Unfortunately, it appeared that the businessman's weight prevented him from also releasing himself. A session of self-arousing s.e.x had cost him his life.

Cause of death: exposure.

Manner of death: accident.

Case closed.

After receiving official Bureau sanction to proceed with his project, Roy began collecting cases for consideration. Altogether, there would be 157 histories included, most of them submitted by U.S. and Canadian police officers who attended cla.s.ses at Quantico.

From a law enforcement point of view, this approach ensured he'd gather the best possible selection of histories. Students only submitted cases for consultation and discussion at Quantico if they otherwise defied solution, or were so strange that the officer sought enlightenment from experts.

Among the mysteries Roy helped to explain was a college professor discovered dead in full western gear, including chaps, twin .45s in his hip holsters, and a ten-gallon hat on his head. Another victim was found dead in scuba gear. A third was fully attired as a surgeon.

One female victim was dressed as a harem girl.

He was able to show the officers how in each case the individual died of accidental asphyxiation while engaged in dangerous autoerotic acts.

In another consultation, Roy reviewed the death of a black woman, twenty-three, who was found nude in her bathroom, resting on her knees, with her head submerged in the bathtub. Her hands were bound in front of her, and a nine-and-one-half-inch metal bolt, which she had previously inserted within her, lay on the floor beneath her b.u.t.tocks. A rope was looped around her neck, with the two free ends draped over her right shoulder.

"She is thought to have been engaging in a m.a.s.o.c.h.i.s.tic fantasy (hence, the bound wrists)," Hazelwood wrote in his a.n.a.lysis, "inducing hypoxia with the neck ligature, when she lost consciousness, falling across the tub and into the water."

The most violent death was also the most horrible. A young man with a roller-skate-strap fetish trussed his wrists and ankles with twenty-eight of them. Then he lowered himself into a garbage can, b.u.t.tocks first, with his knees drawn up to his chest, intending to sink to the point where the garbage can constricted his chest and induced hypoxia.

His escape mechanism was a roll of wire standing next to the garbage can. As Roy reconstructed the death, the young man failed to appreciate how low his center of gravity would go, making it impossible to tip over the garbage by grasping the roll of wire.

He died, slowly and painfully, from progressive asphyxiation.

"Neighbors," says Roy, "reported that they thought they heard a dog howling all night. It was this young man."

5.

Terminal s.e.x In October 1979, Dr. Park Dietz, then director of forensic psychiatry at the Bridgewater Hospital for the Criminally Insane in Ma.s.sachusetts, invited Hazelwood to appear with him on a panel to discuss autoerotic fatalities at the annual meeting of the American Academy of Psychiatry and Law.

"I remember Roy as a short guy with peculiar interests," Dr. Dietz says. "I shared those interests, and that's why I liked him."

Dietz, the son of a Camp Hill, Pennsylvania physician, is today as central a figure among forensic psychiatrists as Hazelwood is in law enforcement.

Among the infamous defendants Dietz has evaluated for both prosecution and defense attorneys have been Jeffrey Dahmer, Milwaukee's flesh-eating serial killer; Arthur Shawcross, the upstate New York serial killer; Susan Smith, the South Carolina mother who murdered her two sons; John du Pont; and Betty Broderick of San Diego, whose murder of both her ex-husband and his wife prompted not one, but two made-for-TV movies.

Dietz has also done pioneer studies of stalkers, and worked as a security consultant to celebrities including Michael Jackson and Cher.

He operates the Threat a.s.sessment Group in Newport Beach, California, a consultancy to government and business which focuses on the potential threats posed by disgruntled employees and solutions for dealing with them.

Dr. Dietz's fascination with aberrant minds started even earlier in his life than did Hazelwood's.

"I can trace that interest in odd behavior back at least as far as my boyhood, when I tagged along with my mother when she did volunteer work at the state hospital in Harrisburg, near where we lived," he recalls.

"She'd organize Christmas parties. I'd help with refreshments and decorations and would sometimes dance with the patients."

Dietz says he never seriously doubted that he'd follow his father into medicine, or that his specialty would be psychiatry. However, as his interest in odd behavior deepened, he began to question what sort of light, if any, psychiatry could shed on these subjects.

A premed student at Cornell in the late 1960s, where he studied biology and psychology, Dietz seriously considered bolting for the University of California at Berkeley to take up criminology.

Then one day in the Cornell bookstore he discovered a text, Forensic Medicine, by the British physician Keith Simpson. The experience proved an epiphany every bit as profound for him as the discovery of Harvey Glatman had been for Roy Hazelwood.

It changed Park Dietz's life.

"That book was my salvation," he says. "It was full of dead babies and skeletons and bodies in trunks. It made me see that there was a way to do criminology and medicine at the same time, so that my parents would pay for my education and I could do what I wanted to do."

His senior honors thesis at Cornell was on the sociology of deviance. When he later studied medicine at Johns Hopkins University in Baltimore, Dietz worked in the same medical examiner's office Roy Hazelwood had on his AFIP fellowship five years earlier. It was in the Baltimore morgue, coincidentally, that Dietz encountered his own first autoerotic fatality, a young girl who'd hanged herself with her panty hose.

Forensic psychiatry afforded Park Dietz an avenue of access to explore strange behavior, the stranger the better. In an early and memorable case, he interviewed a young schizophrenic who, during a psychotic episode, deliberately had placed his right arm across a train track for the limb to be severed by a pa.s.sing locomotive. When the psychiatrist wondered why the gory self-amputation, the patient said the explanation lay in the Gospel according to Matthew, and quoted to Dietz the applicable verses.

"Whosoever looketh on a woman to l.u.s.t after her hath committed adultery with her already in his heart.

"And if thy right eye offend thee, pluck it out, and cast it from thee: for it is profitable for thee that one of thy members should perish, and not that thy whole body should be cast into h.e.l.l.

"And if thy right hand offend thee, cut it off."

Where forensic psychiatry disappointed Dietz was in the way it subordinated scientific inquiry to the narrower, practical needs of the law. "At the time, it wasn't considered a psychiatrist's job to critically a.s.sess a police investigation," says Dietz, "or even to get hold of information about it. Certainly we were not to go out and reinvestigate where the police already had been. Nor were we to ask them to go back to check something."

Park Dietz, however, wanted to investigate aberrant behavior, not just study or describe it. Instead of a doctor-diagnostician, he wanted to be a doctor-detective.

It was Roy Hazelwood, says Dietz, who showed him the way.

"It was when I first started working with Roy on the autoerotic fatalities research project that I got the idea that forensic psychiatrists were probably getting a lot of things wrong by not conducting our own inquiries," he explains. "So I started to do that, and for a while I called it investigative forensic psychiatry."

Dr. Dietz's first major opportunity to apply what he learned from Roy and to demonstrate his new approach to forensic psychiatry came eighteen months after meeting Hazelwood. He was retained by government lawyers to examine and evaluate would-be a.s.sa.s.sin John W. Hinckley, Jr., who shot and wounded President Ronald Reagan at the Washington Hilton Hotel on March 30, 1981.

Hinckley, twenty-five, became obsessed with Jodie Foster after seeing her play the young prost.i.tute, Iris, opposite Robert De Niro's character, Travis Bickle, in the film Taxi Driver. Hinckley began hara.s.sing the nineteen-year-old Foster by telephone and mail.

Just as the unstable Bickle eventually became a political a.s.sa.s.sin, Hinckley decided to kill Reagan in an effort to impress Foster. He'd later call the shooting "the greatest love offering in the history of the world."

Dietz interviewed Hinckley at a number of federal detention centers up and down the eastern seaboard. He was first to uncover Hinckley's motive for the shooting.

But the forensic psychiatrist also discovered one reason why Hinckley chose to shoot at Reagan from such close range, practically guaranteeing that he'd be captured, if not killed himself.

Poor eyesight.

"We went to Colorado to interview Hinckley's parents," Dietz says. "They let us go through his bedroom. I found some shot-up targets the Bureau had missed when they searched the home. They were labeled, so we could see that Hinckley was a lousy shot beyond close range."

Another question was why Hinckley waited to shoot until Reagan was departing the Hilton, rather than when the President was walking in. The crime scene photographs offered no explanation, so Dietz decided to visit the Hilton himself.

"It was clear when we got there that Hinckley didn't have a clear shot when the President was on his way in," he says.

"There was a curve in the brick wall at the Hilton, which limited the amount of time he would have had to aim and shoot. But as the President emerged, Hinckley had more time and stood at closer range."

Hinckley also planned to draw Jodie Foster to him by abducting a planeload of airline pa.s.sengers, whom he intended to trade for the young movie actress as his hostage. Dietz shed light on those plans with a discovery he made while sorting through Hinckley's personal effects.

In the bottom of Hinckley's suitcase the forensic psychiatrist found a Band-Aid can. Stuck to its bottom was a folded-up note that previous searches had overlooked.

Written on the secreted sheet was a skyjack demand that Hinckley had cribbed almost verbatim from the book The Fox Is Crazy, Too, which Dr. Dietz also found in the suitcase.

Besides applying what he learned from Hazelwood to the Hinckley investigation, by 1981 Dietz also was well into his joint research with Roy on dangerous autoeroticism. Dietz had begun his work with a review of the medical literature, which he found disappointing.

"It was largely garbage," Dietz says. "One or two case histories. A couple accounts of people who survived. A hodgepodge of information."

His historical researches took him as far back as a.d. 1000 and a Mayan stone sculpture from that era. On display at the Anthropological Museum in Mexico City, the sculpture depicts a naked man with a rope around his neck. The figure is scarred on his cheeks and forehead. His p.e.n.i.s, clearly carved in erection, is partially missing.

Although the sculpture does not prove the Maya had discovered hypoxia, to Dietz it strongly suggested they did. He also points out that the Maya believed the souls of those who hanged themselves went straight to paradise, where they were met by the G.o.ddess Ixtab, who is depicted in an extant ma.n.u.script in a kneeling posture, her one visible nipple erect. She is suspended by a noose around her neck.

Eight centuries later, the Marquis de Sade included an autoerotic hanging scene in his novel Justine, probably the best-known treatment of s.e.xual asphyxia in Western literature.

Much more compelling to the scientist in Dietz was an anonymously written pamphlet, Modern Propensities: Or an Essay on the Art of Strangling, that he traced to a microfilm collection at Yale. Propensities, published in London at the end of the eighteenth century, describes in detail the deaths of two men due to s.e.xual asphyxia: one a Reverend Parson Manacle (possibly a pseudonym), and the other, Francis Kotzwarra, a Czech musician and minor composer, whose demise is possibly the earliest recorded example of an accidental autoerotic fatality being mistaken for homicide.

On September 2, 1791, Kotzwarra visited a London prost.i.tute named Susannah Hill. After performing what her trial transcript describes only as "several acts of the grossest indecency" with her, Kotzwarra asked Hill to fetch some cord with which he wanted to hang himself.

She obliged, and watched as Kotzwarra accidentally killed himself. Charged with manslaughter, the prost.i.tute saved herself with her seeming honesty and frankness over what had occurred. Hill withheld nothing of the incident, repeating to the judge the same unpleasant details she had related to both a neighbor and a constable.

The court reporter added his own bit of corroborative detail: She was neatly dressed in common apparel; and, on her countenance, we could discover nothing that seemed to indicate a rooted depravity; nor was there any thing in her person particularly attractive: from which it may be inferred that the unfortunate-if not lamented-Kotzwarra trusted more to the charms of the cord than to those of his fair one.

Dietz's discovery of Kotzwarra's prototypical autoerotic death led the forensic psychiatrist to suggest a t.i.tle for their book in progress, Kotzwarraism. Hazelwood was adamantly opposed.

"I think it was the only thing about which we ever had a true disagreement," Roy recalls. "I was inflexible. The book was going to be called Autoerotic Fatalities. Park agreed."

Hazelwood, Dietz, and Ann Burgess from the University of Pennsylvania a.n.a.lyzed 150 deaths in all. Of the seven female victims, four were white. Of the 143 male victims, 139 were white.

The victims' average age at death was twenty-six. Three out of ten, male and female, were married.

The oldest victim was a seventy-seven-year-old man; the youngest was a nine-year-old paperboy found asphyxiated in a deserted stable. Sears catalogs opened to lingerie ads were spread around him on the floor.

According to Hazelwood, children as young as six have died during experimental asphyxia. Some years ago, three California children died in their grade-school washroom as a result of placing their necks in cloth towel dispensers and twisting.

Hazelwood, Dietz, and Burgess also evaluated eighteen nonasphyxial autoerotic fatalities. Among them, six victims died by electrocution, four suffered heart attacks, three from inhaling an aerosol propellant, two from aspirating vomit, and one from "popping" a volatile nitrate. Another, the midwestern businessman originally believed to have been kidnapped, died of exposure. The eighteenth victim's cause of death was undetermined.

From his extensive interviews with survivors and a.s.sociates of the victims, Roy discovered how difficult autoerotic practices can be to detect. One father told Hazelwood that he'd noticed a red linear mark on his son's neck. When he asked his son about it, the boy reasonably explained he'd been playing football, and that someone had grabbed his T-shirt from the rear, causing the shirt collar to leave the mark. One month later, his father found him dead, clothed in his mother's lingerie, suspended from a rope in his closet.

"There are no definitive signs of involvement with dangerous autoeroticism," says Hazelwood. "Outside of general, nonspecific indicators such as red eyes or red marks around the neck, there are no clues. I know of nothing that will alert a person to the possibility that someone is partic.i.p.ating in this type of activity. To all appearances, they are perfectly normal and healthy people. They certainly are not psychotic.

"Unlike suicides, victims of dangerous autoeroticism rarely are described as depressed, anxious, irritable, or particularly stressed prior to their deaths. To the contrary, the great majority are described as optimistic and future-oriented."

Nor does there seem to be a single source, or type of source, from which most people learn about the practice. Besides fictional treatments such as Justine, the victims' apparently learn about hypoxia from friends and acquaintances, discover it by accident, read about it in magazines (Larry Flynt's Hustler published a widely read article, "o.r.g.a.s.m of Death," in 1981) and newspapers, or encounter it in the cinema, most recently in the movies And Justice for All and In the Realm of the Senses.

Those attracted to terminal s.e.x, as it has been called, also are willing to fill in their blanks. The 1970 movie A Man Called Horse, for example, features the British actor Richard Harris as an itinerant nineteenth-century British n.o.bleman who is subcutaneously skewered and threaded with buckskin cords by a band of Indians. The Indians test Harris's mettle by hoisting him high above the ground by the leather ligatures in a sort of aboriginal crucifixion ceremony.

The scene, reprised in two sequels, is powerful but hardly erotic.

Nonetheless, Hazelwood recalls a Horse-inspired autoerotic fatality in which the victim, wearing a horse bit and bridle, pierced his nipples with fishhooks before hanging himself by the neck.

The props and paraphernalia found at an autoerotic death scene will vary according to the victim's fantasy, and the variations are endless.

Roy cites a case in which a man was found dead, cross-dressed in his wife's lingerie, with a pair of her panties pulled over his head. He had suspended a ligature from a garage rafter and tied a thirteen-loop hangman's knot in its free end. Then he climbed on a stool, placed his neck in the noose, and stepped off. His feet did not quite touch the garage floor, so he died from asphyxiation.

The key to understanding his ritual came later, with the discovery among his personal papers of a handwritten fantasy script, describing the military execution of his wife for treason.

As Roy put the evidence together, the victim was enacting this script, standing in as surrogate victim. By donning her lingerie he symbolically became his wife. For the condemned's hood, he used her panties. Stepping off the stool was a.n.a.logous to the hanging victim's thirteenth and final step before dropping to his or her death.

In another case, a shoe fetishist secured a rope to a door-k.n.o.b, ran the line over the door, and accidentally asphyxiated himself while hanging from it, totally nude, on the opposite side.

"Surrounding him," Roy recalls, "were four full-length mirrors. Attached to them, and the door behind him, were women's high-heeled shoes.

"He had hanged himself surrounded by the shoes. Everywhere he looked he would see himself and his love objects."

Asphyxiation caused by hanging is by far the most common form of accidental autoerotic fatality.

"Outside of jails or mental inst.i.tutions, I've never seen a nude suicide by hanging," says Hazelwood. "So if I find someone hanging nude in their bedroom I'm going to suspect it is an autoerotic fatality."

Among the atypical deaths, one victim was discovered seated on a couch, dressed only in a shirt.

He'd set up a projector and screen to watch an erotic film.

Judging from the plastic bread bag found near his left hand, and the aerosol can he still grasped in his right, the twenty-three-year-old victim apparently had planned to enhance the experience both by asphyxia (the bread bag) and by inhaling the can's fluorocarbon propellant.

Instead, he suffered what the medical examiner believed was a fatal cardiac arrhythmia.

Hazelwood counsels investigators that the autoerotic experimenter, unlike a suicide or murder victim, invariably includes some sort of escape, or self-rescue, mechanism in his or her apparatus. Tempting death may be a partial objective for many of them-achieving it is not.

The safety arrangement need not be elaborate. "It may be nothing more than the victim's ability to stand and relieve the pressure on his neck," says Hazelwood.

Evidence of bondage also is commonly found at autoerotic death scenes. Bondage, although not yet recognized as a distinct paraphilia by the American Psychiatric a.s.sociation, is in fact integral to such a wide spectrum of aberrant s.e.xual activity, especially criminal behavior, that Hazelwood emphasizes its importance in all his presentations.

Hazelwood and Dietz distinguish between two types: motor bondage (restricted movement of limbs) and sensory bondage (blindfolds, hoods, gags, etc.), and they have devised a method for discriminating s.e.xual bondage from the general use of restraints.

In their opinion, an investigator may confidently conclude s.e.xual bondage is involved when the victim has been bound in a variety of positions, or bindings aren't necessary for restraint (as in the upper arms or calves), or the bindings reflect that time and effort were spent ensuring their neatness and symmetry; for instance, if both wrists are bound identically, or each eye is covered with an exactly two-inch-long piece of white adhesive tape.

Fetishism also is frequently encountered in autoerotic cases, as well as s.e.xual crimes in general. Twelve of the victims in Autoerotic Fatalities, for example, practiced some form of fetishism.

Almost any inanimate thing can be a fetish.

"I always caution investigators not to apply their own criteria when searching for materials that someone else might find s.e.xually exciting," Hazelwood says.

For that reason, he asks three questions when a.s.sessing whether an object is a possible fetish item.