My first thought, strangely, was consensual BDSM. Some places online brag about how much pain that their masochistic partners can take through photography. Why he'd choose to not talk about it however is another story, and the lack of pain's kind of strange. How long had the cuts been there? Did they have any chance to heal, or were they fresh?
Interesting stuff though. Could that far down be done by someone flexible enough with the use of a mirror? Could the source of the cutting have been mounted on a wall with him moving his body to guide the cuts against it?
I had a patient last week who arrived in trauma with two enormous flaps of tissue missing from each shoulder. They were bilaterally symmetrical and seemed professionally excised, and deep enough that his sternoclavicular joint was exposed. He didn't appear to be in any pain, though he was extremely agitated.
I asked him what had happened and he couldn't tell me. Said he didn't know. I asked him if he was aware his shoulders had been flayed and he shrugged, unconcerned. It didn't seem possible that this could have been self-mutilation, because the flaying extended down to the bottom of his scapula and I can't imagine anyone being able to reach over their back and cut with such precision.
We called the police and the psych team, who weren't able to get any more information out of him.
I've been ruminating about this all fortnight, because the flaying almost resembled wings. Possibly some kind of ritualistic cult thing? A weird religious practice? Who knows.
Anyway, I'm back now.
Hmm we didn't consider the BDSM angle. Quite possible scenarios. I still don't think it would have been possible to do yourself even with a mirror, but the mounted blade is a very interesting idea. I just struggle to fathom why someone would go to those lengths, and it would have taken excruciating hours. I spoke to a colleague and he said, half-jokingly, "Serial killer." Unnerved me a bit.
The wounds were about a week old, I'd guess. Hard to say since he might have been interfering with the healing. He'd been dressing them with tissues (they were sprouting white fluff all over).
For reference, these flayed patches (wrapping from above the nipple to base of scapula) might have been almost half a meter in length, and ~20cm wide).