Blind Eye: The Terrifying Story of a Doctor Who Got Away With Murder (43 page)

It is significant that Swango indicated in his high school yearbook that he wanted to be a state trooper, and that he later enlisted in the Marines. His fascination with what might be called armed careers was also manifested in the arsenal found in Quincy when police searched his apartment; in his obsession with disasters; in his work as a paramedic, when he came to the scene of accidents even when he was off duty; and in fantasies in which he would arrive on the scene of disasters and have control over the fate of the victims. All these were situations in which he had control over the lives of others. The narcissistic psychopath is not motivated by empathetic concern for the victims or by desire to help them, but by a grandiose sense of self.

There are numerous theories suggesting a biological, genetic predisposition toward psychopathology, and this may have played a role in Swango’s development. But narcissism, in the classic Freudian view, is an attempt to compensate for early, profound feelings of being unloved and undervalued. Swango experienced an absent, detached father, and a mother, who, however devoted, had difficulty expressing love and affection. The father who is either physically or emotionally absent figures in the history of most male psychopaths, and is a common feature in the profiles used to detect serial killers.

Swango spoke often of his absent father, glorifying Virgil’s career in Vietnam while expressing his own anguish at being all but abandoned. Yet his fascination with disasters, with killing, and with weapons echoed similar interests he perceived in his father, as when he learned that Virgil also kept scrapbooks of disasters. “It is almost too simplistic to say that Swango is trying to close the gap between himself and his dad,” Dr. Smalldon noted.

In Swango’s case, the problem may have been compounded by Muriel’s focus on him, to the exclusion of her other children, as “special,” as “gifted,” as someone deserving of a private school education.
“In someone who seems as narcissistic as Swango,” Dr. Smalldon said, “you find a pattern of overvaluing by one or both parents. Everything they do is superior and special. His mother’s inability to absorb that Michael wouldn’t graduate with his class, and the need to keep up the front that he was special and brilliant, is significant. He may have lost the ability to evaluate his own self-worth by any realistic standard.”

Severe narcissists often demonstrate their grandiose sense of self by deceiving others. They experience both exhilaration at their own superiority and contempt for their victims when they successfully put something over on another. Their activities may range from relatively innocuous lies, to, in extreme cases, serious crimes, committed largely for the thrill of eluding detection. Paradoxically, the thrill and sense of superiority may be enhanced by taking risks that actually increase the likelihood of getting caught.

Swango seems an extreme example of the grandiose personality in action. He lied constantly, sometimes for seemingly rational reasons, such as concealing his past in order to get a job, but often, it seems, simply to get away with something. He lied about his military record, telling Quincy College he received a Bronze Star and a Purple Heart, and saying his mother was dead. He was a good liar, able to deceive even trained psychiatrists at Stony Brook, which no doubt stoked his own sense of importance. His claims that he didn’t give Rena Cooper an injection, that he wasn’t even in her room; that he didn’t give Mzezewa an injection, even as Mzezewa pointed to him as the doctor who had injected him with a paralyzing drug, must have been intensely thrilling.

Dr. Smalldon said he was “struck by the gratuitous falsification, the idea of putting one over just for its own sake, just because you can get away with something. There’s a sense of power in this.” Noting Swango’s bizarre comments about violence, sex, and death in Quincy, his open admiration for serial killers like Ted Bundy, his calling attention to articles about serial killers and to movies such as
The Silence of the Lambs
, Dr. Smalldon said that “he continually drew attention to himself in ways that are hard to understand except in terms of the thrill of going right to the edge.”

Another revealing clue to Swango’s psychopathic mind was his reaction to criticism. He bridled when teased and belittled in medical school. Dr. Smalldon suggested that the incident in which
Swango botched his cadaver and was criticized and mocked would have been experienced by him as an extreme humiliation. He may have begun killing in retaliation. Swango’s failure to graduate with his SIU medical school class was so humiliating he couldn’t bring himself to tell his mother or show up at the dinner where he would have to face his relatives. He subjected himself to the self-punishment of push-ups when criticized by residents at Ohio State, and his apparent crime spree there began right after his performance as an intern was criticized by a faculty member. He seems to have poisoned his fellow paramedics after he was mocked for not being assigned to the primary ambulance. He appears to have begun poisoning at least two of his girlfriends, Kristin Kinney and Joanna Daly, and his landlady, Lynette O’Hare, immediately after they questioned his innocence. And he erupted in rage when Sharon Cooper commented that he had put on a few pounds.

While some of the criticisms he encountered may seem trivial, “a cardinal feature of the severe narcissistic personality is that they cannot brook criticism or challenge of any kind,” Dr. Smalldon said. “He was criticized in med school. He couldn’t take it. He was thin-skinned. He was extraordinarily self-absorbed. The narcissistic theme is very strong.” The extreme narcissistic psychopath almost invariably attributes criticism or a challenge to persecution, as did Swango in his many claims to be the victim of a “miscarriage of justice.”

Besides enjoying the thrill of controlling life and death and getting away with it, serial killers feel no empathy for the victims, so complete is their absorption in themselves. When Swango poisoned his victims short of the point of death, he very well may have felt they deserved the punishment he meted out. But a serial killer who chooses his victims at random has no motive in any rational sense. The thrill of killing and getting away with it simply has no deterrent in the form of empathy for the victim. Precisely why this would be the case—why some people utterly fail to develop a capacity for emotional bonding or identification with another human being—is a subject of much debate among psychologists. Some Freudians have suggested that a child who fails to undergo an Oedipal transfer to either parent risks losing the capacity for empathy, and other researchers have suggested biological causes. Psychopathic serial killers invariably lack any capacity for empathy.

This deficit may have been most evident in Swango’s numerous callous remarks about death, in his delight in being the doctor to inform relatives of the death of a loved one, in his failure to express any remorse after people died while in his care, and especially in his curious lack of emotional reaction to the death of Kristin Kinney. Yet many people found Swango charming, attractive, and personable; numerous women dated him, and at least three loved him. But this seeming paradox is also common in the psychopath.

As Dr. Smalldon explained, “I would imagine him [Swango] as profoundly deficient in his ability to connect emotionally with other people, but probably very adept at exhibiting counterfeit displays of emotion when he’d perceive a purpose in doing so”—for example, to maintain a relationship that provided sexual gratification. “The psychopathic personality is often described as the mask of sanity. It’s superficial. These people seem to have the normal emotional equipment. But it doesn’t run deep. They pantomime it. They don’t feel it. It appears Swango was obviously very good at crafting a social persona that would serve his interests.”

Another telltale clue in Swango’s behavior is his peculiar relationship to food: eating the entire chocolate cream pie his mother baked for him; hoarding the cream cheese pastries at the hospital in South Dakota; and especially, obsessively wrapping and storing the bacon sandwiches he prepared at Lynette O’Hare’s house. Such obsessions are usually characterized as aspects of an attachment disorder, an attempt to overcome the deep insecurity fostered by the failure to bond with a parent.

It is, of course, easier to describe a psychopath than it is to explain one. No doubt many people grow up with an absent father and an emotionally distant mother, aspire to be a policeman or a Marine, have a controlling personality, and even hoard food. Mercifully few are psychopaths. As Dr. Smalldon cautioned, nothing entirely explains someone as aberrant as Swango. His good looks, his charm, his intelligence—our very inability to predict or explain his psychopathology—are part of what makes him so frightening.

N
EARLY
all those who came into contact with Swango and were duped by him defended themselves by pointing out that he was such a skilled psychopathic liar that they could not have been expected to detect his deception, and that his behavior is so aberrant
that the possibility of similar occurrences is remote. It would be comforting to believe this to be the case, but all indications are to the contrary.

The disturbing fact is that serial killing, while mercifully infrequent, is on the rise and is largely a contemporary phenomenon. While isolated examples surface in the nineteenth century—Jack the Ripper is a notorious example—serial murderers have proliferated since the 1950s, especially in America. Over half the known instances of serial killing in America since 1795 have occurred since 1970, when the rate soared exponentially. It increased tenfold in the 1970s alone. There seems to be little doubt among experts that serial killing is a socially influenced phenomenon, and that one instance with its attendant publicity encourages emulation, especially on the part of grandiose, narcissistic personalities determined to generate a blaze of publicity for themselves.

Swango is the first alleged serial killer in this century to have emerged in the guise of a physician. (Two other known physician cases, Dr. Thomas Neill Cream in Britain and Dr. H. H. Holmes, thought to be the first serial killer in America, committed their murders in the late nineteenth century.) But serial killers within the health care field, while they remain relatively few, have been increasing at an alarming rate. Even since Swango’s arrest, there have been two examples that received national publicity: Orville Majors, a nurse in the intensive care unit of a hospital in Indiana, and Efren Saldivar, a respiratory therapist in Los Angeles. Serial killings were discovered in hospitals in Ann Arbor in 1975 and in San Antonio in 1981. Some killers have defended their murders in a hospital setting as mercy killings, but relatively few of these claims stand up to scrutiny. Others seem to be random acts of serial murder. From the point of view of a determined serial killer, a hospital is almost the ideal setting, since murder can so easily be camouflaged as natural death.

A chilling counterpart to Swango emerged in 1987, when a medical examiner in Cincinnati smelled cyanide in the stomach cavity of a man believed to have died from injuries suffered in a motorcycle accident. The cyanide poison was traced to a quiet thirty-five-year-old nurse’s aide at Drake Memorial Hospital named Donald Harvey. When confronted, Harvey admitted to poisoning the accident victim and to a killing spree that spanned sixteen years and
four hospitals, including the Veterans Administration hospital in Cincinnati, where he worked for nearly ten years. He admitted to fifty-two murders and eventually pleaded guilty to twenty-five Ohio murders and nine in Kentucky in return for being spared the death penalty. He was sentenced to multiple consecutive life sentences, and will be ninety-five before he is eligible for parole.

As in many such cases, it is hard to know precisely how many victims Harvey actually killed. Henry Lee Lucas, the itinerant killer who had so excited Swango, was convicted of eleven murders and confessed to nearly six hundred. But in 1998 his death sentence was commuted to life in prison by Texas governor George W. Bush after the state officials concluded that Lucas’s claims were a bizarre hoax and that he was responsible for, at most, three deaths. In Harvey’s case, investigators felt they could prove only one instance, and it is common for a grandiose personality to exaggerate. But there seems little doubt that Harvey ranks among the nation’s most prolific serial killers. Harvey kept a written list of his victims, and cited a litany of the methods he had used to kill them: pressing a plastic bag and wet towel over the mouth and nose; sprinkling rat poison in a patient’s dessert; adding arsenic and cyanide to orange juice; injecting cyanide into an intravenous tube; injecting cyanide into a patient’s buttocks.

Harvey confessed that he didn’t always poison people to kill. Fearful that his lover was cheating on him, Harvey slipped small doses of arsenic into the man’s food so that he would become sick and have to stay home. When a tenant quarreled with his lover over utility bills, he put arsenic in the topping on a piece of pie he gave her.

Harvey’s arrest and confession shocked people who knew him. He was religious, polite, and a reliable employee. A family friend told the press: “He was such a good boy. He was such a good Christian man. No finer fellow ever lived.” But Harvey had a troubled childhood and had attempted suicide on several occasions, he later said, to try to stop himself from killing.

In a 1991 interview with a reporter from
The Columbus Dispatch
, Harvey revealed many of the characteristics typical of a psychopathic, narcissistic personality:

“Why did you kill?”

“Well, people controlled me for 18 years, and then I
controlled my own destiny. I controlled other people’s lives, whether they lived or died. I had that power to control.”

“What right did you have to decide that?”

“After I didn’t get caught for the first 15, I thought it was my right. I appointed myself judge, prosecutor and jury. So I played God.”

Harvey also described the thrill he experienced when he escaped detection: “I felt a feeling of power. I was able to pull one over on the doctors. I had plenty of common sense. It made me feel smart that the pathologist couldn’t catch me, plus to show that doctors are prone to mistakes.”