What Drives People to Want to Be Amputees?

April 5, 2006 — -- Karl is a double amputee, but not by accident, birth or disease. He is an amputee by choice.

Six years ago, Karl (who asked that his real name not be used) sat alone in a parked car with 100 pounds of dry ice and an obsession to destroy his legs.

"The first thing I did was I used a wooden flour scoop to scoop some granulated dry ice into the bucket. ... It filled the wastebasket with carbon dioxide gas, which was 79 degrees below zero," he said.

Over the next 45 minutes, Karl put his legs in the wastebasket and then kept adding dry ice until it got to the top. "I spent the next six hours well-packed in the dry ice, and then I'd add more dry ice to keep it topped off," he said.

A chemistry major in college, Karl had done his research well.

"I'd done all the thermodynamic calculations, the mass of tissue, how much heat you had to subtract from that tissue to achieve freezing temperatures," he said. "And I knew that after six hours I had certainly achieved more than enough to freeze the full thickness."

After those six hours, Karl calmly drove himself to an emergency room, using the automatic hand controls he had installed in the car.

Within days, his legs began to blacken as the frozen tissue died away, and within a month surgeons had no choice but to amputate both of Karl's legs.

Karl is not a one-of-a-kind medical mystery, however. There are others like him, who believe their bodies don't match the picture of themselves they have in their minds.

"I wasn't born in the correct body," said Lilly, who has twice tried to amputate her legs. "The mind doesn't connect up to the body at all."

Dr. Michael First, a psychiatrist at Columbia University in New York, is one of the few researchers to study patients with this strange obsession to lose one or more of their limbs. The rare condition is called body integrity identity disorder, or BIID.

"When these people see an amputee, they see ... a person of strength being able to overcome hardship, someone to be admired," First said.