping off their evil hand. This woman seems to be perfectly sane in every way -- she just wants her legs removed.

Once again: as long as she pays for it, and her family is okay with it, and a doctor concludes it the best course of action for her affliction, then WHY DOES ANYONE ELSE CARE????

Your own beeswax called -- it requests minding.

(Ape: sorry for my confusing example above. I was using a hypothetical example of a woman who wanted one leg gone just to simplify the argument. I'm sure when Eileen's other leg is gone she'll be happy, too.)
posted by skammer at 5:42 PM on February 3, 2007

skammer: If so much as a single cent from health insurance went to fund this amputation, its associated hospital stay, or any of the effects that come from it later, then she hasn't paid for it, and other people are paying for her when they shouldn't be.
posted by oaf at 6:14 PM on February 3, 2007

oaf: fine -- that's the way it works for cosmetic surgeries; I don't see why this would be any different.
posted by skammer at 6:17 PM on February 3, 2007

Yes, but that likely didn't happen, as she doesn't seem to have told anyone that she did this on purpose.
posted by oaf at 6:22 PM on February 3, 2007

I'd be curious to know whether she's applied for disability benefits.
posted by samsaunt at 6:36 PM on February 3, 2007

You know, in the UK, "legless" has another meaning.

fourcheesemac, your comment led me to this Register article. Good times!
posted by telstar at 6:54 PM on February 3, 2007

Agreed about the article-writer. She probably did get public funds.

My argument is that if physicians were (legally) able to do elective amputation (and not wait for someone's botched self-attempt to necessitate it) then it truly could be privately funded, and no doctor would have to worry about going to jail for fulfilling a sane person's (arguably) legitimate request. (Emphasis on the "arguably".)
posted by skammer at 7:37 PM on February 3, 2007

Too bad we can't cobble together a free wheelchair out of those ifs, coulds, and arguablies.
posted by breezeway at 9:22 PM on February 3, 2007

I'm sure Hippocrates would understand.

I'm not so sure.

From Wikipedia :

Hippocrates is credited with being the first physician to reject superstitions and beliefs that credited supernatural or divine forces with causing illness. He separated the discipline of medicine from philosophy and religion, believing and arguing that disease was not a punishment inflicted by the gods but rather the product of environmental factors, diet and living habits.

I think that he would consider Apotemnophilia as a philosophical or religious malady, and not a product of environmental factors, diet and living habits.
posted by Afroblanco at 10:03 PM on February 3, 2007

We better ban tatooing, too.
posted by five fresh fish at 10:03 PM on February 3, 2007

skammer: Once again: as long as she pays for it, and her family is okay with it, and a doctor concludes it the best course of action for her affliction, then WHY DOES ANYONE ELSE CARE????

Well, I disagree with that doctor's assessment; I think this woman is clearly suffering from a psychological disorder and needs psychiatric or neurological help, not amputations. Perhaps if people could agree that this is, in fact, a disorder, we could get researchers searching for a true cure; one that reconciles the patient with their intact body.

Basically, I don't want some doctor to have to go up to this woman in five years and tell her "Hey, we figured out a cure for that mental disorder you had. Sorry about your legs."
posted by Mitrovarr at 1:33 AM on February 4, 2007

I found this - talk about extreme! WARNING: EXTREME NSFW language
posted by Baldons at 2:26 AM on February 4, 2007

Whole
Ghost Limb

perhaps put my leg under a train so they would have nothing more than a stump to stitch up.

My Uncle lost his legs in a similar manner, and all I can think is--he'd probably exchange his stump with this woman's healthy limb any day of the week. Kinda sad, and disturbing.

BIID
posted by hadjiboy at 6:40 AM on February 4, 2007

five fresh fish writes "We better ban tatooing, too."

Except that tattooing doesn't permanently change your body in the same way that amputation does, and you know it, so don't be so disingenuous.
posted by dirtynumbangelboy at 6:41 AM on February 4, 2007

Um, hadjiboy, your link to BIID is part of the FPP itself.
posted by flapjax at midnite at 7:01 AM on February 4, 2007

What struck me on watching whole recently was that all of the individuals were fixated on removal of a specific limb at a specific location. Their body image never shifted, or expanded in scope of amputation desired. They also responded poorly or not at all to treatments other than limb removal. One individual obtained removal from a willing doctor who is now barred from the practice. The others did so by self-injury with shotguns or freezing. I agree that these individuals need effective psychiatric treatment, but until someone develops it, they should be allowed a safe elective limb removal procedure. Maybe a two-year counseling period first to dissuade those who can suppress their fixation.
posted by BrotherCaine at 7:06 AM on February 4, 2007

This is despicable, selfish, dangerous, and altogether just incredibly stupid. However, I can't seem to think of any reason why it should be illegal. So, I'm just going to sit around and be angry for awhile.

*grumblegrumble got two perfectly good legs grumblemumble starving amputees in china would kill for mumbmlemmph*
posted by tehloki at 7:25 AM on February 4, 2007

Um, hadjiboy, your link to BIID is part of the FPP itself

Sorry about that; couldn't bear clicking on the other links after reading the article.
posted by hadjiboy at 8:16 AM on February 4, 2007

Christ, one might think y'all were being forced to remove your own limbs.

Do you have the same sorts of opinions on sex change operations?
posted by five fresh fish at 10:11 AM on February 4, 2007

fff: Let's look at how your analogy, just like all the other times it's been used in this thread, is aggravatingly incomplete.

Sex change: I don't feel comfortable being a fully functional man, so I will elect to be surgically transformed into a partially-functional woman. Partially it's for aesthetic reasons, but moreso it's about how I feel about my identity and my gender, and the way I fit into society. I would much rather be a woman and have sex with men; this operation would repair my sexuality.

Elective Amputation of legs: I don't feel comfortable having two functioning legs, so I will elect to be surgically transformed into a double amputee. It's for purely aesthetic reasons; I can't stand to look at my legs. Additionally, I want a life that requires more care and assistance in daily tasks. This operation will not enable me to do anything I am not already able to do; I simply wish to lose a large degree of functionality for aesthetic reasons.

Only one of those positions has a leg to stand on.
posted by tehloki at 9:15 AM on February 5, 2007

However, I reiterate: I'm not saying she shouldn't have a legal right to do this to herself; I'm just saying it's an action of questionable logic and sanity, which I find particularly bizarre and selfish. Can she not try and donate her "unwanted tissue" to somebody in need? Undergo psychiatric counselling to see if this costly and wasteful medical procedure will really provide her all the psychological benefit she thinks it will?
posted by tehloki at 9:18 AM on February 5, 2007

It's for purely aesthetic reasons; I can't stand to look at my legs.

I have gotten the impression, from what I have read and seen, that for some folks that's completely off. It's for significant identity reasons—not that they can't stand to look at their legs but that they can't stand to have their legs. I don't think the distinction between two different significant body/mind dissonances is all the clear on that point, specifically.
posted by cortex at 12:06 PM on February 5, 2007

The point is, tehloki, that what she's doing is not for aesthetic reasons. This case is as much about self-identity as is that of the sex-changed.
posted by five fresh fish at 1:50 PM on February 5, 2007

Why am I having so much of a hard time accepting that this voluntary amputation shit is fine, but I can accept somebody needing to be a different sex? Is there something wrong with my brain? All I keep coming up with is "what a waste of good legs."
posted by tehloki at 3:13 PM on February 5, 2007

No tehloki, something like these NEEDS a healthy dose of skepticism/caution/thought/analysis before coming to a conclusion.

Even leaving the rest of the (rather large) discussion out of it, I would posit that changing someones genitals is still less significant (physiologically) than the complete removal of 2 limbs.

Again, stuff like this, you have to test at the limits. You'll notice noone addressed my questions above about what if someone wanted to voluntarily blind themselves, would that be "completing their body image" or would that be egregious harm indicative of mental illness?

That's because everyone has already gone on record saying "oh yeah, cutting her legs off is fine" but then they'd look hypocritical if they then said "oh wait, no blindness, that's another thing entirely".

You can stretch this to the breaking point pretty easily. What if she wanted to remove both legs AND both arms where she would have no method of caring for herself and would need constant assistance until she died. Is that still a "body image" problem?

What if she wanted to have her liver, kidneys, pancreas, a lung, and colon removed, to where she required incessant, around the clock medical treatment and machinery until the day she died. Is that still a "body image" problem?

There is a point to where a civilized society intervenes in the wish to inflict harm on oneself. At the VERY least, they don't become complicit.

This woman has a mental illness, and it needs to be treated. The "PC-ness" of being sure to accept transsexuals as perfectly normal is tainting this issue unnecessarily.

Attempting or intending self-harm is one of the most simple, visible, obvious, and easy to understand signs of mental illness.

And while it could be argued, for days, if performing sex change operations constitute "self harm", it can't be seriously argued that having healthy, useful limbs amputated is anything but self-destructive.

As I said above, there is a difference between body modification, and body destruction.
posted by Ynoxas at 8:53 PM on February 5, 2007

I assert that there is a possibility that body dysmorphia can sometimes be best resolved by actually carrying out a surgical procedure instead of:

having the person self-harm time and again; or

locking an otherwise well-functioning, productive member of society into a little padded room.

Given the documentation in the child sex-change article, there are legitimate means by which one can determine with a high degree of confidence that the individual is truly body dysmorphic and would be mentally healthier for losing genitalia/limbs/whatever.

I do not think being wheelchair-bound is an unreasonable handicap for someone who truly doesn't identify their legs with their own sense self-completion.

And given the lengths to which this woman has gone, it'd have been a helluva lot less burden on the public purse had she been able to have her legs legitimately lopped off. Hell, maybe she could have donated them to someone who wants legs.

posted by five fresh fish at 9:23 PM on February 5, 2007

The main thing that makes this such a bizarre case of body dysmorphia is that the body type the person is striving for doesn't occur naturally in healthy individuals, and has no inherent benefits over a full, typical body. It just seems so counter-productive. Perhaps this is one of those situations where a psychological solution is better than a physical one?
posted by tehloki at 10:47 AM on February 6, 2007

fff's arguments are either a joke or the worst I have ever seen on this site. Gender issues are understood and how development/genetics/environment/etc might lead to someone who has the brain of the opposite sex is not a hard to comprehend subject. Mutalting one's body, removing healthy limbs for no goal other than remove a limb, etc is not understood and most likely falls in line with severe mental illness or fetishment of the disabled. Of course the standard reply is 'but but they once said x was mental illness.' Fine, but just because some people were wrong once doesnt mean you're now right.
posted by damn dirty ape at 11:34 AM on February 6, 2007

Of course the standard reply is 'but but they once said x was mental illness.' Fine, but just because some people were wrong once doesnt mean you're now right.

Of course, it also doesn't mean that the argument is wrong, but, hey, it's really WEIRD so we should probably be dismissive about it.
posted by cortex at 11:39 AM on February 6, 2007

we don't have to reason this. the BIIDs have it all stitched up.
posted by de at 1:58 PM on February 6, 2007