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From Ramachandran's Notebook
Case 3
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After publishing his findings on Tom Sorenson, Ramachandran received a flood of phone calls and letters from amputees eager to know more. Some of these responses would help him answer an obvious question: Does the same sort of remapping in the brain take place when body parts other than arms and hands are lost?

One day I got a call from a young woman in Boston. "Dr. Ramachandran," she said, "I'm a graduate student at Beth Israel Hospital and for several years I've been studying Parkinson's disease. But recently I decided to switch to the study of phantom limbs."

"Wonderful," I said. "The subject has been ignored far too long. Tell me what you are studying."

"Last year I had a terrible accident on my uncle's farm. I lost my left leg below the knee and I've had a phantom limb ever since. But I'm calling to thank you because your article made me understand what is going on." She cleared her throat. "Something really strange happened to me after the amputation that didn't make sense. Every time I have sex I experience these strange sensations in my phantom foot. I didn't dare tell anybody because it's so weird. But when I saw your diagrams, that in the brain the foot is next to the genitals, it became instantly clear to me."

She had experienced and understood, as few of us ever will, the remapping phenomenon. Recall that in the Penfield map the foot is beside the genitals. Therefore, if a person loses a leg and is then stimulated in the genitals, she will experience sensations in the phantom leg. This is what you'd expect if input from the genital area were to invade the territory vacated by the foot.

The next day the phone rang again. This time it was an engineer from Arkansas.

"Is this Dr. Ramachandran?"


"You know, I read about your work in the newspaper, and it's really exciting. I lost my leg below the knee about two months ago but there's still something I don't understand. I'd like your advice."

"What's that?"

"Well, I feel a little embarrassed to tell you this."

I knew what he was going to say, but unlike the graduate student, he didn't know about the Penfield map.

"Doctor, every time I have sexual intercourse, I experience sensations in my phantom foot. How do you explain that? My doctor said it doesn't make sense."

"Look," I said. "One possibility is that the genitals are right next to the foot in the body's brain maps. Don't worry about it."

He laughed nervously. "All that's fine, doctor. But you still don't understand. You see, I actually experience my orgasm in my foot. And therefore it's much bigger than it used to be because it's no longer confined to my genitals."

Patients don't make up such stories. Ninety-nine percent of the time they're telling the truth, and if it seems incomprehensible, it's usually because we are not smart enough to figure out what's going on in their brains. This gentleman was telling me that he sometimes enjoyed sex more after his amputation. The curious implication is that it's not just the tactile sensation that transferred to his phantom but the erotic sensations of sexual pleasure as well.

Case 1 | Case 2 | Case 4 | Case 5 | Case 6

*The non-introductory portions of this article were excerpted with permission from Phantoms in the Brain: Probing the Mysteries of the Human Mind, by V.S. Ramachandran and Sandra Blakeslee (Quill/William Morrow, 1998).

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