No stranger to controversy and a lover of the shock factor, Lady Gaga kept her performance for the 2009 MTV Video Music Awards a secret until time came that she had to get up on the stage. All that she promised fans beforehand was that it would be something they’d remember for the rest of their life – and MTV can vouch that this was clearly not a performance for the faint of heart.

The singer ditched her usual, out-of-this-world getups to don something more “down to earth,” if such a term could ever be applied successfully to her. Gaga wore thigh-high, white, leather boots and had only one shoulder covered in feathers, so it’s clear that it was not her choice of the outfit that shocked, but rather the way she chose to reenact on stage the same idea from her official “Paparazzi” video. Some would kill or even be killed for fame, Gaga said with both her video and VMA performance: in her case, the latter applied.

“As the sound of a crashing chandelier interrupted her introduction, the camera cut to Gaga, lying on the floor, her face hidden behind a beaded mask with feather horns, getting helped to her feet by her male dancers. Wearing white knee-high boots and a white belly-bearing unitard with a single feathered shoulder pad, she sang a few lines of ‘Poker Face’ before busting into ‘Paparazzi’ on a set that looked like an ornate mansion. Staggering around the stage with a cane at one point, Gaga pirouetted behind a dancer in a lily-white wheelchair and made her way over to a white grand piano, banging on the keyboard while hoisting one foot up on the keyboard, her voice growing more urgent with every frenzied note.” MTV says of the bizarre performance.

A gasp could be heard from the audience as Gaga got up from the piano, staggered towards the center of the stage and there was blood gushing out from under her ribcage. She dropped to the floor and, almost with tears in her eyes, continued to sing about the “media vultures,” as she dabbed at the blood and stared bewildered at her hand. The ending was even more tragic, MTV confirms.

“[She] collapsed into a heap while a dancer wailed in agony and gently laid her down center stage. Hanging listlessly by one hand, Gaga rose above her dancers and, blood smeared on her face and caked on one of her eyes, stared lifelessly at the stunned crowd while the sound of camera shutters filled the air and a golden halo was projected on the big screen behind her.” MTV says of the shocking performance.

At the moment, the entire performance is available here only for US residents. Those who do not fit the bill but would still like to see what went down when Gaga took the stage to perform “Paparazzi” can see a brief segment of it in the video below.