The Anatomy of Violence (53 page)

Finally, the tearful Christina spoke to a counselor about her stepfather’s pedophilia. The counselor in turn spoke to her incredulous mother. Anne was shocked, horrified, and furious. She found “barely legal” child pornography in his possession—pictures of women supposedly of legal age but who looked thirteen or fourteen. She reported his behavior to the police.

Mr. Oft was legally removed from the home and duly charged with sexual
assault. Diagnosed as a pedophile, he was found
guilty of child molestation and given the option of either completing a treatment program for pedophiles or going to
prison.

Naturally, Mr. Oft opted for the treatment program. But even during treatment Oft could not resist soliciting sexual favors from the female staff and other clients at the rehabilitation center. He was thrown out of the program. That was it. He now had to go to prison.

The very night before he was due to start the prison sentence, Mr. Oft went to the University of Virginia’s hospital complaining of a headache. Unconvinced, the hospital turned him away, but as he was about to be discharged, he claimed he would kill himself if released, slipping in a threat to
rape his landlady. The medical staff could not let someone go in those circumstances, so Mr. Oft was admitted to the hospital’s psychiatry ward under the medical diagnosis of pedophilia. Naturally, one of the first things he did was to come on to the female hospital staff and request carnal medical attention.

That probably would have been his undoing if he had not also urinated on himself. The odd thing was that he did not seem concerned. He also began to walk a little unsteadily. A very astute neurologist—Dr.
Russell Swerdlow—put two and two together and ordered a
brain scan. The scan showed that Mr. Oft had a massive
tumor growing at the base of his orbitofrontal cortex, compressing the right prefrontal region of his brain.
¹
Brain surgeons resected the tumor, and a most remarkable change came about. Mr. Oft’s emotion, cognition, and sexual activity returned to normal. The pangs of guilt and
remorse at what he had
done to his stepdaughter at last set in. He no longer sexually propositioned female staff members. He no longer felt the urge to rape his landlady or to commit suicide.

Mr. Oft was a changed man.
²
He was released from the hospital and went back to therapy. This time he successfully completed the twelve-step
Sexaholics Anonymous program that he had previously failed so spectacularly. His behavior was now entirely appropriate. Seven months later he returned home to be reunited with his wife and stepdaughter to once more lead a normal life. It was a near-miraculous recovery—and it should have been a case of living happily ever after. But what appeared to be a medical miracle was a mirage. The headaches came back.

After several months of normal behavior, Mr. Oft again began to collect child pornography. Suspecting a relapse, one night his wife checked his computer and found the offending material—and once again Mr. Oft was in hot water. Yet thanks to a foresightful re-scan of his
brain, his neurologist, Dr.
Swerdlow, found that the tumor had grown back. In 2002 the tumor was resected for the second time.
³
Once again Mr. Oft made a complete recovery, and this time for six years after the second resection of his tumor his sexual urges and general behavior have been totally appropriate.

The case of Michael Oft is remarkable because it comes as close as one can get to demonstrating a
causal
link between brain dysfunction and deviant behavior. A double reversal of fortune over time. Going from normality to a growing tumor to the development of pedophilic urges then back to normality after the tumor is resected—with the pendulum swinging back yet again to repeat this tumor to pedophilia to resection to normality progression. The temporal ordering of events is very telling. But the powerful evidence suggesting that this man’s antisocial behavior was due to an uncontrollable growth in his skull also raises a profound legal question: Was Mr. Oft legally responsible for his deviant behavior?

Some of the debates in life seem ancient and eternally fixed in time, like the frozen figures encircling a Grecian urn. Here we have such a debate. On one side of the urn we have
Themis, the Greek goddess of law and justice. Themis wants no sob stories—she wants no excuses. Justice and retribution reign, and criminals have to be held responsible for their actions.

On the other side of the urn, we have the pleading figure of Mr. Oft and others like him, victims, in ways we are still trying to understand, of complex biosocial forces—forces frequently beyond our control.

In this penultimate chapter we will take a critical look at how research on the biology of
violence is not just affecting the judicial system—but is also raising questions about core human values including free will. The new subdiscipline of “
neurolaw” is playing a critical role in shaping our perspectives on this issue. Within this context we’ll take a focused look at
criminal responsibility, and, as one would expect in a legal context, we’ll evaluate the cases for and against the relevance of neuroscience research on violence. Finally, we’ll return to the question of Mr. Oft’s responsibility—and examine the credibility of the current legal response.

We have been witnessing so far a myriad of biological, genetic, and brain factors that conspire together to create violence and crime. A number occur even before a child is born. A child does not ask to be born with
birth complications or a shrunken
amygdala, or to have the gene for low levels of
MAOA. So if these factors predispose some innocent babies to a life of crime, can we really hold them responsible for what they eventually do—no matter how heinous the crime? Do they have free will in the strict sense of the word? That’s the key question we must address.

At one extreme, many theologians, philosophers, social scientists—and likely yourself—would argue that barring exceptional circumstances such as severe mental illness, each and every one of us has full control over our actions. Theologians argue that we have a choice as to whether to let God into our soul, that we choose whether to commit sin or not, and consequently our criminal actions—our sins—are a product of a will that is under our full control.

At the other extreme, some scientists eschew the idea of a disembodied soul that has its own free will and take a more reductionist approach.
Francis Crick, who won the Nobel Prize for the
discovery of the structure of DNA, for example, believed that free will is nothing more than a large assembly of
neurons located in the
anterior cingulate cortex, and that under a certain set of assumptions it would be possible to build a machine that would believe it has free will.
⁴
Such a view
harks back to our discussion of evolutionary perspectives. Perhaps we are indeed merely gene machines that con ourselves into believing we have choices in life.

I might argue for a middle ground between these two extremes. Free will likely lies on a continuum, with some people having almost complete choice in their actions, while others have relatively less. Rather than viewing intent in black-and-white, all-or-nothing terms, as the law does, with a few exceptions, I see shades of gray. Most of us lie between these extremes. Think of the free-will concept like IQ, extraversion, or temperature, which are dimensional in nature. There are degrees of free will, and we all differ on that dimension of agency.

What determines the extent of free will? Early biological and genetic mechanisms alongside social and environmental factors play substantial roles. For some, free will is significantly
constrained early in life by forces far beyond their control. Let’s look into the life history of one murderer and rapist I worked with to illustrate my argument. I’ll first present his life circumstances that his defense team argued constrained his free will—but I’ll return to his case later to offer a more retributive perspective from the prosecution.

Donta Page was born on March 28, 1976. His mother,
Patricia Page, was only sixteen years old at the time of his birth. She had
gonorrhea during her pregnancy. Her own mother was fourteen when she gave birth to Patricia, so Donta’s mother was raised by her aunt and uncle, both of whom physically abused her, forcing her into an eight-year-long
incestuous
sexual relationship with the uncle that started when Patricia was four. Donta himself did not have a father at home, but he did inherit a family history from his father’s side of crime, drug abuse, and mental illness.

Throughout his early
childhood, Donta was a frequent visitor to the local emergency room. He had
five
recorded admissions before the age of two. When he was just nine months old he was taken there after he supposedly “fell” out of a car window—but in all likelihood the unwanted child was thrown out. A scar on his
head as an adult is the only external sign of what likely resulted in a very significant closed-head injury. Due to lack of close parental supervision, he was also knocked unconscious by a swing, and when six months old he fell out of the top of a bunk bed. So before he was even two years old he had a substantial history of head injury—and very likely brain
impairment.

When Donta was three he was moved into one of the worst neighborhoods
in Washington, D.C. His defense attorney reported that as he walked in the area where
Donta grew up, he could see that every fourth or fifth house was burned or abandoned. During this time Donta was bounced around from his
mother to his great-aunt and back again, experiencing sustained instability in bonding and a normal family life. Frequently he was left at home alone to fend for himself for the whole day. Things were so bad with his abusive mother that by the time he was ten, Donta often preferred to sleep in an abandoned building rather than face the abuse at home.

Given how Donta’s mother had herself been raised, it was not surprising that she physically abused him. His grandmother testified that as an infant he was vigorously
shaken on repeated occasions for crying. At the age of three, he was punched in the head by his mother so hard that it caused him headaches. At six he was being beaten with an electrical cord that caused bleeding. He was beaten for wetting himself. He was beaten for getting bad grades. He was beaten for any minor misbehavior. When his teacher told his mother that she suspected Donta had
ADHD, his mother went home to beat him because he had a
childhood disorder. It was documented that by age ten he was being hit by his mother with a closed fist. Donta was also burned with cigarettes, leaving him with dark black spots on his arm that remain in adulthood—alongside scars on his thighs, back, flanks, arm, and chest that bear testimony to the bombardment of abuse.

That abuse was dealt out not just by his mother but also by neighboring predators. When he was ten he was violently raped by a next-door neighbor. Back in the local emergency room, it was documented that he had rectal bleeding. It was further suspected that he was also bleeding internally. Despite all the physical evidence of rape, the hospital never referred the matter to child protection agencies. Donta was sent back to live in the same house, across the way from the same rapist, likely to be raped again. He was given neither counseling nor one ounce of understanding. Neither the family nor the hospital cared about the safety of a small, unsupervised boy from predatory
neighborhood rapists.

The abuse escalated. By age thirteen, he was yet again back in the ER because his mother had hit him very hard on the side of his head with an iron. The attending physician documented welts on his arm where his mother had struck him with an electrical cord and the swelling to his temple where he had been hit with the iron. This was clear
documentation of child abuse,
⁵
but no action was taken, and Donta was ultimately returned back home to his mother.

As one might have predicted, Donta was committing property crimes by the age of sixteen and was duly sent to a juvenile detention center. When he was later on trial as an adult for homicide, his attorney carefully pointed out that by the age of eighteen, Donta had been referred by teachers and probation officers for psychological treatment an amazing nineteen times. Astonishingly, he never received even one treatment session. Eight of these attempted referrals were before he had committed a single criminal act.

Given the complete absence of any form of intervention, it is unsurprising that Donta quickly fell into a criminal lifestyle, committing robberies and
burglaries that when he was eighteen resulted in a sentence of twenty years in prison and ten suspended sentences. He’d only served four years, however, before being let out on parole and sent to a halfway house on Stout Street in
Denver, Colorado, in October 1998. The respite from prison did not last long. He
assaulted one of the other residents, and on February 23, 1999, he was told he would be sent back to Maryland to serve the rest of his sentence. It was on the following day, when he was due to be returned to prison, that he robbed and killed
Peyton Tuthill in Denver.

Before the trial began I had been contacted by
James Castle, Donta’s defense attorney, who had heard of my brain-imaging work on murderers. He believed that Page’s abominable social history would likely have consequences for brain functioning, and that this in turn would have consequences for behavioral control. I frequently get requests of this sort and usually turn them down, but after considering the details Jim Castle presented me with, I believed Page’s case deserved a closer look.

We arranged to have Donta Page brought across state lines from Colorado to California, so he could be brain-scanned in the same
PET scanner that I had used in our study
of murderers—using the very same methodology. I presented Donta’s brain scan at his trial as an expert witness and compared it to fifty-six normal controls. I gave my opinion to the judge and jury: Donta Page showed clear evidence of reduced functioning in the medial and orbital regions of the prefrontal cortex, as well as the right temporal pole.