The stories of five people who went under their own knife.

Even if you’ve never seen “127 Hours,” you’ve probably heard what it’s about: James Franco, stranded in the Utah mountains after a boulder falls onto his arm, has to amputate his right arm with a dull pocket knife.

The film is based on a true story. The mountaineer was 27-year-old Aron Ralston. Ralston began hacking at his arm on a Tuesday. By Thursday he realized he couldn’t cut through the bone without a bone saw, and that he would die there. That night, Ralston said he had an out-of-body experience. He was with a young boy, who asked, “Daddy, can we play now?” The next morning, in what he described as a fit of rage, he realized what he had to do.

Ralston threw himself against the boulder to break the two bones of his forearm, one at a time.

“As painful as it all was, the momentum of the euphoria was driving it,” he later told the Guardian.

Ralston fashioned a tourniquet out of cycling shorts, he tied it on and cut through the muscle. “I felt pain and I coped with it. I moved on,” he said. Ralston then scaled 65 feet of rock and began walking to freedom.

A selfie Aron Ralston took before amputating his own arm. | Aron Ralston

Ralston’s story is incredible, and it’s easy to think of him as a hero possessed with superhuman self-possession, but he’s just one of many people who’ve been forced by deadly circumstance to perform self-surgery when there was no other alternative.

Some self-surgeries are done by people with psychological problems and are actually a form of self-mutilation, so we’re not gonna go into those here.

The earliest self-surgery I found record of was by Joannes Lethaeus (also known as “De Doot”), a Dutch blacksmith who suffered from a kidney stone in 1651. As anyone who’s had a kidney stone will tell you, you’ll do anything to be rid of it. A stonecutter (a type of doctor who specialized in removing kidney stones) tried twice to remove it, after which Lethaeus vowed no one else would lay a blade on him. A Dutch surgeon recounted, 20 years later, what Lethaeus did next (after sending his wife to the fish market so she wouldn’t witness it).

Joannes Lethaeus, with knife and kidney stone, looking very pleased with himself. |

“Only letting his brother help him, he instructed him to pull aside his scrotum while he grabbed the stone in his left hand and cut bravely in the perineum [a fancy word for the area between the scrotum and the butthole] with a knife he had secretly prepared, and by standing again and again managed to make the wound long enough to allow the stone to pass. To get the stone out was more difficult, and he had to stick two fingers into the wound on either side to remove it with leveraged force, and it finally popped out of hiding with an explosive noise and tearing of the bladder.”

(That passage is from Nicolaes Tulp’s 1672 book “Observations Medicae.”)

The stone was the size of a goose egg. We don’t know if Lethaeus lived long afterwards, and doot means “death” in Dutch, so the story may be apocryphal, but the editors of the Interstate Medical Journal believed it to be true, reporting in 1908 that the knife and the stone itself had been displayed at a medical history exhibition in Berlin two years earlier.

In 1961, a 27-year-old Russian surgeon named Leonid Rogozov was stationed at a Soviet base in Antarctica. By March, he and 11 other men were cut off from the outside world by the Antarctic winter. In April, Rogozov developed a pain in his abdomen, which he recognized as acute appendicitis. It would be at least October until the weather cleared, but that would be too late. There was no other doctor on base. The pain intensified.

“This is it,” Rogozov wrote in his journal. “I have to think through the only possible way out: to operate on myself … It’s almost impossible … but I can’t just fold my arms and give up.”

As his assistants looked on, Rogozov commenced his operation calmly, using a mirror. “I worked without gloves. It was hard to see,” he wrote. “The mirror helps, but it also hinders?—?after all, it’s showing things backwards. I work mainly by touch.” Every five minutes, he rested for a few seconds. The ordeal took an hour and 45 minutes.

“Finally, here it is, the cursed appendage!” he wrote. “With horror I notice the dark stain at its base. That means just a day longer and it would have burst.” Rogozov recovered and lived for 39 more years.

Antarctica would play host to self-surgery again. In 1998, American ER physician Jerri Nielsen was working at the Amundsen-Scott South Pole Station. In March, she discovered a lump in her breast. By the time she realized it wasn’t benign, there was no hope she could be airlifted out until at least October. She was the only doctor there, and didn’t have the proper medical equipment for a biopsy.

“Dr. Nielsen, using ice as an anesthetic, stuck herself in the breast 20 times, hoping to get enough tissue for a biopsy,” the Washington Post reports. “A welder trained as her co-surgeon, practicing needle pricks and incisions with a potato and thawed chicken; a mechanic set up a microscope and computer to transmit images of the biopsy to the United States.”

The results came back positive for cancer. As the world watched, the US military attempted a perilous drop of medical treatments and supplies. Nielsen them self-administered chemotherapy until she could be rescued in October. She died in June the following year.

Other self-surgeries have been conducted for more mundane reasons. Dwain Williams, a 48-year-old tree cutter in Florida, attempted to carve a growth out of his forehead in 2010 using a box cutter. He also filmed it and posted it on YouTube. (“Entertainment” is probably the wrong YouTube tag, Dwain.)

It took him a few false starts?—?click if you dare?—?but he eventually succeeded, and healed after a few weeks. In Williams’ case it wasn’t the Antarctic isolation or the pain of an untreated kidney stone in 1651 that drove him to self-surgery. He simply couldn’t afford the $2,000 deductible for an operation.

“Every penny I make goes mostly towards mortgage and taking care of family,” Williams told the local Miami news outlet WVSN. As the economy worsened, he had to drop health insurance altogether.

“I’ve always been good at working on anything, anything I set my heart out to do, I usually accomplish it,” Williams said.

And that’s what all the self-surgeons in this story have in common.