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A Not-So-Magnificent Obsession

Bizarre disorder makes sufferers crave limb amputations

SUNDAY, June 3, 2001 (HealthDayNews) -- At any given moment, a small number of Americans are searching for something most of them will never find -- a surgeon willing to cut off their perfectly healthy limbs.

These men and women suffer from apotemnophilia, one of the most bizarre disorders in the annals of psychology, and they want to undergo amputations in order to "feel whole."

"You have this foreign body and you want to get rid of it," says one sufferer who actually found a doctor in Scotland willing to remove his right leg.

But should such surgery even be allowed?

"It just flies in the face of everything that medicine holds dear," says Stacy Running, a San Diego assistant district attorney who successfully brought murder charges against an unlicensed surgeon who botched a leg amputation on an 80-year-old man three years ago.

Adds Arthur Caplan, director of the University of Pennsylvania's Center for Bioethics, "It seems indisputably ga-ga nuts to sit and reasonably talk back and forth about whether this should be done and where we are going to do it."

While some recent, high-profile cases have captured the media's attention, apotemnophilia is not a new disorder.

Medical experts have reported cases of amputation obsession since the 1860s, says Richard L. Bruno, a New Jersey psychophysiologist who specializes in brain-body disorders and is one of the few people in the world who has extensively studied apotemnophilia.

No one knows how many people are obsessed with amputation. However, there are Web sites devoted to the subject -- one was named after Venus de Milo.

Bruno has identified three groups within the larger community of people obsessed with amputation:

  • "Pretenders" use wheelchairs, crutches and other devices to make people think they're disabled.
  • "Devotees" are sexually attracted to amputees and disabled people, and will often search for them on the Internet.
  • "Wannabes," who get the most attention, live for the removal of their healthy limbs.

Typically, sufferers are men and they want one leg or both cut off, Bruno says. However, there are also female sufferers. They include "Corinne," a California woman who wants her legs removed and appeared in a British documentary last year about amputation obsession.

"For me, sexuality is being comfortable with my body," she says. "Inside, I feel my legs don't belong to me and shouldn't be there. There's just an overwhelming sense of despair sometimes."

The cause of apotemnophilia isn't clear. John Money, a psychologist and sexuality expert at Johns Hopkins University, gave the disorder its name in 1977 and declared that sufferers have a sexual fetish centered on amputated limbs.

Apotemnophilia has also been linked to obsessive-compulsive disorder and homosexuality.

Some sufferers deny their obsession has anything to do with sex; they say it's simply a "body-image disorder" that can only be cured through amputation.

Taking a different tack, Bruno suggests that victims desperately seek attention and love from others.

"What these people really want is to be accepted," he says. "They feel they are unlovable and want to be loved."

'It's about becoming whole'

But many obsessed with amputation heatedly dismiss Bruno's theory.

Gregg Furth, a New York City child psychologist who suffers from apotemnophilia, says the disorder revolves around feeling like a complete person.

"It's about becoming whole, not becoming disabled," he says, adding that sufferers "feel there's an alien aspect of their body."

Furth told a San Diego courtroom in 1999 that he first began obsessing about amputation when he was 4 or 5 years old. He's now in his mid-50s.

His search for a cure -- amputation -- ultimately led him to John Ronald Brown, an "underground" doctor in San Diego. The 77-year-old Brown lacked a license to practice medicine but did have a reputation as a shoddy surgeon.

Furth and an 80-year-old friend, Philip Bondy, who also suffered apotemnophilia, traveled from New York to San Diego in 1998, both hoping to have Brown perform their amputations in Tijuana, Mexico. But Furth backed out.

Bondy went ahead and had his left leg removed. Brown left him to recover in a Holiday Inn across the border in a San Diego suburb, where he died a few days later of gangrene.

A jury convicted Brown of second-degree murder.

Furth resurfaced in the news again last year, when he found a doctor in Scotland who was willing to tackle an amputation of his right leg. The doctor had previously amputated the limbs of two other apotemnophilia sufferers.

But the Scottish media picked up on the planned operation, and the hospital where it was to take place quickly banned it.

Caplan, one of the top medical ethicists in the United States, says people struggling with apotemnophilia clearly have a medical disorder, and they can't be cured by giving in to the disease.

"It's like saying I'm a schizophrenic and I hear voices, so I want the doctors to communicate with my demons to exorcise them," he says.

Bruno also opposes performing unneeded amputations. But he says victims of apotemnophilia often live hellish lives.

"I feel terrible for them," Bruno says. "There are just far more questions than answers [about the disorder], and unfortunately, many of these questions may be unanswerable. We may never know why these guys want what they want."

What To Do

Predictably, there are few online resources about apotemnophilia.

You can read this ABC News report on the furor in Great Britain following revelations that a surgeon there had amputated healthy legs from two men.

You also might want to read previous HealthDay articles on amputation.

SOURCES: Interviews with Stacy Running, assistant district attorney, San Diego County District Attorney's office, San Diego, Calif.; Richard L. Bruno, Ph.D., director, Post-Polio Institute, Englewood Hospital and Medical Center, Englewood, N.J.; Katharine Phillips, M.D., director, Body Dysmorphic Disorder and Body Image Program, Butler Hospital, and associate professor of psychiatry, Brown University, Providence, R.I.; Arthur Caplan, director, Center for Bioethics, University of Pennsylvania, Philadelphia; Michael Pinzur, M.D., professor of orthopedic surgery, Loyola University, Chicago, Ill.
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