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“Base Instincts: What Makes Killers Kill?” by Jonathan H. Pincus, M.D. (W.W. Norton & Co., 256 pages, $25.95) Most Americans have some familiarity with the horrid mass killings that have plagued recent history. From Jeffrey Dahmer to Columbine, we can recount when, where and how the murders occurred. In “Base Instincts,” Dr. Jonathan H. Pincus, chairman emeritus of Georgetown University’s Department of Neurology, attempts to give us the why. Through case studies and his own experience treating mass murderers — a mass murderer is someone who has committed more than two murders — Pincus provides a rare glimpse into the minds of killers. According to Pincus, there are three elements present in all mass murders: childhood physical and/or sexual abuse, brain damage and paranoia. Pincus uses vignettes to illustrate his theory about psychopaths he has examined and treated, primarily after they’ve been convicted. In most cases, Pincus has been given access to these defendants because he has been hired by defense attorneys who are looking for mitigating circumstances to appeal their clients’ death sentences. A barrage of colorful if disdainful characters assault the reader. The first case study Pincus presents is about a 12-year-old girl who is constantly bullied until she takes a knife to school and kills her nemesis. Pincus discovers that the patient’s mother is an alcoholic who physically abuses the girl. He also learns that the girl has brain damage as a result of her mother’s excessive drinking during pregnancy. Through a series of tests, Pincus deduces that the girl is paranoid. The paranoia causes the patient to overreact to the situation and establishes all three necessary components of Pincus’ theory. Another story features a Goliath of a man reminiscent of Lennie in John Steinbeck’s “Of Mice And Men.” With a childlike docility, the patient is always eager to please. Severely brain-damaged as a result of childhood physical abuse, this patient has used his brawn to please his foreman, whom he admires and defends at all times against even the most benign criticism. His co-workers, aware of this adoration, constantly tease him by making disparaging comments about the foreman. One worker at the plant persuades the patient to rob a store. The result of the poorly planned and executed caper is that the patient makes off with a mere $100, but kills three people in the process. Pincus seems to be the only one in the legal system to notice this murderer’s mental problems, which are evidenced by the nature of his crime, his admission to it and later retraction and his threats on a tapped prison phone to kill his mother. Pincus contends that the patient’s lack of coordination and extreme gullibility are further evidence of brain damage and succeeds in getting the patient off of death row. Pincus also introduces his readers to a man who rapes a pregnant woman. He kills her and two other people and is caught when he tries to cash a $25,000 check the woman gave him in exchange for her life — a deal he obviously doesn’t make good on. Other case studies feature a child molester sexually abused as a child who thinks that his 5-year-old stepdaughter was looking at him “all sexy”; a paranoid schizophrenic, also severely abused as a child, who burglarizes homes for valuables and takes women’s dirty underwear in the process; and a patient who, before killing his prostitute victims, hog-tied them and masturbated as he fondled their feet, all because he was made to rub his mother’s feet as a child. The gore in “Base Instincts” can be excessive. Rapes and physical abuse are at times described in such detail to cause the reader discomfort. Clearly, Pincus has the detachment of a physician who encounters horror regularly, who maintains a clinical tone unnecessarily, and whose prose suffers from it. Yet, Pincus strives to do more than just chronicle criminal acts. He asks provocatively whether or not these individuals who are so clearly mentally damaged and lack proper reasoning ability can ethically be held accountable for their actions. This question is legitimate. Pincus does, after all, aid in getting these individuals off of death row, but he evades answering his own question. Instead, he lays out statistics to show that poverty and child abuse perpetuate such crimes as the murders he describes. This is not an innovative deduction. Pincus ends his book by talking about his treatment successes. For example, there is a little boy whose extreme behavior indicates that he is a potential murderer. While in Pincus’ office, the boy screams, cuts off the lights and hits his mother. The mother explains to Pincus that the child hates his little sister, who is significantly younger than he is. He has hit her in the past, and the parents fear he will really hurt her. The family has sought all sorts of medical help, all unsuccessful. Pincus prescribes a psychiatric cocktail of drugs which results in the child curtailing his misbehavior. Sometimes Pincus can have mixed results. In one case, his treatment succeeds, but the outcome for the patient is not good. Pincus prescribes an imprisoned murderer drugs to stop his violent outbursts. The patient tells Pincus that he has never felt so good in his life. Unfortunately, before meeting Pincus the inmate made mortal enemies in prison. They learn he is no longer capable of his former violence and take advantage of that to kill him. “Base Instincts” provides a panoramic view into the minds of several killers and explains psychological theories in simple terms. For that reason, it is worth reading. Where the book falls short is in its poor editing — there are several misspellings and proofreading errors — and in Pincus’ demigodlike perception of his abilities. Lee Doman is an associate at Washington, D.C.’s Goldfarb Literary Group.

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