Most people reading this blog will have two arms and two legs. However, the average (here recall your school maths) may well be somewhere just below two of each. Losing a limb through accident or deliberate amputation is uncommon but it is certainly not rare. Taking surgical amputations as an example, five to six thousand operations are carried out in the UK every year – and, notably, about nine out of every ten of them will result in phantom limb syndrome.
A phantom limb is a slightly ghoulish term that’s used to refer to the sensation that an amputated limb is still there. The feelings that result range from mild tickling to intense pain. In Medicine Now a photograph by Alexa Wright shows a disfigured and odd-looking arm extending from just above the elbow of a seated woman, but the arm itself is not real; it’s the visualisation of a phantom limb. The woman (who did not attach her name to the photograph) was in a devastating car crash nine years before the photograph was taken and as a result had her left arm amputated. Like most amputees she subsequently suffered from phantom limb syndrome. Yet despite the discomfort and pain of this, she does give us a perhaps unexpected perspective: “I wasn’t born like this and obviously I do miss my arm, yet sometimes the phantom pain makes me feel whole again.”
Historically, work on phantom limbs has been hamstrung by a lack of knowledge of what causes them. The phenomenon was for a long time thought to be a psychological one, but scientists now suggest it may originate in the brain and spinal cord. My lack of scientific knowledge prevents me from delving too deeply into this and so I want to focus on a different side of the story: the way rehabilitation has been limited.
For years the solution to phantom limbs was thought to be medication, medication, medication; on the whole this had marginal results. Yet if you speak to a Visitor Experience Assistant in Medicine Now or if you are visiting when an object handling session is taking place you might well get the chance to see our mirror box. A mirror box is what you might call a Ronseal-type object – it is a box with a mirror stuck on the side.
For individuals with four limbs it can be used to demonstrate the disjunction that can occur between what the eyes see and what the brain experiences but for people with phantom limbs it can be a very effective form of pain relief. By essentially tricking the brain, the reflection of the one remaining arm or leg can be perceived as that which is missing and the body’s ‘need’ for its absent limb can be realised. Similar work can be done with prosthetic hands or virtual technology.
The photograph taken by Alexa Wright is one of a series of 24 and they can all be seen on her website. In each, you can see the individual with their missing arm or leg and also with their phantom limb. The photographs are humanising and shed some light on one of the many medical conundrums that we still have no complete answer to. Despite the grand narratives and concepts of medical science that we often defer to, the experience of the individual is still paramount.
Charlie is a Visitor Experience Assistant at Wellcome Collection.