Fatal Vision (102 page)

Having received a report from the Fort Gordon laboratory that an analysis of Jeffrey MacDonald's blood—made from a sample taken at 11:40
a.m
. on February 17—"did not reveal the presence of any dangerous drugs or narcotics," Franz Joseph Grebner and all subsequent investigators had simply assumed, with some justification, that Jeffrey MacDonald's drug consumption had not been a factor in the commission of the murders.

An examination I made subsequently of the laboratory notes compiled by the Fort Gordon chemist who had actually performed the tests on MacDonald's blood, however, revealed that no attempt was ever made to determine from the sample whether Jeffrey MacDonald, in the hours or days that had immediately preceded the murders, had been ingesting amphetamines. The chemist had never been instructed to test for the presence of amphetamines, and, in fact, the equipment available at the CID laboratory at the time would not have enabled him to do so. In 1970 these drugs were widely prescribed and were consumed in considerable quantity not only by individuals attempting to lose weight, but by students, truck drivers—and physicians—who found it necessary to remain awake and alert for extended periods of time. In 1970, amphetamines were not considered a "dangerous" drug by military authorities attempting to combat a dramatic upsurge in the use both of hallucinogens and of opiates such as heroin and chiefly concerned with the widespread use of marijuana.

Ten years later, however, the potential hazards associated with

Eskatrol consumption had received considerably wider attention. The drug is listed in
Pills That Don't Work,
the 1981 book by Sidney M. Wolfe, M.D., and Christopher M. Coley that is described on its cover as, "A consumers' and doctors' guide to over 600 prescription drugs that lack evidence of effectiveness."

Wolfe and Coley describe the drug as "not only ineffective but also dangerous
...
To use a combination of an 'upper' and a 'downer' both of which carry significant risks is asking for trouble." Among the possible side effects listed are: "Insomnia . . . restlessness, nervousness and dizziness." The authors also state that "psychosis (insanity) may occur with large doses."

Eskatrol is described in even more detail in the
Physicians' Desk Reference,
a standard medical reference book published by Medical Economics Company.

"Amphetamines have a significant potential for abuse," this text states. "In view of their short-term anorectic effect and rapid development of tolerance, they should be used with extreme caution and only for limited periods of time in weight-reduction programs."

According to his own notes—the notes which Victor Woerheide had asked him to provide to the grand jury but which he had declined to do; the notes which had lain in the bottom of a file drawer since 1970 when MacDonald had learned that CID testing had failed to discover the presence of amphetamines in his blood—MacDonald had lost twelve to fifteen pounds in the three to four weeks preceding the murders.

That was a lot of weight to lose for an already fit, twenty-six-year-old Green Beret officer, fresh from paratroop training at Fort Benning. And boxing would not account for it: his last workout with the boxing team had come more than three weeks before the killings. Neither would an odd hour of basketball late on a rainy afternoon produce that sort of weight loss. And there had been nothing to suggest that MacDonald had embarked upon a formal diet. (Indeed, he'd been eating cookies with Ron Harrison on the night of Valentine's Day and drinking a sweet liqueur with his wife two nights later, and—he had said—one of the most appealing features of Hamlet Hospital was that the nurses served him steak for breakfast.)

"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 fifteen 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