IN ONE GENERATION: A Fantasy

OBD

From People magazine and lots of other media the world did know that immediately after signing with HBO Mike had talked his parents and his doctor into letting him have his legs placed in full-length fiberglass casts for six weeks. He wanted to get thoroughly accustomed to living without the use of his legs, and the recent experience of a schoolmate recently recovered from a broken leg convinced him that this was the way to have his legs look and function more like Rory's when the time came to shoot the movie. During and after his time in the casts Mike used only the HBO-provided wheelchair to get around, never taking weight on his legs at all from mid-February when the contract was signed until shooting was completed in early July.

When Joey learned of this he demanded that the hip-to-heel braces he would use in the movie be fitted for him immediately. Within a week he was crutching along in them as much as he could, just as Rory had done at his age, and otherwise using the wheelchair HBO provided him. A physical therapist sent by HBO three times a week worked the boys through stretches to keep their legs limber. After the shoot it took several weeks for the brothers to regain sufficient strength in their legs to get through an entire day of unaided walking.

The pulp press had been full of speculation about whether they would return to normal walking at all. Through the 1990s many disability "pretenders," otherwise healthy and for the most part seemingly quite normal people marked by a deep need to live as physically disabled persons, began discovering one another on the internet. Almost all of them, especially those with a desire to actually become physically disabled, had kept their proclivities the darkest of secrets, believing no one else could possibly have such seemingly irrational compulsions and desires. As the internet facilitated communication among them they discovered that there were very definite patterns to their behavior, and they began to demand attention from the world of health care.

Dr. Gregg Furth and others, following up on the pioneering work of Dr. John Money, gathered the experience of many of these persons for professional review and analysis. Early in 2026 the National Institutes of Health gave official recognition to orthopedic body dysmorphia (OBD), admitting those diagnosed with it to the national health care system. The application of OBD protocols and procedures was incorporated into the Body Dysmorphia and Voluntary Amputation Act of 2028, one of the last measures of the second Biden administration.

Social acceptance as legitimately disabled persons began to increase for the small but steady number of young persons, mostly male, who each year voluntarily gave up, wholly or in part, the use of their legs or, far less often, an arm. Parents confronted with an OBD child in their own family, however, typically had difficulty accepting the reality of the diagnosis. In most cases they simply would not sign the legally required consent to disability status for minor children diagnosed with OBD. Most OBD patients, therefore, had to wait until age eighteen to begin living openly as disabled persons.

A common practice was to arrive at college on crutches or in a wheelchair clandestinely supplied by the Free to Be OBD organization and work for legal disability status through the university healthcare system. Most institutions, even state sponsored ones, processed previously diagnosed OBD cases to legally disabled status in a matter of days, and quietly permitted freshmen not yet eighteen to go ahead and live as disabled persons until their birthday when their status could be legitimated. The case of those entering employment directly out of high school was more difficult. The organization had set up residential clinics in several major cities for transitioning such cases into disabled status before their entry into the world of work, but the demand for these services far exceeded the supply.

Much more fortunate were the OBD children of enlightened parents. Some had been known to let their diagnosed children openly honor their body image as a mobility impaired person as early as age ten, by consenting to medical authorization of the full time use of crutches, not only in the classic swing-through gait but even to facilitate the complete disuse of one or the other leg. OBD children needing to put both legs fully out of use, however, had to wait until their sixteenth birthday since the law did not permit medical authorization of wheelchair use for younger OBD patients. The voluntary use of assistive devices by minors was not in itself illegal, but the public health plan would not provide them without the medical authorization which could only be secured with parental consent. Moreover, children without such authorization were not permitted to use assistive devices in the public schools or while participating in other government funded programs.

The medical protocol for the amputations sought by many OBD patients, as incorporated into the law, required that they be eighteen or older, have lived without the use of the affected limb or limbs for at least five years, and have been under the regular care of a licensed psychologist or counselor throughout that time. Most, therefore, had their surgery in their middle twenties. A very few, however, could and did qualify for the amputation of a single leg as early as their eighteenth birthday if they had had the affected limb out of use from the time they turned thirteen, with the required parental consent and monthly professional counseling.

Because medically authorized wheelchair use in OBD cases was legally restricted to patients sixteen and over, no one under twenty-one could have both legs amputated. The law also required much stricter scrutiny of OBD involving the arms, and forbade the amputation of both arms entirely, on the grounds that very few occupations in contemporary life required use of the legs, while the efficient accomplishment of almost everything required the use of at least one hand.