I sat at the oversized desk in my Bellevue cubicle, encircled by white powder. The previous week, enraged at the vermin war I was once again losing, I had tossed handfuls of baking soda into every nook and cranny. Fallout from my attack was heavy. A fine white powder covered the books and papers on my desk, and I had to dust off the seat of my chair before sitting down to work. But I had won. Not a single cockroach had dared to cross my path since my offensive. And my trustworthy mouse machine buzzed away at frequencies inaudible to my ears but sufficiently irritating to rodents to send them scampering to my colleagues’ offices. I would be safe behind my powdery moat for the next two years until we moved into modern quarters.
The rest of Bellevue Hospital, the Departments of Medicine, Surgery, and dozens of subspecialties that permeate modern medicine, had long since moved to higher ground down the street. They inhabited the shiny, white corridors of the New Bellevue. Their floors bore some resemblance to the polished corridors of the penitentiary at Starke. But the Department of Psychiatry remained in the old building, its move to the top floors of New Bellevue delayed by a variety of misfortunes. The latest obstacle presented itself in the shape of newly installed parquet flooring. Shortly after installation, the elegant wooden squares started to buckle, and within weeks the floors took on the configuration of a frozen turbulent stream. I recall my first visit to the area to get a look at what would be my new quarters. I made the error of wearing shoes with one-inch heels. I steadied myself by hanging onto walls or grasping the outstretched hands of colleagues wearing sensible sneakers or flats. According to inside sources, the flooring company had skipped an essential step in the installation and had glued the lovely wooden squares directly on top of the cold, damp concrete. A year or so later, when we finally moved to our offices in the New Bellevue, white linoleum and industrial-strength carpeting covered the floors and all traces of the rippling parquet had vanished.
The Old Bellevue Psychiatric Hospital, now a men’s shelter, had enormous charm: high ceilings, marble inlaid floors, a double set of marble staircases leading from the entrance to the first-floor offices, an enormous wrought-iron chandelier over the stairs. So quaint were our quarters that Woody Allen had chosen the old building as a set for his period movie, Zelig.
I recall the morning I climbed out of a taxi at Thirtieth and First (just opposite the city morgue) to find the Old Bellevue Psychiatric Hospital and the street in front of it transformed. The lampposts at the entrance, which since I had arrived in 1979 had been crowned with bare electric bulbs, now sported elegant, turn-of-the-century frosted globes. The date inscribed on a stone slab on the front of the building, like the mileage on a used automobile, had somehow been rolled back a decade. And the assortment of compact cars with MD plates that usually could be found higgledy-piggledy along the curb in front of the hospital were nowhere to be seen. In their place I saw a museum of antique cars, neatly parked one behind the other. The population, too, had changed. In place of the doctors, nurses, patients, and vagrants usually milling about the premises stood a small cadre of men dressed in long, dark woolen coats. It looked to me at first as if a minyan of Hassidim had descended on our facility to pray for a stricken friend.
I walked toward the entrance, trying not to stare. Then I saw him. Right there in the street in front of Old Bellevue, right under my office, stood Woody Allen, dressed in a luscious camel-hair coat that came well below his knees; there he was, gesturing to cameramen, who seemed to hang on his every word. I was no farther from him than I had been from Old Sparky. From that distance I could see that his hair really was red. I stood and gawked like a 1940s teenager who had unexpectedly bumped into Frank Sinatra while on her way to the orthodontist. The funny thing is, as I walked through the set no one stopped me. No one even noticed me as I made my way past the cameramen and actors, past the tall iron gates, down a short path, and into the refurbished entrance. For years my taste in winter fashion has been long, straight skirts and high boots. I must have fit in. Only when I paused at the entrance and looked back did I see the hoard of white-coated doctors, nurses, and technicians lined up behind barricades across the street in front of the morgue, staring at the spectacle through which I had walked.
That evening, when I left for Grand Central Station, I stepped out of the building and found everything gone. The bald light bulbs were back, their frosted globes nowhere in sight. The date on the building again proclaimed its 1930s vintage. The beautiful coaches had disappeared and the pumpkins with their MD plates once more lined the street. As I walked up Thirtieth Street toward First Avenue, I caught a glimpse of a long, double-decker truck headed uptown with its cargo of exquisite antique cars. Events like this kept me at Bellevue and gave me the energy to keep up the battles with my rodent co-tenants.
I blew the white powder off the notes of my first meeting with Marie Moore and studied them. What could have possessed a thirty-six-year-old woman to shack up with a barely adolescent boy? Why then would they together kidnap, torture, and kill a young girl? It made no sense. Granted, Marie and Tony were not your everyday, impulsive convenience-store bunglers; but they were no Bonnie and Clyde, either. I struggled to make sense of what the dark-haired, dark-eyed woman in the oversized glasses who reminded me of me had said. Marie’s account of her life was confusing. Her symptoms and behaviors didn’t quite fit any of the syndromes in the Diagnostic Manual. Sometimes I managed to convince myself that she was manic depressive. Her wacky excursion to California certainly seemed manic. I riffled through my notes, looking for evidence of other manic episodes or for indications that Marie fell into depressive moods. Marie had made several suicide attempts, but it was unclear what had provoked them. There were periods when Marie reported that she would not leave her bed and go to work. She did not sound depressed at these times. During these interludes she simply abdicated all responsibility for her care to Anna Giusseppi and Tony. Anna Giusseppi would dress her, feed her, pamper her, while she remained helpless and immobile. Like a young child, Marie did as she was told.
Anna Giusseppi took advantage of these times to play doctor. Daily, week after week, Anna would shepherd her helpless charge into the bathroom. There, a docile Marie would bend over the side of the tub, remove her pajama bottoms, and permit Anna to administer enemas. Sometimes, Marie said, Tony would participate; he added a sadistic touch to the already perverse procedure by taping the nozzle of the tube to Marie’s buttocks and forcing her to retain the fluid until it pleased him to allow her to empty her flooded bowels. Sometimes he forced her to sit on a chair or on the floor, the nozzle still inside her. How, I wondered, did a grown woman permit herself to be so tortured, so infantilized, and so humiliated?
I struggled to manipulate these bizarre signs, symptoms, and behaviors into the framework of the diagnoses I had been taught. They did not fit. Marie’s moods and behaviors were changeable. But were they really the peaks and troughs of a bipolar disorder (the term used by then for manic depressive illness)? I was not convinced. I had treated many bipolar patients and Marie was definitely different from them. Exactly how I was not sure.
I had promised Marie’s lawyer that I would “check out” her alleged seizure disorder. I love to grapple with mind-brain issues, and I looked forward to exploring this aspect of the puzzle. The task, of course, would not be as much fun as if Jonathan had been involved. Nevertheless, it would be interesting.
Marie, like Lee Anne, had managed to generate a fair amount of medical paperwork over her lifetime. Ever since my explorations of Lee Anne’s hospital charts, I have relished the prospect of foraging through old medical records and reports. The question to be answered was straightforward: What were the signs and symptoms in the past that made some doctors think that Marie suffered from epilepsy? Did she really have a seizure disorder?
Something bad had definitely happened to Marie Moore’s brain; of that there could be no doubt. Results of a CAT scan were unequivocal. According to the neuroradiologist, the pictures revealed “a very striking pattern of frontal lobe atrophy with widening of the interhemispheric fissure and some lesser atrophy of the vermis of the cerebellum.” Marie had something in common with Lucky Larson: she and Lucky had both damaged those parts of their brains that are vital for judgment and the modulation of primitive impulses. Whether this damage was caused by a car accident in which Marie’s head hit the windshield or it was the result of an earlier whack in the head with a baseball bat could not be established. What mattered was that her frontal lobes had been damaged badly, and that the injury was inflicted prior to the murder of Belinda Weeks.
Marie’s EEG, however, was normal. Over a decade before the murder, in about 1972, Marie had sought help from a neurologist. She had come to him complaining of blackouts and memory lapses. People told her of things she had done or said, places she had gone, and she would have no recollection of them. She explained to the doctor that the problem was not new. As a child she was blamed for deeds she swore she had not done. Other children’s toys or clothes would be found in her room, and she would insist that she had not taken them. Playmates called her a thief.
Marie told the neurologist about episodes in adulthood when her behaviors were so violent and uncontrollable that they caused her to be fired from her job at the telephone company. At times, she said, she wet her pants. Given this picture, in spite of a normal EEG, the neurologist diagnosed epilepsy and prescribed antiepileptic medications. He tried, sequentially and together, phenobarbital, Dilantin, and Mysoline. Nothing helped. Marie continued to badger the neurologist with a variety of new and different complaints: buzzing in the ears, “passing out,” numbness on one side of the body, “difficulty with her legs.” Finally the frustrated neurologist decided that Marie’s problems were more emotional than neurologic. His notes reflected his uncertainty about what was causing her peculiar symptoms. The differential diagnosis he gave (differential diagnosis to doctors means “I’m not sure what’s wrong, but these are my hunches”) was of “psychomotor seizures vs. psychosomatic symptoms.” The doctor thereupon tried to cover all bases by renewing Marie’s prescriptions for seizure medications and ever so gently steering her in the direction of a psychotherapist. Marie’s daughter, Debbie, was probably a more astute clinician than all of us doctors. When Marie went into her amnesic states, Debbie would say, “Mom, you’re hypnotized.”
The more I studied the old records and reports, and the notes from my first session with Marie, the more I found myself leaning toward the neurologist’s initial diagnosis. It looked to me as though Marie did have psychomotor seizures. They would explain her lapses, her memory loss, her violent, uncontrollable episodes, her incontinence. The normal EEG could mean nothing—half the time the EEGs of epileptic patients are normal. Her brain had certainly received more than its share of buffeting, and any injury could have created scarring and a focus of abnormal electrical activity. If the scarring was deep enough, a surface EEG might not detect the abnormal electrical activity it caused. If I squeezed them hard, I could fit almost all of Marie’s signs and symptoms into the diagnostic framework of psychomotor seizures.
When I evaluated Marie Moore, my frame of reference included such diagnoses as schizophrenia, bipolar mood disorder, and psychomotor seizures. It did not encompass multiple personality disorder. My frame of reference, like the walls of the ivory tower, delimited my thinking. If I learned one thing from Marie Moore, it was that ivory towers need better ventilation and more windows.
* * *
I had another promise to keep. I had promised Marie’s attorney that I would “check out” multiple personality disorder. I set aside my notes and pondered what seemed to me an impossible task: the exploration of a nonexistent phenomenon. The lawyer might just as well have told me to study the mating patterns of the phoenix or the hormonal status of Peter Pan.
In 1984, I was probably, with one exception, the only citizen of the United States above the age of twelve who had read neither The Three Faces of Eve nor Sybil. Because it took me so long to get through a book, I had to be selective. When I went on vacation and had the luxury of reading fiction, my taste ran to spy novels—Ken Follett, John le Carré. In my mind I had filed Eve and Sybil somewhere between fantasy and science fiction, neither of which interested me. Marie Moore was the other person who had not read either of those books. This fact, I hope, exhausts once and for all the similarities between us.
A colleague, with whom I shared my diagnostic predicament, suggested that I use hypnosis. He said that if an alternate personality existed, under hypnosis he or she was more likely to make an appearance. But this was a forensic case. Because patients under hypnosis are especially suggestible, findings gleaned from hypnosis are suspect in a court of law. However, even if I had wished to, I could not have followed my friend’s suggestion. I did not have the faintest idea how to hypnotize someone. At Yale, when Jonathan and I trained, hypnosis (like multiple personality disorder) was out, psychoanalysis was in. Freud had long ago given up hypnosis and so had Yale.
When I trained, the Department of Psychiatry was steeped in psychoanalysis. Its influence had spread from the Medical School all the way crosstown to the Law School. In fact, Anna Freud had been invited to teach a course at the Law School. Her visiting professorship corresponded in time with the brief period of my life devoted to creating the Abstract Design Test to measure a person’s capacity for intimacy. I was also undergoing the final phases of my own training analysis. I was, in short, a true believer. I even managed to wangle a place in one of Miss Freud’s small seminars on psychoanalysis and law.
I was fascinated, not with what she taught but with her. She was a tiny woman, no more than five-foot-one or -two, with gray, frizzy, uncolored, and uncoiffed hair. She dressed in a cotton T-shirt and full black or navy skirt that fell to her ankles. She was not pretty. And yet from the time she walked in the door of the seminar room to the time she left, I could not take my eyes off her. There was a seriousness and intensity about the way she focused on whoever was speaking—an utter absorption that endeared her to me. She was opinionated. When she disagreed, her eyes flashed—but she did allow others to be heard.
One day I discovered that Anna Freud was being housed in an apartment above mine in the building where I lived. Mel, to whom I was engaged at the time, suggested that we invite her to tea. She declined, but her gracious note of regret remains to this day in my safe deposit box.
Though she refused my invitation to tea, Anna Freud did accept Mel’s invitation to visit the residential treatment center, Highland Heights, where he has consulted for years. It is a Catholic institution, and at the time of Miss Freud’s visit, the teaching sisters wore long, dark habits. They covered their heads with wimples, underneath which their faces barely showed. On the way back from the treatment center, after a morning filled with conferences and case presentations, Miss Freud turned to Mel and stated with satisfaction that this had been one of the most pleasant experiences of her stay in New Haven. “I really felt comfortable there,” she remarked.
“Really?” Mel was delighted. “What pleased you most?” Mel waited to hear how much she appreciated the fact that the center was using her “metapsychological profile” to conceptualize the children’s problems and needs.
“I like the way they dressed,” she declared. “For the first time I did not feel out of place.” Mel glanced down and saw that Miss Freud’s black skirt and the black habits of the sisters were of a length.
I was not certain exactly how I was going to “check out” multiple personality disorder, but I was certain that I did not want to be alone when I did. I therefore prevailed on one of the investigators working on Marie’s case to accompany me to the jail and sit in on the interview.
I opened my second interview by introducing Marie to the investigator. Then, since I was not sure exactly what to do, I allowed Marie to take the lead and I tried to follow. Her thoughts turned to the octogenarian upstairs, the father of Marie’s child, Debbie.
Marie volunteered, “He used to make me have sex when I didn’t want to.… He made me bend over and try to have sex in the rectum.… He had an obsession with sex.… He made me pose nude. The pictures are in a safe deposit box.… We had to run away from him.” Now, reviewing the monologue, my eye rests on the words, “We had to run away from him.” What did she mean by “we”? But in 1984 the pronoun flew by unnoticed.
Then, straight out of left field, she commented, “In the beginning my father didn’t accept my baby.” I figured that most fathers would not be ecstatic to learn that an only daughter had been impregnated by a man more than twice her age. I did not need analytic training to realize that Marie’s choice of mate had something to do with the old man’s resemblance to her father. On the other hand, normal women often choose to marry father figures. I refused to make too much of Marie’s May-December union. Think of Picasso, of Casals, I told myself. In spite of my efforts to remain open-minded, the thought of Marie’s relationship with the sadistic old man upstairs made me queasy.
Marie’s thoughts turned to sex. She began to talk about other male relatives—uncles who had “made advances,” “tried to kiss [her],” “asked [her] to meet [them] in hotels.” One uncle, she said, “was impotent. He told us when we visited Florida.” Again I did not ask the meaning of “us” and “we.”
Marie tended to dismiss her mother with brief comments: “My mother was not smart.” “My mother says, ‘Debbie, tell your mother I love her,’ ” “She [my mother] was always afraid of him [Marie’s father].” I already knew this. Marie’s father had refused to let her mother talk with me alone, and her mother had abided by his wishes.
“Tell me more about your dad,” I ventured, and at the risk of losing everything, added, “Does he have a temper?”
“He did have a temper.”
“You mean when he drank?”
“No. Even when he didn’t drink. He’d slam doors, get red from the neck up.” Then, without skipping a beat, “My mother would tell me he wanted sex.… I kind of think he made my mother have sex when she didn’t want to.… She was always afraid of him.” Marie continued, “When I came back from California she had a big slash on her shoulder. For a short time she came to live with me.… He gets mad.”
Her words had barely had a chance to register in my brain when, again from left field, came the remark, “Once he called me into the cellar and said, ‘I’m a man, I have needs.’ ”
I tried not to sound too curious. “What did you do?”
“I told him to go to my mother.”
“What did he say?”
“He said, ‘She has someone else.’ ”
So Marie’s father had made sexual overtures to her. The question in my mind was whether these whining complaints of a frustrated old man could possibly have driven Marie into the arms of a barely adolescent boy. It seemed unlikely.
Marie began to speak of Tony and his sadistic ways. She described in greater detail than I felt the need to hear how he forced her to bend over, taped her thumbs to her toes, then proceeded to administer enemas. Once started, Marie could not stop. She seemed compelled to describe the many ways Tony had tortured her and the other residents of 989 Madison Avenue.
“He would pick up a hammer and go to hit Belinda.… He would say, ‘I have to eliminate these people.’ I asked him if he meant to kill them.”
“What would you do?”
“I would blank out.” She paused. “I think Billy would be there.”
At last Marie had given me the opportunity to try to conjure Billy. I interrupted. “Marie, how did Billy get there? What made him appear?”
“I’m not sure. Sometimes Tony would say, ‘Make Billy come.’ ”
“Run that by me again.”
“Tony. He would say, ‘Make Billy come,’ and he came.”
I sat still, trying to figure out my next move. Finally I asked, “Would Billy talk with me?” I felt like an idiot. It was like asking if Santa would answer my letter or the Tooth Fairy put money under my pillow.
“I don’t know.” Obviously Marie did not think my question idiotic.
“Is it O.K. with you if I talk with him?”
“I guess so.”
“Great. Let’s try.”
I sat back, took a deep breath, then in my most hypnotic tones, spoke the words. “Make Billy come.”
I waited. The investigator waited. Marie waited.
Nothing happened.
“Let’s try again,” I suggested, trying to appear confident and optimistic. Slowly, distinctly I intoned: “Make Billy come.”
We waited. And waited.
Nothing happened. I was beginning to feel ridiculous. Slowly, calmly, with an air of great authority, I spoke the magic words for the third time: “Maaake Billy Cooome.”
We waited.
I was a failure. Nothing happened.
There was no point in keeping the investigator prisoner. Obviously I was not going to be attacked by a violent alternate personality. I was not even going to have the pleasure of making his acquaintance. He did not exist. I had kept my word. I had “checked out” multiple personality disorder. Now I could move on. I told the investigator that he could take off, smoke a cigarette, whatever. I did not need protection. He left, agreeing to return at five o’clock to pick me up and drive me home.
I spent the remaining time talking with Marie about her unusual household and about the peculiar hold that Tony had over everyone, especially over Marie. Tony had threatened to expose her, to tell the authorities about her bizarre changes in behavior. He convinced her that if they knew of her peculiar switches, Debbie—whom Marie held dearest—would be torn from her and placed in foster care.
During what I expected would be the final hour of this, our second meeting, I tried to make sense of Marie’s trip to California. From Marie’s medical records and from the notes of her brief skirmish with a psychotherapist, it was evident that “The Price Is Right” was but one aspect of her motivation. Marie wanted to get away. Once in California, she actually set up housekeeping. In fact, I discovered, a few of the residents of 989 Madison came west to join her. Anna Giusseppi, Debbie, and others whose names were unfamiliar had put in appearances. Even Billy showed up. Marie said that someone she called Helen had tortured her with enemas, and tried to take over her life. Helen tied her to bedposts and imprisoned her. Helen took Anna prisoner and tried to kill her. Or was it Anna who tried to kill Helen? No, it was Marie who wanted to kill Helen. Someone tried to kill herself. I struggled vainly to make head or tail of this sadomasochistic Alice in Wonderland. It was like trying to keep track of a grotesque “Who’s on first?” routine. I could not figure out who had done what to whom. After almost an hour, I did not much care. I asked myself how this woman managed to become entangled over and over again in the same kinds of messes. She was forever running into the very situations she attempted to flee. I recalled the words of one of my college professors when, during an especially depressing period senior year, I confessed that I couldn’t wait to leave Cambridge. He said, simply, “You take yourself with you.” Marie had taken herself to California. At that point I hadn’t an inkling of who else within her had come along for the ride.
I was relieved when, at five on the dot, the investigator poked his head in the door and exclaimed, “Time to go!” As I straightened my papers and prepared to leave, I told Marie that I would come back and talk with her again. Now that I had squared away Billy, I could focus on real issues; learn more about Marie’s moods; get a better understanding of the neurologic consequences of the many blows to her head.
I picked up my papers and pens and started to rise when, in a quiet, plaintive voice, Marie said, “Don’t go. There’s something I have to tell you.” I sat down. The investigator would just have to wait. Marie stared at me through her thick, oversized glasses. Something was on the tip of her tongue. I waited.
After a minute or two I again started to rise. “Don’t worry, Marie. I’ll be back. We’ll have plenty of time to talk,” I reassured her.
Marie continued to stare at me, but was having trouble speaking. Her eyes, peering out through their monstrous frames, grew larger, as if they were trying to express what her lips could not. Once more, in soft, pleading tones, Marie repeated, “Don’t go. There’s something I have to tell you.”
I remained in my seat and waited. “What is it, Marie? What is it you want me to know?” I sat, determined to allow Marie all the time she needed. A minute. Two minutes. Three minutes went by. I snuck a look at my watch. It was well past five and the investigator was waiting.
Eventually I had to accept the fact that Marie was not going to share whatever the secret was that she so desperately wanted me to know. I rose. “Don’t worry, Marie, I’ll be back soon.” Clearly no more would be accomplished that day. I picked up my papers and walked to the door, turning my back on Marie. I placed my hand on the doorknob and started to turn it.
Suddenly from behind me came a voice the timbre of which I shall never forget. It was deep. It was male. And it had the menacing quality of a lion about to strike. Low, guttural came the familiar words, “Don’t go. There’s something I have to tell you.” I could not move, even to turn around. My hand was fixed to the doorknob, but I could feel the fine hairs on my arms rise, and I shivered. Then slowly, so as not to ruffle the beast behind me, I turned and stared.
Marie was gone. In her place, knees spread wide apart, elbows bent, a hand on each thigh, sat a tough young man. After a second or two the young man lifted his right hand from his thigh and reached toward me. “Hulloah,” came the throaty greeting. I reached for his hand and shook it.
“Billy?” I whispered.
He nodded.
I stood staring. Then I turned, stuck my head out the door, and called to the investigator, whose name and face I do not recall. “I think you’d better come back. I don’t think you want to leave now. Someone has arrived.”