In 1966, Charles Whitman, the so-called Texas Tower Mass Murderer, shot 17 people from the rooftop of a University of Texas building in Austin and was ultimately slain by police.
I had two professors at Massachusetts General Hospital in Boston who believed that a small portion of the brain called the amygdala played a large role controlling violent behavior. The professors flew down to Dallas to witness Whitman’s autopsy. He turned out to have a brain tumor. It was an atypical neoplasm with malignant characteristics, and the professors took the position that the tumor might have invaded part of the amygdala and been possibly implicated in Whitman’s rage attack. Later, they authored a controversial book called “Violence and the Brain” in which they promulgated the theory that violence stems from brain dysfunction. But Whitman was a Marine with a host of mental problems, all of which could easily have played a role in his lethal explosion. He stabbed and shot his mother and stabbed his wife in her sleep. Then came the rampage.
It is not such a simple matter to blame a brain tumor for the Columbine killers, the Las Vegas shooter, the Charleston church murderer and other more recent instigators of atrocities. In fact, it is often the case that little is known about these folks at all unless they belong to political causes. Neighbors describe these men as “nice” or “quiet” individuals, later discovering that their living quarters contained hordes of guns and ammunition. Most of the killers do not come to clinical attention, and they are often solitary and isolated. That they do not appear on anyone’s radar is all the more worrisome because it makes early identification quite impossible. Modern society dearly embraces the notion of predictability; amok is among the last predictable pieces of human behavior.
The latest group of mass murders make it appear as though a new phenomenon has taken hold of America. In fact, outbursts of murderous rage have existed for centuries; indeed, Captain Cook witnessed episodes of amok in Malaysian culture dating back to 1771. Amok has been observed in the Philippines, Laos, Papua, New Guinea and Puerto Rico. Typically, a lone male, after a period of intense brooding, goes on a rampage killing all the people he comes in contact with, and then commits suicide. In Rome, during the year 1531, an unknown assailant murdered 53 people and was executed. In past decades within America, Africa and the Middle East, Asia and Europe, over a thousand people were killed in isolated amok-like outbursts by isolated killers who were either themselves killed, executed or committed suicide.
Suicide often follows extreme bouts of rage, as if the brain is convulsed with aggression and cannot distinguish itself from others. And there exists a body of literature showing that extreme violence is frequently accompanied by suicide, a fact demonstrated regularly in the news when a man kills his spouse and children and then himself.
The question is always the same: What made them do this? Sometimes in a man, it is an overwhelming jealousy over the wife’s new lover. Sometimes, in women, it stems from a delusional postpartum depression. But more often the cause is unknown and neither the brain nor the person can be examined because both have been destroyed by the perpetrator or by the police.
Man is an unfathomably complex creature, brimming with unmet needs and conflicts that simmer and occasionally detonate without warning. The rages within some men cannot be self-controlled. Isolated instances of amok will surely continue, but the base rates of such attacks is sparse and memories for atrocities are dismayingly short lived. Tragically, the exponential deadliness of modern-day amok has more to do with the weapons man uses. A deranged man with a knife or machete is one thing, but with a machine gun, his episode of amok approaches a level of carnage that no one can understand or should ever have to comprehend.
Dr. John R. Lion is a physician and psychiatrist practicing in Baltimore; he can be reached at firstname.lastname@example.org.