Online Resource for Victims of Psychopaths and Narcissists

The Psychopath as Physician

Excerpt from: The Mask of Sanity
by Hervey Cleckley, M.D.

25. The psychopath as physician

When first seen by me, he was still in his early forties. From the country town in which he was practicing medicine an inquiry came concerning his professional ability. Everyone regarded him as a brilliant man. His patients loved him, and while he was working regularly, his collections were more than adequate. It was often impossible to find him, for now and then, in the classic manner, he lay out in third-rate hotel rooms or in the fields semiconscious until he could be found and coaxed back home.

This was tolerantly accepted as one of his idiosyncrasies by the rustic folk he attended. It was inconvenient, but like drought and the boll weevil, what the devil could one do about it? The community, in which not only social drinking but even card playing and dances were generally regarded as devices of Satan, intuitively sensed that the Doc's doings had little or nothing in common with the proscribed gaieties or frivolities. Although a man known to drink cocktails for pleasure and even a woman who smoke cigarettes might have been ostracized, local deacons and town gossips made no concerted attack on the doctor.

The inquiry about his ability mentioned previously was prompted by the following incident:

A patient whom he had been attending off and on for several weeks had noticed that he occasionally seemed glassy-eyed and slightly irrelevant. Neither she nor her family, however, was prepared for such a bedside manner as was his on the last visit.

When the door was opened for the doctor, he swung in unsteadily with it, hanging desperately to the knob, which he apparently hesitated to relinquish. Breathing hard, he muttered inaudibly for a moment, winked inanely at three children who had withdrawn to a corner, gave several short, piercing cheers, and slipped to the floor. Retaining his instrument bag in one hand, he began, still prone, to crawl toward his patient's room. Switching his body from side to side, he made slow but spectacular progress, hesitating every few yards to give a series of hoarse, emphatic grunts or barks. This pantomime was taken by the family to represent an alligator slipping through a bog. In this manner he reached the bedside of the patient.

This man's history shows a great succession of purposeless follies dating from early manhood. He lost several valuable hospital appointments by lying out sodden or by bursting in on serious occasions with nonsensical uproar. He was once forced to relinquish a promising private practice because of the scandal and indignation which followed an escapade in a brothel where he had often lain out disconsolately for days at a time.

Accompanied by a friend who was also feeling some influence of drink, he swaggered into this favorite retreat and bellowed confidently for women. Congenially disposed in one room, the party of four called for highballs. For an hour or more only the crash of glasses, scattered oaths, and occasional thuds were heard. Then suddenly an earnest, piercing scream brought the proprietress and her servants racing into the chamber. One of the prostitutes lay prostrate, clasping a towel to her breast, yelling in agony. Through her wails and sobs she accused the subject of this report of having, in his injudicious blunderings, bitten off her nipple. An examination by those present showed that this unhappy dismemberment had, in fact, taken place. Although both men had at the moment been in bed with her, the entertainer had no doubt as to which one had done her the injury.

Feeling ran strong for a while, but, by paying a large sum of money as recompense for the professional disability and personal damage he had inflicted, the doctor avoided open prosecution. Before a settlement had been made, the guilty man attempted to persuade his companion to assume responsibility for the deed. It would be less serious for the other man, he argued, since his own prominence and professional standing made him a more vulnerable target for damaging courtroom dramatics and for slander. His companion, however, declined this opportunity for self-sacrifice with great firmness.

Less spectacular performances include locking himself in a hotel room alone where he would drink to stupefaction, arouse the management, break furniture, telephone his wife that he had decided to kill himself, drink more, and remain until taken by police or friends who broke open the door.

He also contributed vividly to the liveliness of a dance some years ago. His older brother, whom he was visiting in a New England town and who was an officer in a country club where the dance was in progress, remonstrated with him, urging him to leave because his loud and disorderly behavior, having already attracted unfavorable attention, was now beginning to cause consternation. Whooping in indignation, he at once grappled with his elder on the porch of the club where they stood.

The orchestra having stopped for intermission, a large number of ladies and gentlemen were strolling on the terrace below. Attracted by frantic outcries, reiterated curses, and the sound of scuffling above, these bystanders looked up to see the two brothers whirling dizzily in combat. The younger man, his strength finally prevailing, got the older against the banister and seemed about to throw him over. As observers ran to quell the tumult, our subject, having in his position of vantage breath to spare for oratory, caused the golf course to echo with his threats and insults.

"You bastard! You goddamned - bastard! You son of a bitch! I'll kill you, bastard and son of a bitch that you are!" he yelled, pushing his brother back farther over the banister as the echoes returned his violent words. One wonders if the brother was observant enough at the moment to note the two-edged nature of the term with which he was being so loudly reviled. Rescuers soon interrupted the performance. Our subject could very probably have thrown his brother over before they came, but his intention apparently was to make a scene rather than to inflict serious injury.

After one of his longest periods of regular work and apparently satisfactory adjustment, which lasted nearly a year, he attended the meeting of a regional medical society in a large city where an exploit brought him to the notice of local newspapers.


A man listed as Dr. ___ of ____ was arrested yesterday morning and charged with burglary when he was found asleep on the altar of St. Philip's Church. Officer J. G. Coates who made the arrest said that a painter engaged in painting St. Philip's dome found the door to the church open this morning and called him. Investigation revealed the man asleep on the altar. The officer quoted Dr. ____ as saying that someone else had been with him but that he could not remember who. The doctor seemed to be eminently rational but could give no adequate reason for his inopportune presence in such a place. While a charge of burglary had been placed, according to records at police barracks, a complete examination of the church property revealed the fact that nothing was missing.

He proved to the satisfaction of the authorities that he had entered the church with no intention of stealing or doing any other damage. I am indeed strongly convinced that this contention was correct. Finding a man in so preposterous a situation, the newspaper reporters had mistakenly, but understandably, assumed that some motive such as burglary must, of plain necessity, be responsible for his presence. What his purpose really was, we must admit, is difficult to explain in terms of ordinary human strivings.

He often swears off drinking and expresses the intention of devoting himself to constructive and regular occupation but, despite all the serious troubles that his conduct has brought him, he actually continues as before.


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