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Between a rock and a hard place

By Timothy Cocks Graded Motor Imagery, Patient examples 03 Apr 2014

Father builds guillotine and chops off his own hand in bid to end years of agony after accident left him in pain but doctors did not help…and it still hurts

“A motorcycle crash victim has amputated his injured hand with a homemade guillotine to end 16 years of unbearable pain only to find his arm still hurts.

Desperate Mark Goddard, 44, says he was driven to cut it off because the NHS refused to, and even burned his severed limb to ensure surgeons could not reattach it.

The father-of-one took a fortnight to build the guillotine using an axe, some springs and an old gate post, which took his left hand off ten days ago.

But unfortunately the DIY amputation in his garden, carried out without any anaesthetic, has failed to take away the pain that has tormented him since he was 28.

Mr Goddard from Newton Abbot, Devon, has now told his local hospital that unless they cut his arm off from the elbow by December he will do it himself.”

This story has been doing the rounds over the past few days, making headlines around the world.

The last self-amputation that garnered so much attention that I can think of was that of Aron Ralston. Ralston describes his ordeal in his book “Between a rock and a hard place“.

While Ralston’s rock and hard place were rather literal, I can imagine that Mr Goddard felt pretty trapped himself between a more figurative rock and hard place; perhaps he felt trapped between the severe and ongoing neuropathic pain and a system that didn’t seem to be able to, or to want to, help him.

“The unemployed former garage owner, who is right handed, says his severe pain began after a 1998 motorbike accident left him with nerve damage.

But doctors refused to operate because they considered his hand and wrist healthy, he said.

‘I should not have to go to such extremes to get my pain stopped,’ Mr Goddard said.

‘There was an alternative and that was having it done properly in hospital. But no one would do anything to help me – so I did it myself.

‘I got rid of it because they told me they had problems amputating my arm with a good hand on it.

‘So It took it off myself and now there is no reason why the can’t operate.'”

The article linked to above quotes a response from the NHS Trust

‘We were very sorry to learn that Mr Goddard had amputated his hand. We will continue to support him through our orthopaedics and pain management services,’ a spokesman said.

‘It would be wrong of us to comment on the details of his specific case, as that would breach our duty of confidentiality. However, doctors always try to avoid amputation if they possibly can, particularly for patients with non-paralyzed limbs.

‘There is no evidence that amputation removes pain. In fact nerve pain is often generated in the spinal cord, rather than in the painful limb itself; so for many people, the pain continues. They can also get phantom limb pain after amputation, and therefore may be in a worse situation than they were before’.

I’d argue the point that “pain is generated in the spinal cord” but the lack of evidence for amputation to reduce pain and the chance of phantom limb pain strike me as very valid reasons for avoiding amputation – borne out by the fact that Mr Goddard is still experiencing pain.

I haven’t read anywhere what treatment was offered or provided to Mr Goddard but his extreme measures scream of significant disembodiment and disownership of his left hand and I can’t help but think a bit of modern neuroimmune pain science education combined with some Graded Motor Imagery and “learning to love the left hand again” might have offered some hope.


– Tim Cocks



Get along to a noigroup Explain Pain or Graded Motor Imagery course to get your think on and get up to date.




  1. davidbutler0noi

    What an awful story -I guess some benefit may have come from the story if it makes more people aware of the horrors of chronic pain and the place of the brain in its construction. If you click back to the original blog images, note that the apparatus he made to remove the limb is quite complex. While we will never know , the complexity suggests there may have been some function in the limb. A careful progressive GMI programme linked to quality explain pain education in a multidisciplinary team where all involved have similar modern philosophies may have been and may still be an option.


  2. Poor man ……shocking………..It appears not to be such an exception as, sadly for this next poor soul who had to experience an equal dramatic choice……..A so called medical team of “Pain experts” wait for it ……. from Devon had decided that above elbow amputation was the only way forward to relieve the persistent pain of a man who, following a motor bike accident some years previously was suffering…………It gets worse when I were to tell you that his pain was in his leg!!!!!!!!!!!………No, sorry I’m joking ……..However my attempts to explain why this wasn’t going to work fell on deaf ears……….We live in a dangerous world medically were ignorance just isn’t an excuse …….When will they realise that they are in “The wrong room ” ………!!!!!!!!

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