The Body Politic

A short thing on BDS and extreme body modding. Judging by the self-expressive sorts you see in BMEzine and the like, it looks like there are a lot of doctors like our narrator out there.

“I blame Action Man,” Louise said, and for the first time that morning her eyes sparkled. Her hands, until now folded awkwardly in her lap, fluttered eagerly at me. She illustrated her story with lightning sketches, cut from the dust motes drifting in the deep gold of the late afternoon sun.

“My brother’s Action Man had the Eagle Eyes and realistic gripping hands,” she said. “Except over time the hands became slack with overuse. A crack developed between the fingers and the rest. Eventually, the fingers, well, they just came off, and poor Action Man was just left with a palm and a thumb.” Louise demonstrated, giving me a perky thumbs-up.

“Now, I looked at Action Man, and I didn’t see a mutilation. I saw a neat, unified package of flesh. I saw something to aspire to. All of a sudden these…” and she riffled her long fingers at me, “these didn’t look so great. I looked at my hands and I saw squids, spiders, tentacles. These two awful thrashing things attached to the ends of my arms.”

She shuddered, and suddenly her hands were a self-conscious tangle bunched in her lap again.

“I was eleven,” she said, in a voice that was barely a whisper. “Eleven. Can you imagine what that’s like? I couldn’t bear to be touched, I couldn’t bear to touch. Schoolwork suffered because I couldn’t stand to pick up a pen. The doctors suggested I use a word-processor.” She let out a snort that was both derisive and desperate. “They wanted me to type. You can imagine how I felt about that.”

She smiled faintly, but there was more irony that humour in the expression. “Actually, no, I don’t imagine you do. I can’t work. Not in any conventional sense. Mobile phones and remotes, yes, I can use those because…” She mimed for a moment, an imaginary phone caught in her palm, her strong thumb jabbing at invisible buttons. “But really, I’m trapped. Stuck. Every day it’s worse. I don’t want the pills any more. The therapy doesn’t help. I have two options open to me now, and one of them is suicide. You’re the other.”

She made an attempt to reach towards me, caught sight of her hand, fingers extended, and drew back again, cradling herself. Her eyes, as she looked at me imploringly, shimmered with tears. “You have to help me,” she said. “No-one else can. No-one else will.”

“I don’t know what you mean, Louise,” I said. “What you’re asking is for me to betray every ethical consideration in the book. You’re asking me to do away with the central tenet I’m supposed to live my professional life by. Do No Harm, Louise. You want me to take away your fingers. What doctor could possibly say yes to a request like that?”

I’d adopted a high, stentorian tone as I harangued Louise. While I was orating, I’d pulled a fat yellow legal pad out of my bag, and scribbled a note on it, which I passed over. Louise took it gently between the thumb and palm of her left hand, bunching her fingers out of the way as best she could. She looked at the note, then at me. I paused in my speechifying just long enough to press a warning finger to my lips. These days, most surgeon consultations are taped, to avoid the kind of thing that even now I was agreeing to carry out on the girl in front of me. Louise was in tears again, but now they were tears of gratitude.

It’s called BDS. Body Dysmorphic Syndrome. An irrational, but extremely powerful aversion to parts of your own body. It’s a disease that has led perfectly rational intelligent people to hack off fingers, toes, feet out of the desire to feel normal. Something they could not in all honesty do with the offensive limb or appendage taunting them.
That’s the phrase that’s been used, when patients try to describe their feelings towards themselves. They feel that their own bodies are rebelling against them. It’s the warped sister of anorexia, a thought form that has come of age as the most extreme form of body modification. It is a disease with a following, a disease with a community.

I am its facilitator. I am the surgeon these desperate, frantic people come to when they realise that they can no longer live with their God-given shapes. I am the one that understands their need to reform, to recreate themselves, to finally become the person they always imagined themselves to be. While other surgeons twist themselves in a Gordian knot of morals and ethics, I know that solving the problem is achieved with one simple, clean cut.

I led Louise back out of the consulting room. Sweetly, she was holding my hand, gripping it between thumb and fist.

“Next week,” I tell her, trying to look stern. “Wait for my call. Don’t contact me. As far as the authorities know, you’ve been warned off. So try and look like you’ve just been yelled at, for God’s sake.” She pouted, unconvincingly.

“Now scoot.”

“Thank you, Doctor.” she whispered. “Thank you for making me complete.” She gave my hand one last clumsy squeeze, then she was away, across the receiving area, where a tall figure was already rising from chairs to greet her.

As they walked away, her boyfriend looked back at me, and winked. Something cold spiralled up my spine. I knew that man. Billy Hefrin. One of my first. One of my failures. The empty left sleeve of his jacket was testament to his triumph.

As he had left me, after that first operation, he had turned to me and said “All I need now to complete this is a girl like me. And I’ll find one. Even if I have to talk her into it.”

And then I remembered the rest. The things he could do to a girl with no fingers, the things he planned to do with a girl who had no choice but to make a fist. I felt suddenly sick. Billy looked back again. He couldn’t help it. He had a smile he’d been hanging on to for a long time, and the day wouldn’t be complete until he’d given it to me.

Then he was gone, and I’d love to say that he’d had to tug Louise along, that his grip on her arm was vicelike, that she looked back at me with a glint of fear in her eyes. I’d love to tell you that she wanted to let me know, somehow, that it was all a lie, that Billy was forcing her into it. Somehow, I’m still trying to put some signs of coercion into her straight back, her jaunty stride, the sassy toss of her hair as she led Billy away. There’s something there that tells me something’s wrong, surely.

And of course, it’s not as if I can refuse the procedure. Louise has the piece of paper I gave her, telling her I would perform the surgery. Hardly a cast-iron legal document, but it would be enough. If she showed it to the papers, or even a hospital administrator, that would be the end of it for me. It doesn’t matter whether everything she told me was a lie or the truth. She had me, held firm in her gnarled little fist, and the only way she would ever let me go would be when she no longer had the fingers to hold me.

I looked down at my hands, swooning as the balance of power shifted around me. Surgeon’s hands, strong, long-fingered, sensitive. The hands of a healer, I always believed.

No more. I regarded the instruments of my undoing with a kind of horror, and all at once I understood how Louise felt, how Billy had felt. Everything that the wounded souls I had laid my hands on had lived through flooded into me as I looked at my hands and felt nothing but revulsion. And with that revulsion, the knowledge that unlike them, I had no- one to go to. There would be no-one to save me. I was trapped. I was locked in a cage that I had built with my own hands.