Doctors: Pedophile 'Cured' After Surgery

Associated Press ^ | July 28, 2003 | CHRIS KAHN

[Pharmboy]

CHARLOTTESVILLE, Va. - There was something wrong with the schoolteacher with the headache — doctors could see that from the start.

Though charming and intelligent, the 40-year-old man couldn't stop leering at female nurses. He had been in trouble with the law for sexual advances toward his stepdaughter, and now he was talking about raping his landlady.

University of Virginia Medical Center neurologists Dr. Russell Swerdlow and Dr. Jeffrey Burns had never seen a case like this.

The man had an egg-sized brain tumor pressing on the right frontal lobe. When surgeons removed it, the lewd behavior and pedophilia faded away. Exactly why, the surgeons cannot quite explain.

"It's possible the tumor released some pre-existing urges," Burns said. "But that's a tough debate, we just don't know."

The outcome raises questions not only about how tumors alter brain function, but also how they can influence behavior and judgment.

Daniel T. Tranel, a University of Iowa neurology researcher, said he has seen people with brain tumors lie, damage property, and in extremely rare cases, commit murder.

"The individual simply loses the ability to control impulses or anticipate the consequences of choices," Tranel said.

Dr. Stuart C. Yudofsky, a psychiatrist at the Baylor College of Medicine who specializes in behavioral changes associated with brain disorders, also has seen the way brain tumors can bend a person's behavior.

"This tells us something about being human, doesn't it?" Yudofsky said. If one's actions are governed by how well the brain is working, "does it mean we have less free will than we think?"

It's a question with vast implications in the criminal justice system.

The U.S. Supreme Court has ruled that executing mentally retarded murderers is unconstitutionally cruel because of their diminished ability to reason and control their urges.

Chris Adams, a death penalty specialist for the National Association of Criminal Defense Lawyers, thinks the next logical step would be to include people who have brain tumors.

"Some people simply don't have the frontal lobe capacity to stop what they're doing," he said.

Human behavior is governed by complex interactions within the brain. But scientists think most "executive functions" — decisions with major consequences — are controlled within the frontal lobes, the most highly evolved section of the brain.

Tumors in that area can squeeze enough blood from the region to effectively put it to sleep, dulling someone's judgment in a way that's similar to drinking too much alcohol.

Only in very rare cases would the tumor turn the person to violence or deviant behavior on its own, Tranel said.

Dr. Patrick J. Kelly, chairman of the Department of Neurosurgery at New York University Medical Center, said he's never seen a tumor turn someone into a pedophile.

"I've seen them make people hyperactive, forgetful, apathetic," Kelly said. "And it usually takes a fairly extensive tumor to do that ... the size of an orange maybe."

The Virginia schoolteacher with the tumor didn't respond to written interview requests by The Associated Press made through his doctors. But according to his case report, which Swerdlow and Burns wrote in the Archives of Neurology, the man didn't remember having abnormal sexual urges for most of his life.

In 2000, the man began collecting sex magazines and visiting pornographic Web sites, focusing much of his attention on images of children and adolescents.

Eventually he couldn't stop himself, telling doctors "the pleasure principle overrode" everything else. When he started making subtle advances on his young stepdaughter, his wife called police. He was arrested for child molestation.

The man was convicted and failed a 12-step rehabilitation program for sexual addiction because he couldn't stop asking for sex favors, according to the case report.

The day before he was to be sentenced to prison, the man walked into the emergency room with a headache. He was distraught, Swerdlow said, and was contemplating suicide.

He also was "totally unable to control his impulses," Burns said. "He'd proposition nurses."

An MRI revealed the tumor, and it was cut out days later. The man's behavior began to improve. Swerdlow said the judge allowed him to complete a Sexaholics Anonymous program. The man eventually moved back home with his wife and stepdaughter.

About a year later, Swerdlow said, the tumor partially grew back and the man started to collect pornography again. He had another operation last year, and his urges again subsided.

"That's one of the interesting things about frontal lobe damage," Swerdlow said. "This guy, he knew what he was doing was wrong, but he thought there wasn't anything wrong with him, and he didn't stop."

[Pharmboy]

Raises many interesting issues. Have a go, ladies and gents...

[Pharmboy]

Big biology/anthropology/medicine ping...

[2 Kool 2 Be 4-Gotten]

You can always find a rare case in neurology in which the patient exhibits any given bizarre behavior. Maybe like the guy in Memento who forgets everything as soon as he learns it. Huge danger in generalizing this case to the whole universe of sex criminals. One swallow does not make a summer (absolutely no pun intended).

[bedolido]

Until I read this I thought they had removed something else.

[2 Kool 2 Be 4-Gotten]

Or as they say in medicine "One case is no case".

[AxelPaulsenJr]

Reminds me of Cheech and Chong. "Baliff whack his pee pee".

[goldstategop]

Some people like Charles Whitman in the 60s went on a murder spree as a result of a brain tumor. One can make a case that in exceptional circumstances, a pre-existing disease can absolve one of knowing the difference between right and wrong. On the other hand, most murderers are sane and do know the moral rules in question but simply disregard the rights of others to get what they want. If its a physical condition, the determination about one's moral capacity is easy enough to make. The real controversy is over a mental condition and that's where it gets controversial.

[CholeraJoe]

The plural of "anecdote" is not "data."

[Lunatic Fringe]

Very interesting. As behavioral science progresses, we are finding how the magic of bio-chemistry governs our behavior. I have a friend who is perfectly normal when she takes her medication, but becomes completely irrational, paranoid, and depressed if she forgets. Not to say that chemistry is the end-all of mental disorders, but it certainly seems to be a big factor.

[Chancellor Palpatine]

I don't see it as applying to any broad issue. This is one case involving one man with a very complicated brain disorder brought about by a tumor, and it sounds like it is being handled appropriately by the medical and legal communities.

Sad part is that the recurrence indicates that a tumor will surface again, maybe there, maybe somewhere else.

[harpseal]

Clearly some brain problems can cause abnormal behavior. Further it is clear that every person has sexual urges as do most animals. Charles whitman of Texas Clock Tower fame was a an exemplary person until that day when he started shooting people and he had a brain condition found in his autopsy.

[goldstategop]

You can cure a physical disorder that contributes to anti-social behavior. But the medical and psychiatric profession still has no answer to curing the sociopath's state of mind.

[goldstategop]

Exactly. One can make a good case Charles Whitman was insane. A jury would have found him not guilty by reason of insanity.

[King Prout]

while "one case is no case" is true, this case might present some interesting avenues of research into some of the terrible sexual deviancies in human behavior.
Was the tumor in a very specific single location, or were there multiple loci?
Which blood vessels were affected, and what areas of the brain, proximal AND distal, were affected by loss of blood flow?
These areas, if identified, might need to be studied in the brains of convicted pedophiles.
It might turn up a diagnostic tool useful for predicting or confirming tendencies towards pedophilia.

[ClearCase_guy]

Perhaps deviant sexuality is a sign of "sickness" of one form or another. Perhaps not always a tumor, but perhaps some other malformation of the brain, or some psychological damage suffered in the past.

Maybe homosexuality can be cured. Maybe they aren't "born that way". Maybe pedophilia and homosexuality are both illegitimate forms of human sexuality which should not be "embraced" or "celebrated" but should, instead, be struggled against, for the good of the patient as well as the good of society.

[aculeus]

Thanks for the ping.

Interesting!

[harpseal]

IMHO those cases where criminal behavior can be directly tied to a physical brain abnormality might well be a legitimate aquital by reason of insanity. Whitman may not have been aquitted because teh abnormality may not have shown with the diagnostic tests of the time.

[Savage Beast]

There are obviously lesions--not necessarily tumors--responsible for destructive deviant behavior, including pedophilia, compulsive homosexual behavior, intractable obesity, psychopathic personality, addictive personality, et al. They have not been discovered yet.

In such articles as this, the specific abnormality, e.g. in this case the type of tumor, should be identified, for the benefit of physicians and other cognoscenti. In not including it, the author reveals a lack of sophistication.

[Savage Beast]

I do not agree that "one case is no case". This anecdotal case is obviously significant.

[joesnuffy]

so one case in a million proves what?
that crimes of rape and murder are caused by brain tumors
or that in rare cases an operable brain tumor when removed
restores a recalcitrant man back to
normal moral behaviors and thoughts?
I would need more long term data on the individual just to determine if this is the case
in his case
As far as this being casual in society as a whole
Having worked with juvenile and adult offenders I dont think so