The Human Centipede (First Sequence) is a 2009 Dutch body horror film written, directed and co-produced by Tom Six. The independent film concerns a deranged German surgeon who kidnaps three tourists and conjoins them surgically, mouth to anus, forming the eponymous "human centipede". It stars Dieter Laser as Josef Heiter, the creator of the centipede, and Ashley C. Williams, Ashlynn Yennie, and Akihiro Kitamura as Heiter's victims.

According to Six, the concept arose from a joke he had made with friends about punishing a child molester by stitching his mouth to the anus of a "fat truck driver". Other sources of inspiration were Nazi medical experiments performed during World War II, such as those performed by Josef Mengele at the Auschwitz concentration camp. When approaching investors to fund the project, Six did not mention the premise of the film for fear of putting off potential backers; financiers did not discover the full nature of the film until completion.

The film held its premiere at the London FrightFest Film Festival on 30 August 2009. It received a limited theatrical release in the United States on 30 April 2010. Despite a mixed critical reception, the film won several accolades at international film festivals. Two sequels that were also written and directed by Six—Full Sequence and Final Sequence—were released in 2011 and 2015, respectively. The entire trilogy was combined into a single film in 2016, titled Complete Sequence, which Six described as a "movie centipede" due to each Sequence leading into its successor while simultaneously working as a separate standalone cinematic film.

Plot Lindsay and Jenny, tourists from New York City visiting Germany, get a flat tire on their way to a nightclub and seek help at the house of Dr. Josef Heiter. He drugs the women with Rohypnol in their water and locks them up in a makeshift medical ward.

The misanthropic, psychopathic surgeon Heiter is a retired world-renowned expert at separating conjoined twins, but dreams of "making new creatures." He plans to surgically connect his three victims' mouths to their anus, so that they share a single digestive system. His prior experiment, the 3Dog, conjoined three Rottweilers into a "conjoined triplet"; all three dogs died following the operation.

Lindsay and Jenny find themselves trapped on their gurneys next to a Dutch truck driver, whom Heiter kidnapped at the beginning of the film. Heiter declared the trucker incompatible with the ladies and ends his life. He later kidnaps Japanese tourist Katsuro. After Lindsay tries to escape and fails, Heiter decides to make her the middle segment of the centipede. Heiter performs the surgery, placing Katsuro at the lead, Lindsay in the middle, and Jenny at the rear; mutilating Lindsay and Jenny's mouths and stitching each to the anus of the person in front. He severs the ligaments of his victims' knees, forcing them to crawl.

Once the operation is complete, Heiter takes the centipede to his living room, takes photos of each segment to humiliate them, and passes a mirror around so the segments can view their new form. Heiter treats his human centipede as a pet by caging the centipede in a dog kennel, training them into obeying his orders, forcing Katsuro to eat dog food at dinner, and belittling Katsuro with racist insults and beating him with a crop when he becomes rebellious.

Eventually, Katsuro needs to defecate. He does so after apologizing to the girls, after which Lindsay is forced to swallow his excrement. Heiter becomes irritated after being kept awake at night by the caged centipede and threatens Katsuro (who, as the front part of the centipede, has his mouth free and is still able to speak) with the removal of his vocal cords. When the centipede attempts to escape while Heiter is swimming, all three segments are punished by being beaten with the crop. During a checkup, Heiter is displeased to learn that Lindsay is constipated. He proposes to use laxatives on Lindsay, but discovers that Jenny is dying from sepsis.

Two detectives, Kranz and Voller, visit the house to investigate the disappearance of the three tourists as well as the trucker. Heiter is inspired to add them as replacements for Jenny in a new four-segment centipede. He offers the detectives more spiked water, causing them to become suspicious and obtain a search warrant for his home. After the detectives leave, the victims attempt to escape, and Katsuro attacks Heiter. He injures him, but their attempt to escape fails. Katsuro confesses to Heiter that he deserves his fate because he treated his family poorly, then takes his own life by slitting his throat with a glass shard.

Upon returning to Heiter's home, the detectives conduct separate searches as Heiter, injured, hides near his swimming pool. Kranz finds the ward containing Heiter's victims. Voller begins to feel ill from the earlier drugging, and Heiter stabs him with a scalpel that he pulled from his foot during Katsuro's attack, killing him. Heiter takes Voller's sidearm and shoots Kranz when he enters. Kranz fatally shoots Heiter in the head before succumbing to his wounds.

Back in the house, Jenny and Lindsay hold hands as Jenny dies from her infection. Lindsay sobs as she is left alone in the house, trapped between her deceased fellow captives.

Cast

Dieter Laser as Josef Heiter, a retired surgeon who specialised in the separation of conjoined twins, but in retirement is more interested in joining creatures together. Casting for the role of Heiter took place in Berlin, and Six intended to cast Laser before he had even read for the part, after Six saw a DVD of one of Laser's previous films. Laser had previously appeared in over 60 mostly German-language films,Jason Solomons. (19 August 2010). "Film Weekly hooks up with The Human Centipede and experiences Pianomania". The Guardian. Guardian Media Group. Event occurs at 7:15–7:20. Retrieved 8 September 2010. including Der Unhold and Baltic Storm (he speaks German in parts of First Sequence as well). Upon meeting him in Berlin, Six gave Laser a shot-by-shot explanation of Heiter's scenes, and Laser, impressed by Six's dedication and passion, agreed to take part in the film. Laser contributed considerably to the development of Heiter's character. For example, because Heiter views the "centipede" as his pet, Laser felt that it was important that Heiter appear naked during a scene in which he swam in full view of his victims, because Laser said "you aren't ashamed to be naked" around a pet.Tom Six, Director's Commentary, 56:50–57:05 Ashley C. Williams as Lindsay, an American tourist, a friend of Jenny's, and the central section of the centipede. Auditioning for the roles of Jenny and Lindsay took place in New York City. Six said during the auditioning process, many actresses walked out of readings in disgust after hearing the full nature of the role.Berge Garabedian. (22 October 2009). "Sitges 09 Interview – Tom Six/Human Centipede" . JoBlo.com. JoBlo Media Inc. Event occurs at 2:40–2:50. Retrieved 13 November 2009. Others thought they would be able to take on the role, but found it was "too much" for them once they got onto their hands and knees behind another actor. Williams expressed concern about the nudity expected of her in the film, but took the role when she was assured it would be modest and of a non-sexual nature. Ashlynn Yennie as Jenny, an American tourist, a friend of Lindsay's, and the rear section of the centipede, where she acts as the functioning anus. As with Williams, The Human Centipede was Yennie's first major film role. Yennie was one of several actresses to audition for the role, as the producers searched for an actress who would have good on-screen chemistry with Williams. Yennie was able to further develop her relationship with Williams when the pair shared an apartment in the Netherlands during filming.Stuart O'Connor. (1 September 2009). . Screenjabber. Screenjabber.com. Event occurs at 1:55–2:30. Retrieved 28 March 2011. Yennie auditioned to Ilona Six, the film's producer and sister of Tom Six, and did not meet Tom Six, who had viewed tapes of her reading, until fitting for the centipede special effects in the Netherlands. Yennie was drawn to the role by the humanity throughout the story, referring to how the three victims of Heiter are unwillingly forced into their situation. She also said the story was so realistic it scared her.Stuart O'Connor, FrightFest Interview, 1:30–1:55 Akihiro Kitamura as Katsuro, a Japanese tourist and front section of the centipede, acting as the head. Having already acted in or written for a number of films and television shows (including popular American television series Heroes), Kitamura was a relatively experienced actor compared to other cast members. He auditioned for the role of Katsuro via Skype from Los Angeles after the casting director saw him on television and recommended him for the role. The rest of the cast did not meet Kitamura until the day before shooting commenced. Rene de Wit as Truck Driver, one of Heiter's victims. De Wit had previously worked with Six in his 2008 film I Love Dries.Tom Six, Director's Commentary, 2:15–2:21 Andreas Leupold as Detective Kranz, a police officer. Peter Blankenstein as Detective Voller, a police officer.

Production Writing The inspiration for the film's plot came from a joke that writer/director Tom Six once made to his friends about punishing a child molester they saw on TV by stitching his mouth to the anus of an overweight truck driver. Six saw this as the concept for a great horror film, and he began to develop the idea.Berge Garabedian, Sitges 09 Interview, 0:25–0:47 He has said he was heavily influenced as a filmmaker by the early works of David Cronenberg and Japanese horror films.Brad Miska. (29 April 2010). "Tom Six Answers Your Questions About 'The Human Centipede'". Bloody Disgusting. The Collective. Event occurs at 7:30–7:55. Retrieved 8 May 2010. Six has said he prefers horror films that are more realistic over monster films that are "not really believable", and that he gets "a rash from too much political correctness." A major influence for The Human Centipede was Pier Paolo Pasolini's controversial 1975 Italian drama film Salò, or the 120 Days of Sodom, which was notable for its scenes depicting intensely graphic violence, sadism, and sexual depravity, as was the work of Japanese director Takashi Miike. Six has also expressed his love of the works of David Lynch.Jason Solomons, Film Weekly... 9:05–9:15 Further inspiration came from Six's previous role as a director on the Dutch series of Big Brother, where he had been able to observe people who "did crazy things when they were alone and thought they were not (being) watched."Jason Solomons, Film Weekly... 6:06–7:00