CHAPTER 14

I know that “Billy” shook hands with the investigator. The image of Billy is crisp and clear. As for the investigator, I saw only his arm extended toward Billy. Everything else about the investigator—his face, his build, his age, even his name—is gone. Billy filled the room, his presence eclipsing all and everyone else. I saw Billy’s face, his firm, set expression, his authoritative carriage. The face before me was tough and streetwise. Marie’s doe eyes, round and enlarged by her thick lenses, were gone; in their place hard, dark, calculating circles sized me up. Their intensity made me glad that I had summoned Mr. What’s-his-name.

“You got a cigarette?” Billy did not ask. He ordered. Mr. What’s-his-name reached into a shirt pocket and produced an open pack.

“Got a light?”

A lighter appeared. Mr. What’s-his-name’s hand flicked it on and extended the flame. Billy inhaled deeply and the tip of his cigarette glowed.

Billy took a few drags on his cigarette, holding it between the thumb and index finger of his left hand.

“Do you know who I am?” I asked. I was relieved to discover that I could speak. Billy waited for me to explain. If he had been in the shadows, listening to my conversation with Marie, he was not letting on.

“I’m Marie’s doctor. I’m Doctor Lewis.” No response. “Her lawyer hired me to see if I could help.” Billy nodded. The ball was obviously still in my court. “And this is Mr. (What’s-his-name). He’s also working on Marie’s case.” A nod. Still the ball was on my side of the net. I tried a gentle serve.

“Tell me, Billy, how well do you know Marie?” I waited.

“I know her very well,” came the slow, careful response.

“How well?” I tried to conceal my fear, but my throat felt tight and my voice was high-pitched. (My mother always told me never to play poker.) Now I decided to wait. It was a fair return and I had placed the ball well within Billy’s reach.

“I know everything about her,” he responded. I scampered to keep the volley going.

“How old was she when you came?”

“Young, very young.”

“How young?”

“Two, three years old.”

“Two or three years old.” I hate when psychiatrists just repeat the last words of a patient; it seems so patronizing. But at that moment that was all I could think of to say. To my surprise and delight, my moronic repetition did not put an end to the exchange.

“Maybe four. Before she went to kindergarten.”

“Great!” Now I was too friendly, too upbeat. I just couldn’t seem to strike the right tone. The struggle to get things right reminded me of our efforts to dress for death row. Jonathan and I always wound up too preppy or too hippie.

I continued, hoping that in time the pitch of my voice would return to normal. “You know, Billy, I’m really glad that you’ve known Marie since she was little. (Too sweet). You see, Marie doesn’t remember a whole lot about her childhood. Maybe you can help.” (Better. I was relaxing.) He nodded. Billy was not about to volunteer anything. On the other hand, for the first time I had the sense of his willingness to continue the give and take. What remained unclear was just how long Billy would play. Nor did I know if he would ever come back once this set ended. After all, he had not been visible for months. This might be my only chance to learn what he knew about Marie’s past. Therefore, at the risk of frightening him away and losing him forever, I asked what had to be asked. “Marie told me that her father called her into the cellar. He said to her, ‘I’m a man. I have needs.’ She also told me that no one ever bothered her sexually. Tell me, Billy, did her father ever fool around with her?”

The room was quiet. Billy shifted in his seat until we were face to face, directly across the table from each other.

“Sure he did,” Billy growled, but for some reason I was no longer frightened. Something about Billy’s tone or expression filled me instead with a terrible sadness.

“What happened?” I asked. Billy stared straight into my eyes, his gaze so fixed and piercing that it blinded me to the lenses and frames that must have been there. This man, this beast, this man-beast in a woman’s body seemed familiar. Then I knew where I had seen this picture before. It was a word picture, but I had seen it. I was looking at Billy, but superimposed were fragments and images of a Yeats poem I had read in college.

Surely some revelation is at hand;

.     .     .     .     .     .     .     .     .     .     .     .     

A shape with lion body and the head of a man.

A gaze blank and pitiless as the sun,

.     .     .     .     .     .     .     .     .     .     .     .     

 … centuries of stony sleep

Were vexed to nightmare by a rocking cradle,

And what rough beast, its hour come round at last,

Slouches towards Bethlehem to be born?*

A revelation was at hand, and I knew that if I listened, I too would be vexed to nightmare, not by a rocking cradle but by images of a small, helpless child. What had Billy said? Two? Three? Maybe four years old? After this revelation I would never again see people as I had before. My innocence, which sprang from ignorance, would be stripped away, and I would learn things about human beings that I had not been taught in medical school or even during my training as a psychiatrist—things most of us would rather not know.

“Sure he fucked around with her. From the time she was four years old. That’s when he started.”

“Started what?”

Billy sneered, “He took pencils. He stuck them in her vagina. He stuck them in her rectum.”

“He did that to her once?”

“Once?”

Billy glared at me contemptuously. “He did it four times a week. Her mother went to work. He stayed home. He used to put his fingers inside her.”

Billy paused and looked me in the eye, I tried to look neutral, interested but neutral. I did not want to appear shocked (which I was) for fear of turning him off. I did not want to appear overinterested and risk encouraging fabrications. Billy continued. “He would give her a bath. That’s when he used to take it out. Then after, he would put it between her legs. He’d say, ‘Now don’t tell Mama. Don’t tell Mama what we did.’ Then he’d give her presents. Lots of presents. Games. Toys. Money.”

Billy paused.

“How about sex? Did he ever have sex with her?”

“He’d put Vaseline on his penis. He’d put Vaseline in the vagina. Put it in the vagina. She bled. She was only ten. She bled so bad she had to throw her underwear outside. She told her mama she got her period. But that wasn’t her period. She didn’t get her period ’til she was twelve.” Again Billy paused. He was thinking, talking to himself. “Sometimes he would have sex with me. That’s so’s it wouldn’t hurt her.”

“How is that possible?” I asked. “You’re a boy.”

“I was in a woman’s body,” came the immediate response. Billy’s was the logic of dreams.

“You’re telling me Marie’s father had intercourse with her? I mean with you?” I wasn’t quite sure what I meant.

“Sure he did,” the growl was deep, the words enunciated slowly as if the speaker relished his listener’s discomfort.

“When she was in high school, maybe she was twelve, he came to her room. He said, ‘I wanna do more for you, Marie, but you gotta do more for me.’ He took her into her bedroom.”

“Where was her mother?” I would prove him wrong. This could not have happened.

“Her mother? Why her mother worked. Hannibal Electronics. Her mother worked. Seven A.M. to seven P.M. her mother worked. Seven A.M. to seven P.M. she was out of that house.”

Now the voice was cruel.

“So he takes her in the bedroom. Then he says, ‘I’m just gonna ask you to take off your panties.’ He was tryin’ to be nice and gentle. Then he says, ‘I’ll ease on in. We’ll just take the Vaseline.’ ”

“What happened?”

“Gradually. Gradually, over a period of time, he got in. They had intercourse.” Then, as though it were an afterthought, an insignificant detail, Billy added, “You know Marie had an abortion in 1972. You know that. She went to a clinic in New York.”

“Why did she have an abortion?” I asked. “Marie already had one child. Why not another?”

Billy looked at me with an expression that asked how I could be so stupid.

“She had an abortion ’cause she thought it was her father’s baby.”

And that is how I learned that Marie’s incestuous relationship that began at age two or three or four had continued into adulthood, first with her father, then with the old man upstairs. Only her escape to California had brought it to an end. Now Marie’s symptoms started to make sense. It was at the time of the abortion that Marie began to experience the blanking-out spells, the so-called seizures. Around that time she started seeing doctors, complaining of numbness, of headaches, eventually of paralysis. Something else also fell into place. Marie had told me that in 1972 she was raped by a stranger. She said that when she awakened she saw her father. She said her father had taken care of her. These years coincided with a period during which her father bought her three cars. The stakes were now higher. Toys and games no longer bought silence.

“Did her mother ever know? I mean, did she ever find out what Marie’s father was doing?”

“Sure she did.”

“How do you know that?”

“I know ’cause her mother used to yell at her father. She used to say, ‘Leave her alone. You’ve got me.’ ” So this was why Marie’s father refused to allow her mother to see me alone. This was why her mother became so confused and illogical when I tried to speak with her in her husband’s presence.

Billy had said his piece. He was finished. Nowadays if something like that happened I would handle things quite differently. I would know enough to take the time to thank Billy profusely, not only for all the pain he had taken on himself in order to spare Marie but also for having the courage and trust to confide in me. But right then all I really thought about was talking with Marie and sharing with her what Billy had told me.

“Billy, it’s been really good talking with you, but now I need to speak with Marie again,” I explained. He had been so reluctant to come, I figured he’d welcome the chance to leave.

A look of loathing crossed Billy’s face, and he snarled, “You can’t talk with Marie.”

“What do you mean, Billy? I have to talk with Marie.”

“I won’t let you.”

Billy was obviously enjoying the game. He smiled, but it was not a friendly smile. It was the smile of a young Caligula just beginning to enjoy his power. I have discovered since then that violent alternate personalities are usually caricatures of evil; they are characters created in the minds of tormented children to take their pain and defend them against real or imagined enemies. They embody the strength, courage, and wiliness needed for a tortured child to survive. They also keep the memories. Nevertheless, they are the constructs of child minds. But then, in 1984, I saw only a fierce, intimidating young punk, determined to thwart my efforts to help Marie.

Billy was not done with me. He had an uncanny way of knowing exactly how to unsettle me.

“You know I could kill her.”

“What did you say?”

“I said I could kill her. I could kill Marie.”

“What do you mean?”

“I could make her take pills. I’ve done it before.” He paused and smiled. Marie had told me of her suicide attempt with phenobarbital. “I could make her hang herself,” he threatened.

Now I was scared. “Oh, Billy, please don’t do that. Please promise me that you won’t do that,” I pleaded. But Billy refused to promise.

“Billy, at least let me talk with Marie,” I begged. Billy was adamant. I had conjured the malign genie and now could not stuff him back into his lamp. In desperation I tried the technique Marie had taught me. Over and over again I chanted the words, “Make Marie come. Make Marie come.”

I watched with relief as the face before me slowly changed, softened; Marie was back. She removed her glasses and, like a small child, rubbed her eyes with her fists, as though she were awakening from a nap.

Visiting hours were over. We had overstayed our welcome. As a guard ushered me from the room, I did the best I could to explain to Marie what had transpired during her absence. She had obviously been absent, dissociated during my talk with Billy. When I asked her to promise not to kill herself, she looked puzzled. Why would I make such a request? She had no intention of killing herself. There was no time to explain Billy’s threats. Not long thereafter I was told that guards discovered a sharpened plastic implement in her cell and feared she might be planning to harm herself.

On the way home in the car, seated next to the investigator, I reflected on the events of the day. I was satisfied. I had kept my promise to Marie’s attorney; I had “checked out multiple personality.” I was also grateful for the company of Mr. What’s-his-name—not so much for protecting me but rather for bearing witness. Without him, I was convinced, nobody would believe me.

How could I expect a judge and jury to believe in a phenomenon I, a psychiatrist, had so recently questioned? The only witnesses to Marie’s tragic childhood were her parents. Marie’s mother was a potential resource, but her father refused to allow the woman to speak with me alone. There were, of course, several witnesses to Marie’s dramatically changeable demeanor and behavior, but the motley crew from 989 Madison Avenue was not about to come to the aid of the fiendish woman who had terrorized them.

Today, a decade later, I know what I should have done. Alternate personalities leave evidence of their existence all over the place. Jonathan and I have been able to trace clues of multiple personality disorder all the way back to early childhood. Teacher reports, social service records, medical charts, letters to friends and relatives, journals, diaries, drawings—all are pieces of the puzzle that, when fitted together, reveal the picture of a divided, often fragmented mind. School records attest to widely fluctuating academic capabilities. Homework samples from the very same week or month of the child’s schooling look as if they were the work of different students. Handwriting in journals and diaries can vary markedly from one entry to the next. Sometimes it looks like the writing of a “righty”; sometimes its slant suggests that a “lefty” wrote it. Styles of drawing differ. One day drawings appear to be the work of a preschooler; the next day they show the sophistication of an adult. Driver’s licenses, hospital admissions, job applications, and letters to friends and family reveal different signatures, even different names. These constitute the evidence needed to show that multiple personality disorder existed years before the diagnosis was even considered. They are proof that the interviewer did not create the disorder.

Old medical records can be gold mines of information about abuse: inexplicable accidents and injuries; vague complaints of illnesses for which no causes can be found; repeated urinary tract infections; rectal pain and bleeding. (As I write this I think back to Lee Anne and wonder just how much Jonathan and I missed.)

Friends. Acquaintances. Employers. When families are mute, sometimes near-strangers can help; they have observed the memory lapses, the changing demeanors, the inconsistencies. We once saw a patient with multiple personality disorder who, in an alternate personality state, suddenly took off for Las Vegas with a girlfriend of the moment. No one, including his boss, knew where he was. A week later, dressed in his usual lab coat, he returned to work, oblivious to the events of the prior week. The man was flabbergasted when his boss fired him on the spot. In the patient’s mind, he had never missed a day. Employers tend to remember these kinds of episodes.

In short, there are numerous ways a sophisticated clinician can document multiple personality disorder objectively. Unfortunately, in 1984, when I saw Marie, not only was I unsophisticated, I was downright ignorant.

The first thing I did on returning to Bellevue was go to the library and look up what had been written on multiple personality disorder and who had written it. I found that the number of clinical investigators whose work had passed the scrutiny of reviewers and whose papers had appeared in the scientific literature could pretty much be counted on the fingers of one hand. I called them. Two returned my calls. The secretary of one of these gurus informed me that for $150 her boss would return my call. Clearly his expertise was in demand. I left my number. He did call back. To date, and it is now over ten years, I have not received a bill. If two can be considered a consensus, then there was a consensus: judges and juries were not likely to believe what I had witnessed unless they saw it for themselves. Both consultants were adamant. An interview with Marie/Billy had to be videotaped and shown in court.

I presented the advice I had received to the attorneys. They were adamant. Videotaping was out of the question.

“Why?” I asked.

“Why? Because Marie might incriminate herself,” came the answer. I was dumbfounded. Here they had a client who had already admitted to participation in the murder—she had to admit to it in order to mount an insanity defense. Now her lawyers were worried about self-incrimination? The very reasoning behind this decision sounded insane to me.

The attorneys could not be budged. There would be no videotaping. How, I asked myself, was I to present to the jury in words a phenomenon that even I had not believed existed until I saw it? It could not be done, and I said so. Eventually I would come to recognize the limitations even of visible, tangible, objectively verifiable evidence. By 1986, I would realize that videotapes could be insufficient proof. Other psychiatrists had to see for themselves a mental condition that they were convinced was bunkum. In Marie’s case, all I wanted to do was videotape, and her lawyers said no.

Very few mental illnesses can be confirmed by laboratory data. There are a few rare ones for which biochemical tests clinch diagnoses. For example, acute intermittent porphyria, the illness thought to be responsible for George III’s episodic madness, could today be confirmed in a biochemistry laboratory. Some forms of mental retardation can be demonstrated through biochemical tests and chromosomal studies. But for the most part, those psychiatric disorders that fill our mental hospital beds—those categorized now as schizophrenia—have defied intense efforts to document their biologic underpinnings.

Multiple personality disorder, too, has no laboratory test to validate its existence. The illness, however, is especially interesting because different personalities or personality states tend to have different physiologic responses. Temperature and blood pressure may vary; different personalities may have different visual acuities; there have been reports of personalities with different allergic responses; performances on certain psychological tests may vary markedly, and even encephalographic recordings of brain wave activity may differ. However, fascinating as these findings may be, they are still research findings. They are considered experimental and not yet accepted as diagnostic proof of the disorder. Trained method actors, adopting a variety of roles, have been able to call forth or duplicate many of the physiologic changes that occur spontaneously when patients with multiple personality disorder switch from one personality state to another. Thus, none of these physiologic tests could be used to document Marie’s condition.

Neurologic testimony is always more believable than psychiatric testimony. You can see the brain; the mind is invisible. Fortunately, in Marie’s case, the jury would be able to see her damaged brain. They would be provided the next best thing to X-ray vision: CAT scan pictures. These pictures showed atrophy of both frontal lobes—graphic evidence that the parts of her brain on which she had to rely for judgment and modulation of sexual and aggressive drives were in poor repair. If Marie’s neurologic deficits did not explain or excuse her acts, at least they might be accepted by a jury as mitigating her responsibility. Mitigating factors are the difference between a life sentence and being condemned to death.

Marie’s seizure history was also important. If any of her lapses of consciousness, her long periods of memory loss, were the result of seizures rather than dissociative states, then perhaps a case could be made that she was in an altered state at the time of Belinda’s murder. However, Marie’s EEGs in the past were always normal. The outside possibility existed, however, that the previous EEGs had been performed between seizure episodes. The lawyers decided to obtain a forty-eight-hour electroencephalogram. Maybe at some time during this lengthy procedure her brain waves would go awry.

I was delighted with this decision. I could meet once more with Marie, elicit Billy, and determine whether, when Billy materialized, his brain waves differed from Marie’s. It would not prove Billy’s existence. As mentioned, actors can modify their own brain waves. It would still be an interesting finding.

The forty-eight-hour electroencephalogram was conducted in a hospital, which is where my third and final interview with Marie took place. No seizure activity was found. Unfortunately, the strip of paper containing all of the electrical activity of the brain recorded during the period of time when Billy emerged was inexplicably lost or destroyed, and those data were never analyzed.

When I entered her hospital room, the Marie Moore I saw looked like no one I had ever seen before. The metamorphosis was not because another personality had emerged. Rather, a garden of electrodes had sprouted from Marie’s head. The combination of Marie’s oversized glasses and her electrical antennae produced to my eyes a cross between an extraterrestrial and a surprised grasshopper. I tried not to stare. Or laugh.

We had work to do. As usual, it was best to begin with something relatively nonthreatening. I opened with questions about the real-life characters that populated Marie Moore’s 989 Madison Avenue world.

“Tell me about Tony,” I started off. “What was he really like?”

“Tony?”

“Yes. Tony.”

“He was slow. He was really slow.”

She thought for a moment. “He could only print. I had to teach him how to write.”

Another pause. She seemed to be counting in her head.

“He repeated eighth [pause] twice.”

So Tony was no genius, or if he was, it didn’t show academically.

Then, unsolicited, she volunteered, “He threw a chair at a teacher.”

“How about his family? What were they like?” I asked.

Expressionless, as though catching me up on the latest episodes of a boring sitcom or the new characters in a soap opera whose first appearances I had missed, Marie proceeded to provide me with a précis of Tony’s family life. Marie was a woman of few words.

“Tony’s brother Mario tried to rape him.”

“The father beat him with a belt.”

“Sometimes they were undressed.”

“The father had weapons. A machete.”

“The father had a handgun near the bed.”

“The father was in jail for something.”

“That’s what the mother told Tony.”

“That’s what Tony told me.”

Not the flicker of an eye, no hint of a grimace, no pause or fleeting hesitation suggested a trace of anxiety. The words emerged from Marie’s mouth devoid of inflection. She could have been reading a grocery list: avocado, celery, American processed cheese slices, rape, belt, machete.…

On and on she droned.

“Tony’d beat up his little sister. He’d beat up Louisa.”

“He’d lock Louisa out of the house. He’d lock her out in the cold.”

“The mother was afraid to leave Tony with Louisa.”

“Tony’s mother said she hated to leave Louisa in the house alone with Tony.”

“I met the mother.”

“She told me that.”

The grocery list continued, but now Marie was telling me about Tony’s mother. It was as though we had turned down the next aisle of the supermarket: soap flakes, detergent, Mop ’n Glo, rape, beat, lock out in cold.…

“Tony had bumps on his head.”

“Tony said his mother deliberately dropped him on his head when he was little.”

No wonder Tony “repeated eighth twice,” I thought. In her unrelenting monotone, Marie provided a picture of the grotesque household out of which her juvenile paramour had crawled.

This was as close to Tony as I would come. I would never be allowed access to him or his family. He was going to be the state’s prime witness. But Marie had given me a pretty good sense of the forces that had propelled Tony toward the apartment on Madison, and the enticements or stimuli that kept him there. Had the helpless Belinda taken the place of Francesca or Louisa? When he tortured Belinda and Marie and Anna Giusseppi, did he become his brutal father—the man who, Tony told Marie, beat his mother and threatened Tony himself with a gun and a machete? Certainly the intensity of Tony’s maliciousness, his relentless persecution of the members of his surrogate family, far exceeded anything Marie and the others might have done to invite this degree of brutality. Tony brought his fury with him when he moved into 989 Madison Avenue.

Marie continued, sounding ever more like a robot. I began to feel as though each time I asked something I had pressed “play” on a tape deck or answering machine. I took off my glasses and sat for a minute or two, elbows on my knees, hands over my eyes, trying to figure out what was going on. In our first meeting Marie had been lively. I had laughed at her story of the quiz show, at the mental picture of a washer-dryer and breakfront on her parents’ lawn. Now her voice was dead. It was as though Marie could talk with enthusiasm about anything—anything, that is, that did not matter to her. As emotions stirred within her, her voice lost all trace of feeling. The events that she described had been stripped, separated from any emotions that might once have been attached to them; information and feelings had been dissociated, one from the other. When Marie did not retreat entirely from painful events and memories, fall into a waking sleep, and allow Billy to handle them, she simply split off the feelings from the events. I asked for pictures of flesh-and-blood people in her life. She showed me skeletons.

“Tell me about Anna Giusseppi.”

“Anna Giusseppi.” Marie repeated the name. The computer registered the name; a pause while it sought the data file.

“Anna Giusseppi was born October 4, 1923.”

“Anna Giusseppi was very slow. She had no high-school diploma.”

“When Anna Giusseppi’s mother died, Anna Giusseppi was hospitalized at Middletown.”

“Anna Giusseppi was hospitalized when she was twenty years old.”

“Anna Giusseppi’s sister Rosetta says, ‘If Anna’s nervous or peculiar it’s ’cause she’s been through a lot.’ ”

“Anna had shock treatment.”

“Rosetta said she had shock treatments.”

“Anna Giusseppi’s father was a drunk. He beat her mother.”

“Anna didn’t like men.”

“Anna said, ‘Men hurt you.’ ”

“Anna had hallucinations.”

“Anna thought she saw her mother.”

“Anna said, ‘Oh, Ma, you’re here. Ma. Ma.’ ”

I stopped asking questions. Again, I placed my glasses on the table and sat, my hands over my eyes, pondering the lives of Marie’s entourage, the battered brood that sought shelter under Marie’s roof.

For years Jonathan and I had been puzzling over the question of how the mothers and fathers of our incarcerated delinquents and condemned murderers found each other. We had pictured encounters on shuttle buses transporting visitors from bus stations to prison yards; mixers between male and female wards of state hospitals; chance meetings at police precincts, while awaiting fingerprinting. But what forces of nature or society could have conspired to draw together this benighted group of castoffs? I reviewed in my mind what I had learned about each: Belinda, orphaned, in the care of an aged grandmother who lacked the energy to cope with a teenager; Tony, his violent father and brothers, his victimized mother. Anna Giusseppi, her drunken father, the death of her mother, her psychosis, her shock treatment, her sister’s cryptic, “she’s been through a lot.” And, of course, Marie. Marie who practically from infancy knew nothing but pain, sexual abuse, and humiliation; Marie, who had run from her father to the bed of a sadistic man her father’s age. Chance may have brought them all together; I now understood what kept them together. Long before any of them had met each other, torture and humiliation had become a way of life; for all of them pain and degradation were an old pair of curiously attractive but excruciatingly uncomfortable shoes. Whenever they slipped into them they hurt, and yet they could not bring themselves to get rid of them. Over and over again, unaware of what they were doing or why, they reinvented the only lives they had ever known. For each, Marie provided a home away from home.

In spite of my efforts to think scientifically and avoid making inferences I could not prove, in order to understand the situation I found myself drawn back to my psychoanalytic roots. Freud had described the way we all tend to repeat or perpetuate the relationships we know. He called it a repetition compulsion. He labeled it, but could not explain it. We drag out the old game board, choose the most familiar pieces with which to play, and arrange and rearrange them in familiar patterns. Sometimes we find ourselves playing against ourselves. If we have been tortured as children, we do not merely root for the opposition; we become the opposition. We, the aggressors, try to beat ourselves at our own game. No one knows why we do this, but this is what we do.

And so the forlorn, sadomasochistic clutch of misfits at 989 Madison Avenue stuck together. They could not tear themselves away from the place or from each other. They fulfilled each other’s needs, alternating roles. They took turns. Today I am my abuser; you are the child; you are me. Tomorrow I shall be the child; you will torture me. Over and over they replayed the events of childhood as if these painful reenactments could somehow exorcise the past and set the players free. Even Belinda, tortured by all, and prostituted to Marie’s aged common-law husband, could not stay away. She kept coming back. Eventually she was held captive, thumb-cuffed to the floorboards. But the others stayed by choice; they stayed until the games got too rough or the apartment began to stink.

As for Marie, she too floated from one role to the next: now a nurturing mother; now a cruel tormentor. The residents of 989 were made for each other.

I do not remember whether I summoned Billy or whether he came on his own. Suddenly he was there in the hospital room. My notes state in large print: BILLY ARRIVES!

At our previous meeting I had an agenda. What did Billy know about Marie’s childhood? What memories did he keep? What did Billy do for Marie? At this, my third meeting with Marie and second and final encounter with Billy, he was determined to set the agenda. There were things he wanted me to understand. First and foremost, he wanted me to know how powerful he was. In retrospect I can appreciate how vulnerable Billy felt after our first meeting. Until Billy and I had spoken to each other, no one outside the bizarre little household at 989 Madison Avenue had met him; or if they had, they did not know it. No one even suspected he existed. I had suddenly put an end to that secrecy. As Billy saw it, I had jeopardized everyone’s safety. Secrecy and safety, I have learned, are synonyms to protector personalities. Billy was taking no chances. He would scare me into silence.

“My business is violence,” he began, puffing himself up like a superhero balloon at a Macy’s Thanksgiving Day Parade. The more Billy tried to intimidate me, the crazier he sounded.

“I am the Mafia,” he declared. That would show me.

“Really?”

“I have guys who work for me,” the voice was streetwise, menacing.

“Oh?”

The first time I met Billy, he frightened me. This time I was curious, not scared. He was not a threat, but was, rather, a two-dimensional cartoon of evil. Billy was the construct of a frightened child’s mind. Marie’s brain at two or three or four years of age had fashioned him, brought him into being to protect her from her father. He had not matured much since then.

Over the years Jonathan and I have met a lot of Billys. What I mean is that we have made the acquaintance of many protector personalities; they are entities called forth in early childhood by tortured children unable to endure their pain alone. How these beings are created, no one really knows. It looks to observers as though certain chronically abused children self-hypnotize; they remove themselves from the situation. They see what is happening, but do not feel it. It is as if it were happening to someone else—someone else feels the pain and is strong enough to endure it. In time that someone else becomes a protector. Over the years, we have come to appreciate the ambivalent relationship that exists between protector personality states and the helpless children who created them. These protectors boast, “I took the pain.” Then in the very next breath, they threaten to hurt, maim, even kill the “wimp” whose pain they endured. They are contemptuous of the child they saved. It has taken us a while to understand this problematic relationship. Now I can see that the first time I met Billy, when he threatened to kill Marie, he was giving me a crash course in the psychology of protector personality states. I was too scared and inexperienced to catch on just then.

“I have ten men under me.” Billy was determined to impress me, but the more he boasted, the crazier he sounded.

“You do?”

Billy continued, “Uncle Ricciola, he got me in the Mafia. He was in the Gambino family.”

It sounded to me as though Billy or Marie or someone were pulling my leg. But the speaker was deadly serious. Billy was providing me with a picture of the imaginary universe that he inhabited when Marie was out in the real world. Billy’s was an underworld in every sense of the word. While Marie lived out her tortured days in the apartment with Debbie and Belinda and Tony and Anna Giusseppi, and the others, Billy led a parallel life surrounded by a hierarchy of gangsters and thugs.

This kind of imaginary or delusional system, so new to me in 1984, I know now to be commonplace. Over the past decade, Jonathan and I have encountered many patients whose protector alternates function somewhere beneath conscious awareness, within the hierarchies of fantasy worlds. The nature of these inner worlds—their structures, their complexities—are bounded only by the limits of the human imagination, by the individual’s singular frame of reference.

Time was running out. Now I had an agenda. I had to know more about the murder of Belinda Weeks if I were to be of any help to Marie or Billy or anyone else. I interrupted Billy.

“Billy, I have a question. Does Marie know all about the murder?”

“No.” The response was immediate. I sat very still and listened to Billy’s account of the murder. He enjoyed describing it.

“Tony said he would starve Belinda. But Marie tried to sneak food to her. When Tony found out she did that, he punished Marie.… November, December, January. That’s when the heavy beating started. That’s when the burning started. He set fire to her.…”

Whom was Billy talking about, Marie or Belinda? Maybe both. Both had started out as sex partners and ended up as victims. This explained why, when the police visited 989 Madison Avenue, they listed Marie and Belinda as victims. In the end, Tony killed Belinda and came to loathe Marie. What, I wondered, was Tony’s relationship with Billy?

“Tell me about the murder.” I tried to keep my voice even and as unemotional as Marie’s had been when she gave the grocery list account of her housemates. I did not want to stop Billy, just focus him. I waited, hoping my question had not put an end to his revelations.

He continued. “That morning Belinda was handcuffed to the kitchen floor. Marie woke up early. It was cold. She went to the kitchen. She said, ‘Belinda.’ There was no response.… Marie took a barrette and opened the handcuffs. She got a blanket.…”

Then, according to Billy, Tony woke up. Annoyed at the disturbance, he marched into the kitchen and became enraged at the sight of Marie, leaning over the pitiful girl. Belinda was his to do with as he pleased. Tony grabbed Belinda by the hair. Now Billy’s voice was excited.

“He dragged her toward the bathroom. He stomped on her chest. He stomped on her face.”

“What did Marie do?” I asked, careful to avoid any expression of reproach.

“Tony pushed Marie. Marie fainted. That’s when I came.” The last sentence was said with pride. Billy was the strong one. He wasn’t squeamish like Marie.

“What happened next?”

“Then? Then Tony flung the kid against the tub. Even after he stomped her face, he flung her against the tub.”

“And Marie?” I interjected, “What did she do?”

“Marie was gone. She disappeared.” I was not surprised at this piece of news. Marie knew how to remove herself from ugly situations. She had had lots of practice.

“I tried to get Marie back, but it didn’t happen,” Billy smirked contemptuously. There he was, Billy, left to clean up a mess Marie could not tolerate.

In the end, it was Billy, not Marie, who went to the hardware store for the duct tape and garbage bags. Together the men, Tony and Billy, wound the corpse, lugged it upstairs, and stashed it in the attic. They had become fast friends, partners in crime. They didn’t need Marie or Belinda. Marie could die, too, for all they cared.

“Where was Marie during all of this?” I asked.

I never got an answer. Billy had shared all he intended to share. He had made clear that Marie did not participate in the murder or its aftermath. I wondered where she was. Asleep? In a world of her own? Or had she been watching from some safe place in the wings? If so, did that make her an accessory to the crime?

Regardless of her role, I knew it would be hard for a jury to empathize with a tormented, divided soul like Marie when a fourteen-year-old girl had suffered so hideous a death while held captive under her roof. Could a jury separate Marie’s acts from Billy’s, her responsibility from his? Would they even believe in Billy’s existence? Had I not met Billy, I surely would not have believed it.

Direct testimony is usually straightforward. The defendant’s lawyer asks all the questions that you want to be asked. There is little tension and, hence, it is rarely memorable. I remember little of the first hour or so of my testimony. It must have included a review of my credentials and an account of my interviews with Marie. I have a vague recollection of explaining to the jury the phenomenon of multiple personality disorder and providing a description of Marie’s personality states. What followed I recall vividly. Those two or three minutes have the clarity for me of Billy’s first appearance.

“Doctor Lewis,” Marie’s attorney asked, “was Marie Moore ever sexually abused?” I paused and considered the question. How could I answer this question accurately? I didn’t know for sure what had happened to Marie. I knew only what Marie’s protector, Billy, had told me. That is what I would have to tell the jury. I began:

“Marie has no memory of having been abused sexually. She denies it. However, according to Billy, Marie’s father abused her sexually. Billy said that when Marie was about four years old, her father used to stick pencils in her rectum and vagina. He did it several times a week. Later on, when Marie was ten …” I got no further. In a flash the mousy, bespectacled Marie jumped up from the defense table where she was seated and shouted, “That’s not true!”

What happened next is a blur. I could see people around Marie, trying to quiet her. I could hear the judge’s gavel as he tried to call the courtroom to order, then cleared the court. A recess was called, guards circled Marie, and she was led out of the courtroom. Marie had demonstrated for the jury better than any videotape the phenomenon of multiple personality disorder. Marie had no memory of what Billy said had happened to her. Decades of stony sleep had protected her from the knowledge.

Either the jury did not understand what they had seen or they did not care. They found Marie Moore guilty of the murder of Belinda Weeks. They sentenced her to death. Tony completed the remaining months of his sentence and was set free.

* W. B. Yeats, “The Second Coming.”