In the TV plastic-surgery drama Nip/Tuck on FX, a man asks the doctors to amputate his foot. There’s nothing wrong with his foot, he just wants it off. They refuse, so he takes a gun and shoots himself in the foot, so mangling it that he gets his wish.

In real life, a middle aged man walked into a Milwaukee hospital recently and asked for something similar: he wanted a perfectly normal limb removed. Again, the doctors refused, so the man went home and packed his legs in dry ice for seven hours. Fe developed such severe frostbite that they had no choice but to remove both legs above the knee. After the surgery, the man told the doctors that he was very pleased.

The desire to have some body part amputated in known as apotemnophilia, and apparently it’s pretty rare. It shouldn’t be confused with acrotomophilia, which is sexual attraction to amputees. Originally apotemnophilia applied to people who fantasized about missing a body part, but now it encompasses people who act on their fantasies as well.

Apotemnophiliacs can go to some pretty bizarre lengths to achieve their goals. Self-mutilation as portrayed in the Nip/Tuck episode or by the Milwaukee man is not unusual. One man in the UK intentionally drank himself into a stupor and passed out on some railroad tracks where the train could start the process.

The shrinks have little to say about this extreme and rather baffling fetish. It seems to involve elements of self-image, a desire for sympathy, and maybe masochism. If you’re interested, there’s a website devoted to amputation where you can read an article by a doctor who tries to understand it: