In January of 2003 Susan's anger reached the boiling point. One evening she enticed Jeff with the promise of sex into a bondage game in which he let himself be tied to the four corners of the bed. In a paroxysm of rage, Susan then sliced at his penis and stabbed him almost two hundred times all over his body. Becoming panicky, she then dragged his body to their backyard where Jeff had for some reason dug a pit. She placed his body there, thinking to tell people he had "disappeared." Their dog dug up the body a few days later. At the trial that took place after her arrest, the prosecution argued that she killed him for insurance money, but this was far-fetched. If the burial had been successful, Jeff would not have been declared officially dead for seven years. The defense argued that she was a battered woman who had "lost it" in a fit of rage but had to resort to trickery because he was twice her size and much stronger. Some courts, recognizing the "unfair fight" element when a large man is abusive to a small woman, show leniency; others do not. Susan was given a twenty-five-year sentence with the possibility of release in half that time. She was not psychopathic. The case has the features of an impulse murder, but some planning was evident just before and just after the attack as a result of her physical weakness compared to her husband's size and strength." Category 5 seems the appropriate level for Susan Wright.
Ed Gingerich
Married to an Old Order Amish wife from the Pennsylvania Amish community, Ed Gingerich was befriended by an evangelical Christian man, David Lindsey, from the surrounding non-Amish population. David hoped to proselytize Ed, who in the process began to feel torn between the two ways of life. Ed had ambitions to be more "free," like the "Eng- lish"-as he called the non-Amish people, yet he felt strong ties to the Amish ways, which included avoidance of cars, telephones, electricity, and doctors from the outside. In this context Ed suffered a nervous breakdown and began to have visions and dreams about leaving the old religion. He was sometimes abusive to his wife, Katie. Though the breakdown led at first to Ed's going to a conventional hospital, his wife and brother persuaded him to stop taking the medications the doctors there had given him. Instead they insisted he see an Amish chiropractor and healer who prescribed molasses for his condition (as the healer did for all other conditions as well). Ed's paranoid preoccupations with visions and the devil quickly resumed. He became combative at times or would crawl on the floor sobbing. In 1993 Ed had wanted to attend a wedding, but Katie insisted he go instead to an herbalist far away.
That man was honest enough to say he could offer nothing of help, urging that Ed be hospitalized instead. The family refused, forcing him to see the molasses doctor instead. The actual day of the wedding, Ed became enraged and beat Katie to death with his fists, tore her abdominal organs out in front of his children, and smashed her skull. At trial he was called "guilty of involuntary manslaughter, but mentally ill," and was sent to a forensic hospital unit in a Pennsylvania prison, where he spent about two years. It was discovered that when Ed was about ten, he had fallen off a horse and was unconscious for a time; this may have played some role in his eventual breakdown. Some people in his community still consider him an unstable and potentially violent man.23 The Gingerich case conforms to Category 6*: impetuous, hotheaded murderers, yet without psychopathic features. I add an asterisk here to draw attention to the presence of mental illness. In the last section of this chapter, I will have more to say about the way certain crimes committed by the mentally ill elicit from us the reaction: evil! more predictably than do the crimes of others.
Dr. Bruce Rowan
The youngest in a large Idaho family, Bruce Rowan had been depressed most of his life, grappling with suicidal feelings and convictions of being "unworthy." His depression continued through his medical school days, in the middle of which he was hospitalized briefly because of suicidal thoughts. At one point he made a suicide attempt with pills. He had a girlfriend, Debbie, who stood by him, partly out of love, partly out of fear that if she were to leave him he would kill himself. They married, and for a while they went around the world doing charitable work among the poor in various countries. Once back in the United States they adopted a baby girl. His wife wanted to get a house and settle down. Bruce was still eager to roam the world, his lofty ambition-to help the poor-being driven in part by the hope this would alleviate his chronic feelings of unworthiness. Debbie of course spent considerable time with the baby. Bruce grew increasingly resentful at having to do chores around the house and at having less "quality time" with his wife.
In March of 1998 his resentment crossed a threshold into rage, and he killed Debbie with an axe. He then put her body into their car, pushing it down a hill to make it appear as an accident. Afterward he stabbed himself in the abdomen, using his medical knowledge to avoid spots that might prove fatal. All this happened the day a half-milliondollar insurance policy he had taken out for Debbie (for which he was beneficiary) had come due. At trial Dr. Rowan was declared not guilty by reason of mental illness and was sent to a forensic hospital. His longstanding depression outweighed, in effect, the planning that accompanied what was otherwise primarily an impulse murder born of rage. The lenient decision was in all likelihood a reflection of his being, in general, neither psychopathic nor sadistic, despite his extreme egocentricity. 24 The Rowan case fits into Category 7 on the scale: highly narcissistic but not distinctly psychopathic persons, often with a psychotic core, who kill loved ones or family members. Killing his wife with an axe, even factoring out the "staging" of the murder to resemble an accident and the insurance windfall, was enough to earn the label of "evil" from the public, even more so because the killer was a physician who once had taken the Hippocratic Oath: Do No Harm.
Gang Lu
One of four children from a middle-class family in mainland China, Gang was an outstanding student. This enabled him to attend an American university for graduate studies in physics. Enrolled at the University of Iowa, he earned his doctorate, but he had hoped to get a certain physics prize as well. He was barely beaten out for the prize by another Chinese student, Lin-hua Shan. Gang became progressively embittered and paranoid, insisting that the heads of the physics department had been conspiring against him to deny him the prize. In the fall of 1991, twenty-eight-yearold Gang obtained a pistol permit, not a difficult accomplishment in this country for someone with a "clean record." Then in November, Gang calmly shot to death the chairman of the physics department, a professor who had sat in when Gang defended his PhD thesis, yet another professor who was his mentor, a female dean who Gang regarded as "dismissive" of his (frankly paranoid) letters of appeal, and last but not least, his archrival, Lin-Hua Shan. He then committed suicide.
People who knew him on campus described his personality as a collection of the following traits: combative, argumentative, envious, bitter, difficult to live with, shy, a "loner," quiet, brooding, resentful, slovenly, "know-it-all," self-centered, nit-picking, abrasive, rigid, aloof, critical, hotheaded, a "spoil-sport," overly proud, and paranoid. A devotee of pornographic and violent films, Gang was narcissistic and possibly personally repellent, but he was not psychopathic. This configuration is very common in persons committing mass murder-a topic I will expand upon later. We know less about the personal lives of mass murderers than we do about most other types of murderers, because they usually die at the time of the murders, either by their own hand or by the police. The appropriate category for Gang Lu would be 8: non psychopathic murderers with smoldering rage, who kill when the rage is ignited. The general sentiment surrounding this case; namely, that an evil had been committed, reflected both the enormity of the crime-five lives lost-and the fact that the victims were all highly placed and highly valued members of the academic community.15
IMPULSE MURDERS AMONG THE MENTALLY ILL
In commenting on murderous or other violent acts by mentally ill persons-acts that reach the level of "evil" in the public's opinion-our first task is to try to take the vagueness out of the inherently vague phrase "mentally ill." People in ordinary life
are inclined to call anyone "crazy" or "mentally ill" who commits a violent act of particular gruesomeness, especially if it is unprovoked. Someone who castrates a man and then eats the genitals or other body parts will unfailingly be called" crazy" not only by the public and by journalists covering the story, but also by most judges who might preside at the subsequent trial. But this is because the act was so repugnant and primitive, nauseating, even, and so rare, that it goes beyond the imagination of most people to think such a person could be "sane." Sane, however, is no longer a psychiatric term so much as a legal term, indicating that the person in question knew right from wrong and understood the nature of his act.26 Most mentally ill people are not so far out of touch with reality as to lose those distinctions, so legal insanity is rare indeed. For our purposes, we will restrict the phrase mentally ill just to those persons who suffer from a condition that, for some extended period, causes them to be in poor contact with reality and to suffer certain symptoms such as delusions, hallucinations, and peculiarities of speech-as seen commonly in schizophrenics or people with a mood disorder so profound as to cause the rapid-fire speech and grandiose ideas typical of the manic person. The extreme selfdisparaging thoughts of the seriously depressed or melancholic person would be another type of mental illness, as we saw with Robert Rowe and Dr. Rowan in the examples above. In some mentally ill people, both thought and mood are morbidly affected.
I recall a particular case as an example. A woman had been in a psychiatric hospital shortly after her husband divorced her. Now at home, she fell into a deep depression, but she also came to believe that her exhusband, who lived miles away, was sending poisonous rays from his eyes that went through her windows and made her ill. Another example: a man took his rifle and shot his neighbor, convinced that God had commanded him to kill "Satan" (the neighbor having, in his mind, somehow morphed into the devil) so that the world could be "saved." Every so often one will hear of a mentally ill man who stabs his pregnant fiancee or wife to death, believing that God, or perhaps some secret terrorist organization, has ordered that the woman die because she is "really" the whore of Babylon or else the enemy of the state, who must be killed so as not to bring destruction upon the world. These are all examples of mental illness. Although the bulk of mentally ill people, defined in this way, suffer from schizophrenia (which primarily affects thought processes) or manicdepression (which primarily affects mood), some will develop conditions with similar symptoms that result from serious head injury or from abusing drugs such as methamphetamine, cocaine, LSD, or alcohol. Extremely heavy, repeated use of marijuana can induce mental illness of this sort as well. All these conditions come under the heading of "psychosis," which is simply a technical term indicating a condition that seriously disturbs one's grip on reality. When a psychosis is connected with a chronic condition such as schizophrenia, the more serious forms of mood disorder, or head injury, we are on more certain ground in speaking of mental illness. The situation becomes more murky and controversial in many cases of drug abuse, because of the seemingly voluntary nature of the abuse. One could presumably have chosen not to get drunk and therefore chosen not to have committed whatever act of violence the alcohol "made" him do (as the offender might try to argue in court). Public opinion is divided on this point. There was a young man from North Carolina, some years ago, for example, who got drunk, and while inebriated shot his rifle through his car window as he was driving, killing a passenger in a car that had been driving alongside his. In court, the shooter was called by his attorney "temporarily mentally ill because of the alcohol" and thus not capable of exercising judgment as to right or wrong-hence not responsible. Surprisingly (surprising to me, anyway) the judge accepted this interpretation and sent the man to some treatment program rather than to prison. In my view, the man had effectively willed himself into a state of lowered self-control, where he was more at risk to do something foolish and dangerous-and was therefore doubly guilty and doubly dangerous.
But if we now turn our attention to the unequivocally and chronically mentally ill, controversy and disagreement will evaporate. It turns out that some of the most horrifying and repellent acts of violence, where the word evil comes immediately to almost everyone's mind, are committed by mentally ill-especially schizophrenic-people. Those laboring under bizarre delusions or who have succumbed to psychotic rage may act as though freed from all inhibition, or as though the victims they are attacking or mutilating are not really "people" at all. All restraints are off; no "punishment" is too great. And when a psychotic person commits mayhem in this way, through dismemberment, cannibalism, mutilating disfigurement, and the like-the scene will be splashed on the front page of the tabloids as a combined titillation and warning about what shocking things crazy people are capable of. And herein lies a problem of immense consequence to the general public. In the minds of many people, events that make headlines appear to be precisely the kinds of events that "happen all the time" against which we must be perennially on guard. Yet the hard facts and the statistics tell a different story-one that has great meaning for our discussion of mental illness, evil, and the supposed overlap between the two. Apart from the crimes of serial killers and mass murderers (most of whom are disgruntled loners but not necessarily psychotic), it so happens that the term evil is applied with particular frequency to certain acts of violence by the mentally ill. We saw this in two of the examples above: the schizophrenic man, Ed Gingerich, and the psychotically depressed man, Dr. Rowe. But if we looked at our entire population, what would we see?
In the whole population of America, there were about 20,000 murders in a year during the 1992-1998 period. This decreased to approximately 17,000 in 2003.27 If one looks at the larger number of victims of violent crime in that year (since most victims survived), 480,000-one in five-needed care in an emergency room or in a hospital. The offenders were usually an intimate partner (48 percent) or family member (32 percent), and less often a stranger (20 percent). Firearms were the instruments behind most of the murders (72 percent) in the United States. Most of the killers were male (90 percent) as were the victims (77 percent). The murder rate per 100,000 persons dropped from about ten (1972-1994) to five and a half or six in recent years. Whereas most murderers in Sweden had a record of mental illness (90 percent), the figure is very low in the United States owing largely to the much easier access to guns in this country such that many mentally fit people can easily obtain pistols or rifles. The best recent estimates for the number of homicides committed by those with "severe persistent mental illness" in the United States suggest a figure of about 1,000 per year. Compared with the figure of 17,000 in the year 1998, this would mean approximately 6 percent of the murders were committed by the severely mentally ill. This number is misleading, however, because the mentally ill without substance abuse account for barely 3 percent of the murders; those who abuse alcohol or other drugs may account for 9 percent to even 15 percent.28 In Britain as well, one is much more likely to be killed by an alcoholic than by a "crazy person."29
Another important figure to keep in mind is that the rate of violence (including the much larger number of minor to moderate injuries, not just the rare murders) among the mentally ill (among schizophrenic and manic-depressive persons, for example) is about 3 to 5 percent.3° Of one hundred mentally ill people, if followed for several years after release from a hospitalization in the United States, three to five will have engaged in a violent act-meaning that ninety-five to ninety-seven will not have done so. This should be reassuring to the public, who may fear the risk posed by the mentally ill.31 But it is not. Why? To begin with, most acts of violence by the mentally ill are done on impulse, lending them a disturbingly unpredictable, and thus more frightening, quality. Secondly, their violent acts, rare though they be, all too often are not only unpredictable but unnerving and spectacular. And the headlines will often contain the word evil. It is not easy to avoid sensationalism in describing these headline-grabbing cases. The examples I am about to relate I have accord
ingly toned down as much as I can without obscuring the nature of the violent acts altogether.
In a case that earned national attention, a schizophrenic man, Andrew Goldstein, pushed a woman, Kendra Webdale, off a New York City subway platform into the path of an oncoming train, killing her. He had lived for a time in a supervised residential setting where he took his prescribed antipsychotic medications, but after a time he chose to live on his own. From that point on he stopped taking his medications and relapsed, experiencing delusions and hallucinations, and engaging in unprovoked aggressive behaviors. There were many emergency-room visits and a "revolving-door" situation where he would spend a little time in the supervised residence and then leave of his own accord, always neglecting to take his medications when on his own, and always spiraling down into active psychosis as a result. The death of the woman he pushed later spurred legislators to enact "Kendra's Law," authorizing long-term assisted outpatient treatment for patients with severe mental illness.32 The program, where implemented, has had good success in reducing (though by no means eliminating) the frequency of harmful behaviors .13
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