The Danger in Medicalizing Murder


Last October, Robert Card killed 18 people and injured 18 others in a shooting spree across several locations in Maine. Card was later found dead of a self-inflicted gunshot wound.

Now, the New York Times reports, an analysis of Card’s brain reveals significant damage, probably related to his eight years of exposure to explosions as a US Army grenade instructor, and quite possibly explaining his paranoia and “increasingly erratic and violent” behavior in the months leading up to the shootings and his suicide.

While some people tend to unduly write off avoidable atrocity as unavoidable tragedy, it’s difficult to deny that brain trauma — natural or artificial — can play a role in turning otherwise reasonable people into killers.

For example,  former US Marine Charles Whitman, who killed 17 people in a rampage at the University of Texas at Austin in 1966, presented with a behavioral history not dissimilar to Card’s, and an autopsy found a pecan-sized brain tumor that may have caused his mental collapse by pressing on the part of his brain responsible for anxiety and “fight or flight” response.

I find the whole topic at least a little bit scary on a personal level, as I stood right next to thousands of bone-rattling explosions in the Marine Corps myself as an 81mm mortarman.

No, I don’t hear imaginary voices. No, I’m not paranoid (at least I don’t THINK I’m paranoid). No, I don’t plan to pick up a gun and go kill anyone. And fortunately I’m surrounded by family and friends who would notice and take action if I started showing symptoms of any such kind of breakdown.

But Card’s family and co-workers noticed and took action too. His son and ex-wife talked to the local sheriff’s office about his seeming mental decline. His army reserve unit also reported problematic behavior and he was detained for psychological evaluation and treatment. Even when “the system” seemed to “work” as advertised, it didn’t work for Card or for his eventual victims.

When writing on issues of public concern (I hope we can agree that mass murder is such an issue), I often try to offer practical and ethical solutions. Here, I have few to offer. But I do want to offer a cautionary note:

If we allow government to “medicalize” murder and simply attribute mass shootings to mental illness, traumatic brain injury, etc., the flip side of that coin won’t be pretty when it comes to personal privacy.

We’ll start seeing mandated examinations — first for persons actually displaying symptoms, then later for anyone working in jobs deemed “unsafe for the human brain” — at risk of involuntary commitment if we “flunk” our CTs or MRIs.

If you think that can’t happen, you’ve probably never been ordered to urinate in a cup or blow into a breathalyzer to prove you don’t use drugs or haven’t been using alcohol.

Unless we, and our healthcare providers, get better at going the extra mile to help those who might otherwise become Robert Cards, that’s the dystopia we’re heading for.

Thomas L. Knapp (Twitter: @thomaslknapp) is director and senior news analyst at the William Lloyd Garrison Center for Libertarian Advocacy Journalism ( He lives and works in north central Florida.