The Psychopath Whisperer: The Science of Those Without Conscience (16 page)

I was surprised that Dr. Forster didn’t run out of his office when I cavalierly told him the plan to transport maximum-security inmates eighty miles from a prison to the university and then remove their handcuffs and put them in the MRI. I may have forgotten to tell Dr. Forster we have to take their handcuffs off when we scan them because no metal is allowed in the MRI room. I figured we
could cross that bridge when we got there. I’d put enough new things on his plate.

Over the next several years, I spent nearly every Wednesday night from 6 p.m. to midnight working for Dr. Mackay. I was often the volunteer, a guinea pig, who got in the MRI scanner as a test case as Alex and his team of graduate students developed new MRI pulse sequences. My brain was scanned dozens of times in those years. I would come to find the MRI bore a comfortable place to sleep. Indeed, it is hard for me to not fall asleep as soon as I get into an MRI at this point.

We managed to do a couple of presurgical mapping patients for Dr. Forster. He was thrilled and presented the data at a number of professional meetings, discussing the future possibilities of what this new technology might bring to bear on such cases.

One of the cases was an eighteen-year-old girl who had a small malformation in the arteries and veins in her brain. About a week before I met with her, she had started experiencing symptoms that included tingling in her face, hands, and tongue. Then one day she woke up and could not speak, although she remained conscious and alert. She had walked to her parents’ bedroom and tried to communicate to them what she was experiencing but she passed out. Her frantic parents rushed her to the UBC emergency room, where Dr. Forster found the abnormality. He suggested she undergo the presurgical mapping fMRI.

I designed tasks to map out the hand, face, and tongue areas of her brain. Then I designed a task to reveal the speech producing regions of the brain. On the day of her scan, I met with her and helped her practice all the tasks. She was very curious about the procedure, but her eyes relayed her emotion and concern. She was worried about what we might find.

We figured out where the arteries and veins had gotten twisted and which parts of the brain were linked to the area that the surgeon was going to glue shut. The procedure literally uses glue to close the faulty artery. But the brain tissue supplied by that artery
could die as well, removing her ability to move her face, hands, or tongue. The procedure could take away her ability to speak.

I agonized over the analyses of her brain imaging data. I had to make sure there were no mistakes. I did not want a surgeon removing an important piece of her brain because I made a mistake. I reviewed the results with the neurosurgeon and told him about all the possible caveats and limitations we know about the fMRI technique.

The surgeon used our results to help guide where he would glue shut the faulty artery. To everyone’s delight, she made a full recovery.

I collected brain imaging data on weekends when I was not in prison. Most graduate students were happy to volunteer for MRI studies in return for getting pictures of their brains. Before the end of our first year of scanning, nearly all the graduate students at UBC had gotten MRI pictures of their brains. Our team was developing all the tasks and procedures we were going to perform on the inmates once we arranged to transport them for scanning. I spent long days at the MRI suite collecting and analyzing data, and even longer days at the prison interviewing inmates and collecting more brain wave studies.

I could not have coordinated the logistics of the first fMRI study of criminal psychopaths without a lot of help. Andra Smith, a graduate student at UBC in neuroscience, had started graduate school studying aggression in rats but then developed a severe allergy to them. So she switched to work with prisoners and study psychopathy. Andra and I spent a lot of days working together at the prison; she was the one who wrote most of the grants that we got to support our project. None of the original brain imaging studies of psychopaths would have been completed without her help and dedication.

Dr. Peter Liddle, a physicist and psychiatrist, was instrumental in training us in the intricacies of brain imaging analyses. Before moving to UBC, Dr. Liddle had been a founding member of a group at Hammersmith Hospital in London, where the software package
called
Statistical Parametric Mapping
, or SPM, was born. Peter had hired a young psychiatrist named Karl Friston to help do clinical assessments of patients with schizophrenia. Karl also had an interest in math, and he went on to develop the most popular software in the world for the analysis of brain imaging data. Over 80 percent of the peer-reviewed publications in the world use SPM to analyze their imaging data. I was fortunate to be able to work with Peter, Karl, and their respective laboratories and learn the best ways to analyze brain imaging data from the very beginning of the field.

UBC’s new GE MRI machine was not without its quirks. We were pressing the machine to the limits, and GE engineers had not anticipated some of the problems that would arise. One challenge was that the system was limited to being able to collect only 512 images consecutively. But in fMRI we collect thousands of images at a time. In my quest to solve this problem, I met a couple of fellow scientists who were trying to overcome this and other issues with the GE scanner.

At an MRI meeting in Vancouver that year, I met a physics graduate student from Wisconsin named Bryan Mock. Over a burger and a couple of beers, he transformed how we collected data on our GE scanner. Bryan provided us with code to pull the MRI data off the scanner and reconstruct the raw data on another computer. It was Bryan’s “offline reconstruction” that allowed us to circumvent GE’s 512-image limitation. Bryan then told me if we wanted to make the scanner go faster, we could turn off a couple of the heating calculations. It appears that GE engineers never anticipated scientists pushing the MRI system as hard as we do when collecting fMRI data. GE had installed a little governor, like a system that limits how fast a car can go, on the MRI. Bryan taught me how to turn off the governor.

After my lunch with Bryan, I called the techs in the MRI suite and had them turn off the governor on the GE MRI. Then I asked them to run our fMRI sequence on a phantom (the water bottle dummy we use in MRI to test sequences). The techs dropped the phantom in and ran the new sequence. Our MRI was 40 percent faster! Amazing.

Bryan was quickly hired by GE right out of graduate school. He now runs the MRI product development team, and I continue to buy him burgers and beers anytime we get together.

I also met by e-mail a graduate student at the University of Maryland, Vince Calhoun, who was trying to solve the same problem of lack of speed on the GE scanners he was working on. Vince was an engineer working on novel ways to analyze brain networks. So I shared with Vince all the tricks I learned from Bryan Mock. Years later Vince Calhoun and I became junior faculty together. And Vince continues to buy me burgers and beers.

My fellow graduate student Andra Smith took to dealing coffee from my Starbucks source to the Regional Escort Team of the Canadian Department of Corrections. The Escort team is responsible for transporting inmates from prison to prison or from prison to special medical appointments. After about six months of supplying the team with free coffee, Andra approached them to see if they would transport the inmates from our prison out to the University Hospital for MRI scans. They said they would be happy to help.

The prison security staff was a little wary about letting the inmates know what day they were going to be transported to the hospital for MRI research. The Regional Escort Team wanted to make sure that the inmates did not try to plan an escape. The team especially wanted to make sure the inmates did not recruit confederates on the outside to help break them out when they were being transported. Our project had to be top secret.

Escape was a pretty serious concern. On June 18, 1990, confederates had hijacked a helicopter and landed it inside the fences of a maximum-security Canadian prison (coincidentally named Kent Institution). An inmate serving a life sentence had organized the escape, and another inmate joined him when the helicopter landed inside the prison walls. The confederates shot and seriously wounded a guard. The escape plan was right out of a Hollywood movie. The inmates and the confederates made it out of the prison but were caught a few weeks later hiding out in the woods.

One day I was talking with the head of the Escort Team about security measures, and I asked him whether they prevented inmates from making phone calls on days we transported inmates for research.
He told me that on transport days, the prison planned to cancel all phone privileges to make sure that an inmate did not call someone outside and tell him or her the inmates were being transported.

That should help
, I thought. But then I asked the team leader what if the absence of a call was the signal? In other words, if an inmate called the same person every day and then one day failed to call, that might be the clue it was the day the inmates were being transported.

The team leader hadn’t anticipated that. So for the weeks leading up to our first scan day, the prison randomly shut down phone privileges for the entire prison. The Canadian Department of Corrections was amazing; they were doing all this for research.

One morning in the middle of the summer we began our brain scan project. Five psychopaths were transported under armed guard eighty miles from Abbottsford to Vancouver. There were four vehicles in total. The first vehicle was a scout, and it traveled ten minutes ahead of the caravan to make sure the coast was clear. Then came the security car, followed immediately behind by the transport truck. The truck looked like an armored car, similar to those used to haul money. Five minutes behind the truck was the trail car with two heavily armed guards.

The University Hospital set up a special traffic route and posted guards around the hospital. The university even built a wooden shield that closed and locked the truck full of inmates down in the MRI delivery area. The truck was able to drive down the brick road and park within ten feet of the MRI exterior entrance.

I’ll never forget our first delivery.

I’d awoken before dawn and gotten busy prepping for the day. We had the MRI suite cleared of anything that the inmates might use for a weapon. We had hospital security guards checking the perimeter to make sure there were no confederates lurking nearby who might try to help spring an inmate.

I had picked up a couple dozen donuts and lots of coffee for the guards and inmates on my way into the hospital. Dr. Liddle and
Dr. Forster were there, as well as my fellow graduate student Andra Smith and our trusted MRI tech Trudy Shaw.

The scout car arrived at 7 a.m., well before most of the hospital staff had reported for work. The guards came in and looked around, double-checking all our local security measures. They called on their radio for the truck to descend into our little fabricated parking lot. After the truck came to a stop and the guards secured the wooden doors, they unbolted the huge metal arm that locked down the rear door of the armored truck. The inmates were seated on steel benches shackled to the floor. Each inmate was unshackled from the floor and escorted into the hospital. The inmates squinted as they adjusted their eyes from the dark confines of the truck to the sparkling MRI suite. Shackles around their hands and feet were both attached to a chain around their waist. The inmates shuffle-walked into the waiting room and sat down in the plush seats. The guards removed the belt chain so the inmates could raise their hands and eat their donuts and drink some coffee. The shackles were left on their hands and feet.

The first inmate to be scanned was my pal Shock Richie. He was escorted into the MRI room for prep. I explained the procedures to Richie and gave him examples of the tasks he was going to perform while in the MRI scanner.

Shock Richie said, “You’ll let me know if there is anything wrong with my brain?”

“Don’t be shocked if there isn’t anything in there,” one of the guards quipped.

Apparently, Richie had already given the guards a bit of trouble when he showed up naked at his cell door when they called him out at 5 a.m. for the transport. The guards had waited, unimpressed, while Richie got dressed.

Shock Richie smiled at me as the guard knelt down to remove the shackles around his feet. As the final set of cuffs came off, Richie rubbed his wrists for a minute as we walked into the MRI room. I noticed Dr. Forster watching intently from the window in the control room. He had come to grips with the fact that the inmates were going to have all shackles removed before they went into the MRI
room. But I never should have told him to watch the movie
Con Air
with Nicolas Cage and John Malkovich, in which a planeful of convicts escape their shackles and take over the transport plane; he had nightmares for weeks.

Shock Richie jumped up on the MRI table. We positioned him on the table and made sure that he was comfortable. Trudy handed Richie the pneumatic squeeze ball, explaining to Richie that the little ball sets off an alarm in the control room and is to be used only in case of emergencies. She cautioned that he was to squeeze the ball only if he needed to get out of the MRI. I knew what was going to happen next even before it occurred.

Shock Richie squeezed the emergency ball. A piercing alarm went off in the control room, startling Dr. Forster, who spilled his coffee on his suit. There was a loud commotion and noise coming from the control room as the group struggled to disengage the alarm.

Richie, able to see the commotion he had caused, smiled; he told me to make sure that everyone knew his name was “Shock Richie.”

Trudy spent a few more minutes getting Richie settled; I showed him the video screen he would be watching while doing our tasks. Trudy and I then exited the MRI room, and I pulled closed the heavy, magnetically shielded door behind us. The click of the lock elicited a feeling similar to that of the lock shot firing at the prison doors, but this time I was locking my first psychopath into the MRI.