Thursday, August 07, 2008

Bruce Ivins


Bruce E. Ivins, a microbiologist, killed himself on July 29 with an overdose of Tylenol. He had a history of mental illness. People blame his death on pressure from the FBI, accusations and "proofs" tying him to the 2001 anthrax murders. I blame it on mental illness.

Prior to 9/11, Dr. Ivins suffered what FBI court documents deemed "serious mental health issues." He had been in treatment and talked about it in emails that dated from 2000 to 2001. He wrote about his depression, his counseling, and his medication.

Reporting for the Wall Street Journal, Evan Perez, Siobhan Gorman, Gary Fields, and Elizabeth Williamson, paint a Chilling Portrait of Dr. Ivins.

In August 2000, he wrote,

"I get incredible paranoid, delusional thoughts at times, and there's nothing I can do until they go away, either by themselves or with drugs."
We hear that in late 2001, he emailed a series of short poems ruminating about what he called his split personality:

"Hickory dickory Doc - Doc Bruce ran up the clock

But something then happened in very strange rhythm

His other self went and exchanged places with him."
And then there's this one,

"I'm a little dream-self, short and stout,

I'm the other half of Bruce-when he lets me out.

When I get all steamed up, I don't pout.

I push Bruce aside, then I'm Free to run about!"
Sounds like Free is a name, does it not? The word is capitalized in the middle of the sentence. Free is another Bruce.

Dr. Ivins thought he had a split personality, but when we speak of such a thing, a split personality, we're really referring to at least two separate personalities, separate people within the same body that co-exist.

Each personality is whole, if not altogether well. Each personality may have multiple Axis I or Axis II disorders, or not.

This sounds like Dissociative Identity Disorder, what used to be called Multiple Personality Disorder. A person like Dr. Ivins, if he suffered from it, had at least one high functioning self, the doctor, the microbiologist who worked diligently for the United States government on a vaccine to immunize us against the deadly effects of Anthrax.

And he had a second personality, clearly disturbed, but also high functioning, one that escaped detection while under FBI investigation for three full years. He is the one referred to as Free.
Free could carry out destruction, wreak havoc without conscience. Free could even justify his atrocities, say to himself, If the government associates these deaths with a terrorist group, then surely I will have funding for my vaccine. The ends justify the means.

Perhaps he had a third self, the one who fell in love with a sorority girl and stalked her. With his counselor, Ivins discussed killing the young woman. From the Washington Post,
More than a year before the anthrax attacks that killed five people in 2001, Bruce E. Ivins told a counselor that he was interested in a young woman who lived out of town and that he had "mixed poison" that he took with him when he went to watch her play in a soccer match.

"If she lost, he was going to poison her," said the counselor, who treated Ivins at a Frederick clinic four or five times during the summer of 2000. She said Ivins emphasized that he was a skillful scientist who "knew how to do things without people finding out."
And yet a fourth, a religious Catholic:

. . . a churchgoing family man and volunteer whose mental health eroded -- culminating in suicide -- because of escalating pressure applied on him by federal investigators as they came to regard him as the prime suspect in the attacks.
Surely a troubled, angry, psychotic individual, a scientist who struggled against his admitted paranoia, depression, and mounting social and professional pressures, a man who lived with a voice in his head, a violent amoral voice.

That voice talked to him, I think.
I think Dr. Ivins heard Free, and that Free, as such, was a delusion, not a conscious perception of self, not him. But when the stress got the better of Ivins Free broke out. Ivins became his delusion. Then he had more than one self.

And when he looked back on what Free had done, assuming it is true that he is the man who committed the anthrax murders, he said to himself, This is the work of another person inside me, the bad me. I did all of that as Free. But the ends justified the means, and the FBI should have canonized me, not punished me.

Insanity reigned. People died.

So although it sounds like definitive Dissociative Identity Disorder, there is a second diagnosis, Schizophrenia.

I would bet that Free wasn't another self at all, not until he acted out. Until Ivins gave in, Free had been only a voice, one who mocked and scolded him for years. Then, when the time was right, when Ivins could take it no longer, he gave in to what he had been hearing for years, "Do it. And don't tell anyone about me."

Since he was a smart man, it is likely he knew about things like multiple personalities, perhaps from his treatment even. But he decided to not make mention of the voices to anyone, as is often the case in schizophrenia. He used his poetry to suggest that what he had was a split personality, for to him, schizophrenia, carried more stigma.

He carried the shame honestly. The illness went undiagnosed in his family, Dr. Ivins said. Read this Washington Post excerpt:
"The skeletons are all out," he wrote in one GreekChat posting from 2006.

"I'm having a devil of a time rounding them back up. Let's see . . . how about mom who was an undiagnosed paranoid schizophrenic. . . . Is that bones enough?"

Dr. Ivins was delusional. He suffered from paranoid schizophrenia, like his mother. And ironically, the FBI actually did follow this poor man with schizophrenia.

At some point, when a mentally ill person takes his life, perhaps, diagnosis becomes moot. It's a so what? Dr. Ivans died. He left two children. Other people died, no matter what the diagnosis. (See the comments section for a more thoughtful discussion of how the two diagnoses are related).

He was a scientist who shouldn't have passed a background check. And much worse, he did not get sufficient treatment for his mental illness.

You can read all about this at WSJ, The New York Times, the Washington Post, everybody's telling the story, so I don't have to repeat the details here. Suffice it to say that Ivins spent late nights in the lab, ostensibly cooking up the anthrax for delivery the following week. He was one of the world's foremost anthrax experts, according to news reports. He fooled the FBI for three years, switching anthrax samples on them, deliberately hiding the flasks with mutations that would have made a direct match. When it became clear he would be charged for the crimes, he killed himself.

I imagine that Free told him to do that.

I looked for childhood history but so far, nothing. He did work for the government, so perhaps his history is top secret.

I feel that the people he worked for should have picked up on his suffering, his severe emotional stress. Why treat only depression? His counselors, his doctors must have known he had delusions. Anyone reading his poetry (maybe they didn't) should have said,
"Dude, take off a month. Get into a hospital. Get the proper doses of the right medication. Get well. Shake off Free."
That is the treatment in schizophrenia, shaking off the delusion, muting the voices, ending their tortuous reign, by using medication.

People who notice strangeness in co-workers should get closer, not move farther away. We should wonder, when a person is cooking up Anthrax, What is he doing with that?

I know, 20-20 hindsight.

Yet I have to wonder. Where were his people? Weren't there people watching him slide? He did have a previous suicide attempt.

But then I think, mental illness is masterful. It can hide itself pretty well.

therapydoc

13 comments:

Mind Body Shop said...

Our destiny changes with our thought; we shall become what we wish to become, do what we wish to do, when our habitual thought corresponds with our desire.

Leora said...

Scary guy. You (at least I do) want to believe that if people are more tuned in, we would notice that someone is off his rocker and beyond. But as you say, it's not so easy.

Anonymous said...

I didn't know much about this case - it's had very little coverage from where I am and certainly knew nothing about the background but your breakdown analysis is excellent and makes such perfect sense!

Familydoc said...

Are you saying he had dual diagnoses? Or is DID simply a feature of schizophrenia in this case?

therapydoc said...

See, the docs all want a dx.

I thought about this and wondered exactly that, except in the opposite fashion. I thought maybe one of the personalities had schizophrenia.

Then I thought, but how can that be? And reversed course, like you're suggesting, and considered dual diagnosis.

Except the first presentation of the illness is schizophrenia. As his condition worsened, he presented, and had, for all intents and purposes, Dissociative Identity Disorder, D.I.D.

So yes. We could say that D.I.D. is a feature, in this case, of schizophrenia.

I think this may be where the initial conceptualization of schizophrenia as a split personality probably came from.

Now, because we have this medical model of diagnosis, and we are looking for very different clusters for D.I.D. than for Schizophrenia, and this particular presentation is probably so rare, we choose one diagnosis or the other, we don't look for both of them or for a developmental disorder.

Maybe forensics people see it all the time. I sure don't. And I'm glad for that.

A Living Nadneyda said...

Your analysis of his case is interesting and informative, as well as sensitive, and better than most of what I have encountered in the media.

Thanks,

ALN

Merelyme said...

it is chilling to read his writings and rhymes. i suppose it is possible to have a dual diagnosis. dissociative disorder is not the same as schizophrenia and there does need to be a distinction.

Anonymous said...

Diagnosis is anything but moot to his kids. Dr. Ivins left two children who are bound to wonder about the heritability of his illness.

My own father was not unlike Dr. Ivins in some ways -- brilliant, chillingly violent, delusional, and with an initial assessment of schizophrenia. He was one of those people who make you wonder about the distinction between illness and evil. He actually got some therapy, not that it seemed to do him much good. (Though he never actually went quite so far as to murder anyone, so perhaps it did.)

The details were kept from me. It wasn't until my twenties, well after his death, that I learned that his illness, in its last diagnosis, was one that was not known to be heritable. It's a terrible thing to grow up wondering if you are going to lose your mind. Bad enough when it's any mental illness; worse yet, I think, when the illness is one you've seen drive a family member into moral calamity.

And it's a terrible thing not to know enough about what might be coming down the pike that you can research it while you're still reasonably mentally healthy and make some plans for eventualities.

No -- I can say from experience that those kids have a legitimate need to know, just as the children of a man who might have had Huntington's Disease need to know.

Just Me said...

I think this is the kind of situation that reinforces what I tell people frequently: so many, maybe even most people think mental illness is obvious, that they can easily recognize someone who is mentally ill.

But that's not always true. My bipolar is "the most severe I've seen someone doing so well with" per my doctor, a respected psychiatrist at a highly ranked psychiatric department at a major hospital. I'm on as much or more meds than essentially every bipolar patient in the department of this hospital, and yet the net effect is that I still work in a professional capacity. My mental illness messes with certain parts of my life, for sure, but I very easily could be working with your loved one and you'd have no idea.

Anonymous said...

Interested in the Anthrax / Bruce Ivins case ..

read this new exclusive story ..

http://www.ersnews.com/permas_stories_updates/anthrax.htm

Anonymous said...

Ivins' children are ADOPTED! He and his wife adopted the twins when they were babies! Do your research before you go assuming things! They cannot inherit any mental illness from him! It's now been established that MANY are skeptical that Ivins even commited this crime, even congressmen and experts think Ivins was innocent!

Anonymous said...

First off, he never showed any signs of violence towards his family and has NEVER been linked to ANY other crimes. Interesting how all if a sudden, he's crazy and violent and so on...he was a normal, but brilliant man and until the FBI began harassing him and his family he was not unstable in any way. He worked at Ft. detrick for almost 30 years. Shouldn't have passed a background check? For what??? Even the FBI admits their evidence against Ivins is ALL circumstancial and scientific reviews have cast much doubt on his guilt. Was their an autopsy? NO! However it was considered a suspicious death and there was an open death investigation...and no one knows how the tylenol got in his system....that there warrants an autopsy. ANY thought suicide or homicide and or unatural death almost always warrants an autopsy...! As for his children being concerned about inheriting anything from him, THEY WERE ADOPTED! Do a little more research before you go making assumptions and throwing around accusations! People like you are why his family will never be able to move on from this... May God grant you forgiveness! Shame on all of you uneducated, speculating gossips!

Anonymous said...

Idiots, acting as though they KNOW everything because of what the media has reported and twisted. Your accusations and assumptions, based on speculations, are ridiculous! Did you personally know Ivins or his family? Do you REALLY know what they went through?! No! By the way Ivins and his wife ADOPTED, their twins when they were babies! Do a little more simple research before saying such absurd statements! Everything, everyone has said is not based on knowledge, but on their perception of what the media has reported! If you had a brain, you would know not everything in the media is factual. Infact, most stories are amplified and exaggerated to add a sensational spin to the story. The public is more interested in dramatic overly exaggerated stories then the TRUTH. All of you posting on here are not brilliant, you are pathetic no one's who want to comment on what you have HEARD!!! Wow, you cannot even get simple facts correct. Do some real research before you go around making assumptions and claims about Ivins and his family! His family is still here, they read of your ignorant statments and you make their lives even more of a living hell!