Tess Gerritsen - The Apprentice

“Why would you waste any time writing to someone like Hoyt?”

“He’s exactly the sort of person I want to know more about.”

“He’s been seen by half a dozen shrinks. There’s nothing wrong with him. He’s perfectly normal, except for the fact he likes to kill women. He likes to tie them down and slice open their abdomens. It turns him on to play surgeon. Except he does it while they’re wide awake. While they know exactly what he’s doing to them.”

“Yet you called him normal.”

“He’s not insane. He knew what he was doing, and he enjoyed it.”

“So you believe he was simply born evil.”

“That’s exactly the word I’d use for him,” said Rizzoli.

O’Donnell regarded her for a moment with a gaze that seemed to bore straight into her. How much did she see? Did her psychiatric training enable her to peer through one’s public mask, to see the traumatized flesh below?

Abruptly O’Donnell rose to her feet. “Why don’t you come into my office?” she said. “There’s something you should see.”

Rizzoli and Dean followed her down a hallway, shoes muffled by the wine-red carpet running the length of the corridor. The room she led them into was a stark contrast to the richly decorated sitting room. O’Donnell’s office was devoted strictly to business: white walls, bookshelves lined with reference texts, and standard metal filing cabinets. Walking into this room, thought Rizzoli, would snap one instantly into work mode. And it seemed to have precisely that effect on O’Donnell. With grim purpose, she crossed to her desk, snatched up an X-ray envelope, and carried it to a viewing box mounted on the wall. She thrust a film into the clips and flipped a switch.

The viewing box flickered on, backlighting an image of a human skull.

“Frontal view,” said O’Donnell. “A twenty-eight-year-old white male construction worker. He was a law-abiding citizen described as considerate, a good husband. A loving father to his six-year-old daughter. Then he was hurt at a work site when a beam swung into his head.” She looked at her two visitors. “Agent Dean probably sees it already. How about you, Detective?”

Rizzoli moved closer to the light box. She did not often study X-rays, and she could only focus on the broader picture: the dome of the cranium, the twin hollows of the eye sockets, the picket fence of teeth.

“I’ll put up the lateral view,” said O’Donnell, and she slid a second X-ray onto the box. “Do you see it now?”

The second film showed the skull in profile. Rizzoli could now see a fine web of fracture lines radiating backward from the front of the cranium. She pointed to them.

O’Donnell nodded. “He was unconscious when they brought him into the E.R. A CT scan showed hemorrhaging, with a large subdural hematoma-a collection of blood-pressing on the frontal lobes of his brain. The blood was surgically drained, and he went on to recover. Or rather, he appeared to recover. He went home and eventually returned to work. But he was not the same man. Again and again, he lost his temper on the job and was fired. He began to sexually molest his daughter. Then, after an argument with his wife, he beat her so brutally her corpse was unrecognizable. He started pounding and he couldn’t stop. Even after he’d shattered most of her teeth. Even when her face was reduced to nothing but pulp and bone fragments.”

“You’re going to tell me it can all be blamed on that ?” said Rizzoli, pointing to the fractured skull.

“Yes.”

“Give me a break.”

“Look at that film, Detective. See where the fracture is located? Consider which part of the brain lies right beneath it.” She turned and looked at Dean.

He met her gaze without expression. “The frontal lobes,” he said.

A faint smile twitched on O’Donnell’s lips. Clearly she enjoyed the chance to challenge an old rival.

Rizzoli said, “What’s the point of this X ray?”

“I was called in by the man’s defense attorney to perform a neuropsychiatric evaluation. I used what we call the Wisconsin Card Sort Test and a Category Test from the Halstead-Reitan Battery. I also ordered an MRI- magnetic resonance imaging-scan of his brain. All of them pointed to the same conclusion: This man suffered severe damage to both his frontal lobes.”

“Yet you said he fully recovered from the injury.”

“He appeared to recover.”

“Was he brain-damaged or wasn’t he?”

“Even with extensive damage to the frontal lobes, you can still walk and talk and perform daily functions. You could have a conversation with someone who’s had a frontal lobotomy and you might not detect anything wrong. But he is most certainly damaged.” She pointed to the X-ray. “What this man has is called frontal disinhibition syndrome. The frontal lobes affect our foresight and judgment. Our ability to control inappropriate impulses. If they’re damaged, you become socially disinhibited. You display inappropriate behavior, without any feelings of guilt or emotional pain. You lose the ability to control your violent impulses. And we all have them, those moments of rage, when we want to strike back. Ram our car into someone who’s cut us off in traffic. I’m sure you know what it feels like, Detective. To be so angry you want to hurt someone.”

Rizzoli said nothing, silenced by the truth of O’Donnell’s words.

“Society thinks of violent acts as manifestations of evil or immorality. We’re told we have ultimate control over our own behavior, that each and every one of us has the free will to choose not to hurt another human being. But it’s not just morality that guides us. Biology does as well. Our frontal lobes help us integrate thoughts and actions. They help us weigh the consequences of those actions. Without such control, we’d give in to every wild impulse. That’s what happened to this man. He lost the ability to control his behavior. He had sexual feelings toward his daughter, so he molested her. His wife made him angry, so he beat her to death. From time to time, we all have disturbing or inappropriate thoughts, however fleeting. We see an attractive stranger, and sex flashes into our heads. That’s all it is-just a brief thought. But what if we gave in to the impulse? What if we couldn’t stop ourselves? That sexual impulse could lead to rape. Or worse.”

“And that was his defense? ‘My brain made me do it’?”

Annoyance sparked in O’Donnell’s eyes. “Frontal disinhibition syndrome is an accepted diagnosis among neurologists.”

“Yeah, but did it work in court?”

A cold pause. “Our legal system is still working with a nineteenth-century definition of insanity. Is it any wonder the courts are ignorant of neurology as well? This man is now on death row in Oklahoma.” Grimly O’Donnell jerked the films from the light box and slid them into the envelope.

“What does this have to do with Warren Hoyt?”

O’Donnell crossed to her desk, picked up another X-ray envelope and withdrew a new pair of films, which she clipped onto the light box. It was another set of skull films, a frontal and lateral view, but smaller. A child’s skull.

“This boy fell while climbing a fence,” said O’Donnell. “He landed facedown, hitting his head on pavement. Look here, on this frontal view. You can see a tiny crack, running upward about the level of his left eyebrow. A fracture.”

“I see it,” said Rizzoli.

“Look at the patient’s name.”

Rizzoli focused on the small square at the edge of the film, containing identifying data. What she saw made her go very still.

“He was ten years old at the time of the injury,” said O’Donnell. “A normal, active boy growing up in a wealthy Houston suburb. At least, that’s what his pediatric records indicate, and what his elementary school reported. A healthy child, above-average intelligence. Played well with others.”