"Three to five" Eskatrol Spansules over a three-to-four-week period also would not have accounted for the weight loss. Three to five per day, however, could have had a marked effect. That level of consumption could also have had a number of other consequences, such as, according to the Physicians' Desk Reference, "marked insomnia, tenseness, and irritability, hyperactivity, confusion, assaultiveness, hallucinations, panic states," and "the most severe . . . psychosis.
"Cardiovascular reactions," the reference book states, "may include chilliness, pallor or . . . headache," all three of which symptoms Jeffrey MacDonald exhibited in the immediate aftermath of the murder of his family.
And it is not only the amphetamine component which can pose hazards. Again, as cited in the Physicians' Desk Reference, prochlorperazine—the sedative component of the Spansule—can cause "agitation, restlessness, and reactivation of psychotic processes."
The Physicians' Desk Reference also states that the drug was "so prepared that an initial dose is released promptly and the remaining medication is released gradually over a prolonged period." The prescribed dose was one capsule per day, to be taken in the morning.
"If appetite control is desired through evening hours," the PDR states, "shift dose to midmorning. Late afternoon or evening medication should be avoided because of the resulting insomnia."
Yet Jeffrey MacDonald—outstanding medical student though he had been—was consuming the drug in a manner contrary to this recommendation. How much he might have been consuming will forever be, to employ a phrase used by Freddy Kassab before the grand jury, "a dark area," but if the "three to five" were a daily dose it would have been enough—taken over a period of three to four weeks—to have caused chronic amphetamine psychosis, many of the symptoms of which MacDonald did, in fact, display. (In the hospital after the murders he also displayed symptoms associated with abrupt cessation of high dosages of the drug, such as [as cited in the PDR] "extreme fatigue and mental depression.")
The chapter on amphetamines in Disposition of Toxic Drugs and Chemicals in Man, by Randall C. Baselt (Biomedical Publications, 1982) states that "Chronic usage is associated with a high incidence of weight loss, hallucinations, and paranoid psychosis."
An even more detailed analysis of the effects of amphetamines and prochlorperazine is contained in Goodman and Gilman's Pharmacological Basis of Therapeutics, a widely used medical text edited by Alfred Goodman Gilman, Louis S. Goodman, and Alfred Gilman and published by Macmillan.
In the chapter titled "Drug Addiction and Drug Abuse," Jerome H. Jaffee, M.D., professor of psychiatry at the University of Connecticut School of Medicine, writes, "the user [of amphetamines] is hyperactive and during a toxic episode may act in response to persecutory delusions. . . . The fully developed toxic syndrome from amphetamine is characterized by vivid visual, auditory, and sometimes tactile hallucinations.'' (Such as, one cannot help but wonder, a hallucination involving an attack by three armed hippies and a girl with long blond hair holding a candle and chanting "Acid is groovy . . . Kill the pigs"?)
"Tolerance does not develop to certain of the toxic effects of amphetamines on the central nervous system," Dr. Jaffee writes, "and a toxic psychosis may occur after periods of weeks." He also states that "the syndrome may be seen as early as 36 to 48 hours after the ingestion of a single large dose ... in apparently sensitive individuals, psychosis may be produced by 55 to 75 mg. of dextroamphetamine. With high enough doses, psychosis can probably be induced in anyone."
Other psychopharmacologists have commented that rage reactions are not uncommon in individuals who are abusing amphetamines—particularly when the period of abuse involves sleep deprivation, outside stresses, and, most notably, any predisposition toward psychological instability, such as would be the case with an individual suffering from a narcissistic personality disorder.
"Most observers," Dr. Jaffee writes, "have noted considerable psychopathology in compulsive amphetamine users and their families, which appeared to have antedated the drug use." Whether "considerable psychopathology" existed in the MacDonald family of Patchogue, Long Island, is perhaps another "dark area," but it is fact that the father was given to outbursts of anger and that Jeffrey's only brother was hospitalized after a psychotic episode involving violence.
It is also fact that if Jeffrey MacDonald were taking three to five Eskatrol Spansules daily, he would have been consuming 75 mg. of dextroamphetamine—more than enough to precipitate an amphetamine psychosis.
Chapter 19, "Drug Treatment of Disorders of Mood," of Goodman and Gilman's book discusses side effects of chlor-promazine, the category of drug which includes the prochlorperazine found in Eskatrol Spansules. The author, Ross J. Baldessarini, M.D., professor of psychiatry at the Harvard Medical School, writes that while tolerance to the sedative effects of this drug develops "over a period of days or weeks," it retains a capacity to produce unpleasant side effects, including a syndrome known as akathisia, which is characterized by "the compelling need of the patient to be in constant movement ... the patient feels that he must get up and walk or continuously move about . . . akathisia can be mistaken for agitation in psychotic patients."
Certainly all reports from Womack Hospital indicate that Jeffrey MacDonald, in the first moments after his arrival—indeed, until Merrill Bronstein began intravenous administration of Vistaril, Nembutal, and Demerol—had felt a powerful urge to get up and walk about and that he appeared to be in a state of high agitation.
Concluding their discussion of Eskatrol Spansules in Pills That Don't Work, Wolfe and Coley write that the drug "should have been removed from the market long ago." Late in 1980, as such medications were coming under closer scrutiny from the Food and Drug Administration, its manufacturer, Smith Kline & French, voluntarily ceased the manufacture and distribution of Eskatrol, despite the fact that its estimated retail sales at that time totalled more than $6 million annually.
When Colette MacDonald—pregnant by accident once again— had left for her psychology class that cold and rainy February evening, her husband (whose pallor, fatigue, and changed personality had been noted even by neighbors-in the weeks immediately preceding the murders) had been so exhausted, from having worked a twenty-four-hour emergency room shift and then a full day at the office, followed by an hour of basketball and a trip with his daughters to feed the pony, that he had been on the verge of falling asleep without even putting his younger daughter to bed. His condition had been so noteworthy that Colette had commented on it to the friend whom she drove to class.
Yet upon her return he had stayed up with her watching television and sipping Cointreau. And then, even when she had gone to bed, he—having lost sexual interest in her since her pregnancy had begun to manifest itself (impotence and changes of libido are also among the adverse reactions to consumption of dextroamphetamine)—had remained up until 2 A.M. watching the remainder of Johnny Carson and finishing the Mickey Spillane book Kiss Me Deadly.
Even then, MacDonald had not been ready for bed. Instead, he said, he had donned a pair of rubber surgical gloves to wash the dishes at 2 o'clock in the morning.
This despite his previous state of exhaustion and notwithstanding the fact that he would have to be up again by 7 A.M. to put in another full day at the office.
And, this also notwithstanding that he had lost fifteen pounds in three weeks, that he was in the midst of devising a plan which would permit him to spend a fair portion of the late winter and early spring in the vicinity of New York City, where his old (or maybe not-so-old) girlfriend, Penny Wells, resided, while pregnant Colette cared for the two daughters and the pony, believing him to be in Russia all the while.
And, all this following an autumn which had brought not only the unexpected pregnancy but the unexpected breakdown of his older brother (following a period of amphetamine abuse) and such other frustrations as the demotion in authority, if not rank, which had ensued upon the departure of his idol, Colonel Kingston, for Vietnam.
He had lost fi
fteen pounds in three weeks while taking a drug that can cause insanity. He was suffering from short-term physical exhaustion and longer-term emotional stress. His life, in fact, had been one extended period of stress—financial, intellectual, psychological—ever since Colette had become pregnant and he had had to marry her and to leave Princeton early and to get through medical school while being husband to her and father to two daughters, and the glamour and titillation attendant upon his becoming a Green Beret had provided only a temporary escape.
Might it be too much to surmise that since early childhood he had been suffering also from the effects of the strain required to repress the "boundless rage" which psychological maladjustment had caused him to feel toward "child or woman, wife or mother ... the female sex"?
And that on this night—this raw and somber military-base February Monday night—finally, with the amphetamines swelling the rage to flood tide, and with Colette, pregnant Colette, perhaps seeking to communicate to him some of her new insights into personality structure and behavioral patterns—indeed, possibly even attempting to explain him to himself—his defense mechanism, for the first and last time, proved insufficient?
Would it be too much to suggest that in that one instant— whatever its forever unknowable proximate cause might have been—a critical mass had been achieved, a fission had taken place, and that by 3:40 A.M. on February 17, 1970, the ensuing explosion of rage had destroyed not only Jeffrey MacDonald's wife and daughters, but all that he had sought to make of his life?
Perhaps. Yet his bloody footprint had been found on the floor and there were blue threads on the club outside the house and his wife—already dead or so near to it that the difference was of no
import whatsoever1—had been stabbed in the chest with an icepick twenty-one times after his blue pajama top had been laid across her. And when he had sat down to write the first account of the night's events—knowing that he was now considered the chief suspect—his consumption of a drug which is capable of triggering psychotic rage had been the thing he had felt it necessary to mention first.
3
Though he had denied it under oath during his grand jury testimony, Jeffrey MacDonald had apparently taken a lie detector test during his brief visit to Philadelphia in April of 1970. His own psychiatrist, Dr. Sadoff, had made reference to it during his grand jury testimony, and to the fact that MacDonald "had not come through with flying colors."
Home from California, I put the question to MacDonald in writing. He responded on a tape from Terminal Island.
Ummm ... I guess it was after my psychological interview. Bernie brought up the fact that he wanted me polygraphed. Actually, I guess it was sort of in the middle of these interviews. I felt uhh . . . you know, sort of hurt. I wondered why he wanted 'em . . . and then he explained that perhaps we could use these interviews to head off the Article 32 and the court-martial. That if they came out strong enough, conclusively in my favor, perhaps we could go to the Army with them. I said, fine ... if there was a chance for that we would go ahead and do it.
Now, there were two different men. One was John Reid, and the other was Cleve, I think, Backster. They're both well known in polygraph fields. These are not lightweights. These were expensive examinations.
Uuhhh, as I recall it, the first operator was John Reid. He at first seemed very, you know, very professional to me. He explained to me a little bit about the polygraph, what it can do and what it can't do. And then proceeded to hook me up to the machine—told me the area of questioning that we would go into and then he began questioning me.
However, when he began questioning me, it seemed to me that he was basically a prosecutor. He was not satisfied with my results—by that, I don't even really know what the results were, but they were not conclusively proving my innocence . . . and ... he had a consultation with Bernie, and Bernie uh, sort of abruptly dismissed him. ... the results were not conclusive of my innocence.
But we moved on, because Bernie really wanted a very positive polygraph test. We went on to the second person, who I believe is Cleve Backster. This is the guy who does the polygraphs and is now famous for polygraphing plants. And he's on Johnny Carson all the time, I believe.
In any case, Bernie now spent a lot of time prepping me for this one—saying that this was much more professional, this guy was bigger in his field than Reid, and that I would find him a lot more congenial, and he would treat me a lot better.
Well, in fact, just the opposite happened. He basically gave me no prep, except sort of negative type of prep, in which he said that this machine can detect any sort of lying. . . .
Well, he hooked me up to the machine, and once Bernie was excused from the room, he began going over my sexual history. It was very bizarre. He started talking about had I ever had sex with women other than Colette. And I answered that. And then he asked had I ever had sex with men. And then he wanted to know if I ... if there was a wild orgy the night of the occurrence of the murders.
And I stopped him, and I said uh, I don't understand what we're doing here. I thought this was a polygraph based on my current legal situation—and he says, well, he was just getting me used to the machine and getting a base line ready on truth and falsity.
So I said okay then, let's get back to the point. So then he said okay, and we started going back to some more questions, and he immediately reverted to premarital and extra-marital sexual activities, and unusual sexual activities, and I thought this guy was crazy, to tell you the truth. And I said look, I don't think we can continue. And at this point he made some comment about, well, have you considered the insanity defense. And I said, Jesus, that's the most outrageous thing I ever heard. You haven't even completed your polygraph, and now you're telling me that I should be going for an insanity defense.
And he said, well, in his judgment, and he said, basically, I've never been wrong on a major case. Uummm . . . you should start considering an insanity defense.
When I contacted Cleve Backster to ask for his recollection of the MacDonald polygraph examination, he said he would not be at liberty to discuss it without written authorization from Jeffrey MacDonald. When I asked MacDonald to provide such authorization, he refused.
The fact is, on many tapes Jeffrey MacDonald told me things which, even without the aid of a polygraph, I later determined to be untrue. He recounted, for example, a visit he made to the Fort Bragg boxing team "two or three weeks after I got out of the hospital" in 1970. "I went over and watched them work out and told them that I'm sorry, I wouldn't be able to go on this trip to Russia, and I found the sergeant who was in charge, and he said he understood completely and I wished him luck, and, as a matter of fact, he started crying while we were talking, and then I started crying."
Not only did the boxing coach fail to recall such incident, but the team—as Pruett and Kearns had determined in 1971—was not even planning a trip to Russia.
Once, in discussing Mildred Kassab, MacDonald said that after the death of her first husband, "She took a boat from San Francisco to Hawaii and was originally planning on going around the world, but ended up staying in Hawaii. And she told me many times—many, many times—both on a couple of occasions when she'd had too much to drink when Colette was alive and she was kind of bragging under the influence of wine, but certainly later on after the tragedy of 1970, when I was at their house for dinner, she told me in no uncertain terms that the reason she never went around the world was because she was having so much fun in Hawaii and that she had balled every houseboy on the boat going from San Francisco to Hawaii. She then went back to New York, apparently, and lived in the Plaza Hotel for a period of weeks or months—got a good room and got an excellent table and had lunch and dinner there every day, waiting to meet the right man, and I think that is how she did meet Freddy Kassab."
MacDonald's mother, of course, had told the grand jury much the same story, except that in her version Mildred had gone around the world for a full year and had then taken up residence in a high-priced
New York hotel for six additional months, during which time she met Freddy Kassab, who, as MacDonald's mother recalled, was from "the South."
The facts are that for four months after her husband's suicide, Mildred Kassab remained with her children. Then, leaving them in the care of her sister Helen, she visited a female friend in California for a week and then flew to Honolulu, where she remained for three weeks. She recalls quite specifically arriving home in time to participate, as a class mother, in a group outing which Colette's elementary school class was making to Ebbets Field, to watch the Brooklyn Dodgers play a baseball game.
On New Year's Eve of that year, Colette was spending the night at a friend's house and Mildred—who had at no time taken up residence at the Plaza—was home alone with her son, then sixteen. Having earlier declined an invitation from friends to attend a New Year's Eve party at a Patchogue restaurant called Felice's, Mildred changed her mind in midevening, and, shortly before midnight, she and her son did join the group, and she attracted the attention of Freddy Kassab, who was there with friends of his own. Three months later Kassab managed to arrange an introduction.
There was another tape on which MacDonald talked at considerable length and in extraordinary detail about how the night before his wedding he'd had to drive one of the bridesmaids home to New Jersey, but she could not remember where she lived and they had become lost for several hours and as a result he had arrived extremely late for his own bachelor party. I wondered at the time why he had bothered to tell it at all. It was not until months later that I learned where he had really been: back in Patchogue, putting a red-and-black negligee on the front seat of Penny Wells's car.
Fatal Vision Page 72
