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- - - - - - - - - - - - Aug. 29, 2000 | For just about everyone, losing a limb is a fate too horrible to imagine. But for New York psychoanalyst Gregg Furth, the amputation of his right leg would be a dream come true. Not that there's anything wrong with his leg. It works properly and he walks like anyone else. It's his brain that's broken.
Furth suffers from an extremely rare disorder whose victims are obsessed with the amputation of their own healthy limbs. For decades, he has tried to find a doctor willing to take up a knife and chop off his right leg so he can feel, for the first time, like an intact person. "It's about becoming whole, not becoming disabled," he said. "You have this foreign body, and you want to get rid of it." Last year his quest led him to Scotland to see Dr. Robert Smith, a surgeon who has performed two amputations on healthy limbs. Smith agreed to operate on him after three psychologists reviewed Furth's case, and the two wrote a book about the disorder. But Furth's luck ran out. The public hospital where Smith performed the earlier operations backed out amid bad publicity. Then on Aug. 25, a private Scottish facility rejected Smith's request that he be allowed to perform operations there. Now appalled Scottish politicians are clamoring for laws banning the amputations and creating a media flurry in the U.K. Dennis Canavan, a member of Scotland's parliament, told a newspaper last week that the surgery is "obscene" and demanded an investigation by health officials. "The whole thing is repugnant and legislation needs to be brought in now to outlaw this," said Canavan, who represents the Falkirk region, home to a hospital that allowed two amputations of healthy limbs. Stung by his critics, Smith, who reportedly has six other patients lined up for healthy-limb removal, warned of dire consequences for his patients. "They may take the law into their own hands, they may lie on a railway line and get run over by a train. They may use shotguns and shoot their limbs off," he told reporters recently. "They are really quite a desperate bunch." Meanwhile, officials at the private hospital are suggesting that the surgeries be done at a university facility instead. "We're not unsympathetic to what's happening, but unfortunately we don't think this is the right hospital for the procedure," said hospital manager Beth Martin. Furth in turn contended that the British press misrepresented the hospital's decision as a rejection of an operation on him. Smith did not make a specific request about a patient, said Furth, so they could not have been rejecting his procedure. Could there really be a public debate on the viability and ethics of cutting off healthy limbs? "It's meshugeneh -- absolutely nuts," said medical ethicist Arthur Caplan, turning to Yiddish. "It's absolute, utter lunacy to go along with a request to maim somebody." Caplan, the director of the University of Pennsylvania's Center for Bioethics, explained that such an amputation would violate the Hippocratic Oath in the extreme. "The cure is not to yield to the illness and conform to the obsession. And this is not just about 'do no harm.' It's also about whether (sufferers) are competent to make a decision when they're running around saying, 'Chop my leg off.'" While the fate of Furth's leg hangs in the balance, his public plight has shined a light into the dark world of amputation obsession. No one knows how many people live their lives in hope of cutting off a healthy limb, but Furth says he knows of about 200. Among the annals of abnormal psychology, mentions of the disorder -- known as apotemnophilia -- lurk in footnotes and a handful of academic papers. "I'm not an expert in this. Nobody is," said Dr. Katharine Phillips, a Brown University psychology professor and leading authority on body dysmorphic disorder, a much more common condition in which people cannot accept their bodies. Sometimes those afflicted with the disorder take drastic measures -- including unnecessary plastic surgery and self-mutilation -- to try to fix body parts they think are deformed. Some amputation hopefuls say their condition is a type of body dysmorphic disorder, but Phillips isn't so sure. "My patients are not trying to get rid of a body part. They're just trying to make it look better," she said.
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