John Douglas, a retired FBI special agent and the bureau's pioneering criminal profiler, draws on decades of experience interviewing incarcerated killers to examine four cases that deepened his understanding of violent predators. The book combines investigative memoir with detailed case studies, framing each killer's crimes and psychology within the broader discipline of behavioral profiling that Douglas helped create.
Douglas opens inside a maximum security prison, sitting across from a convicted murderer in a dimly lit room. The scene establishes both the book's method and its guiding equation: Why? + How? = Who. He traces the origins of criminal profiling to the late 1970s, when he and fellow FBI agent Robert Ressler began showing up unannounced at prisons to interview violent offenders. These early conversations, which included serial killers such as Edmund Kemper and David Berkowitz, led to the development of a 57-page Assessment Protocol for documenting offender interviews. The research produced landmark publications, including
Sexual Homicide: Patterns and Motives (1988) and the
Crime Classification Manual (1992), which classified crimes by motivation rather than outcome. Douglas became the FBI's first full-time operational profiler and created the Investigative Support Unit (ISU), a bureau division encompassing profiling, arson and bombing analysis, the Violent Criminal Apprehension Program (VICAP), and coordination with other federal agencies. Three words, he argues, characterize every offender he studied: manipulation, domination, control.
The first case examines Joseph McGowan, a high school chemistry teacher who in April 1973 sexually assaulted, strangled, and battered to death seven-year-old Joan D'Alessandro after she came to his house in Hillsdale, New Jersey, to deliver Girl Scout cookies. Joan's mother, Rosemarie D'Alessandro, grew alarmed when her daughter did not return and walked to the McGowan house that evening, where McGowan displayed a chilling absence of emotion. His alibis collapsed under scrutiny, and after failing a polygraph, he confessed: He had lured Joan to his basement bedroom under the pretense of getting change, assaulted her, and killed her. He then drove her body 20 miles to Harriman State Park in New York, returned home, and joined the neighborhood search. The medical examiner found catastrophic injuries and evidence that McGowan had strangled Joan a second time to ensure she was dead. Douglas draws a parallel between McGowan's controlling mother and that of Kemper, noting that McGowan's inability to separate from his domineering mother surely distorted his psychological development.
In 1998, the New Jersey State Parole Board retained Douglas to assess whether McGowan, already twice denied parole, should be released. Douglas describes his carefully orchestrated interview at the state prison in Trenton: a small room with subdued lighting, no notes, and hours of rapport-building before steering the conversation toward the crime. When McGowan began recounting the murder, he perspired profusely in the freezing room, entered a trancelike state, and declared that the moment he saw Joan through the screen door, he knew he was going to kill her. He distinguished between "red rage," which he could control, and "white rage," which he could not. He expressed no remorse and revealed he had hidden hundreds of thousands of dollars from his family's estates to prevent Joan's relatives from accessing the money. Douglas told the parole board that the crime was an act of displaced rage, not the work of a classic pedophile, and warned that McGowan's indiscriminate anger made any vulnerable person a potential target. Parole board chairman Andrew Consovoy subsequently uncovered the precipitating stressor Douglas had suspected but could not pinpoint: McGowan's mother had forced him to choose between his fiancée and her, and he had chosen his mother. When Consovoy pressed further, McGowan's demeanor shifted to cold hostility before he admitted that whoever came to his door that day was going to die. The board denied parole and imposed a 30-year future eligibility term. Rosemarie channeled her grief into advocacy, establishing a memorial foundation and spearheading Joan's Law, which mandates life without parole for anyone convicted of murdering a child under 14 during a sexual assault.
The second case centers on Joseph Kondro, a former millworker serving 55 years at the Washington State Penitentiary for the rape and murder of 12-year-old Kara Rudd in 1996 and the murder of eight-year-old Rima Traxler in 1985. Kondro was a close friend of both victims' families, and Douglas interviewed him for an MSNBC documentary to understand why he targeted children he knew. Kondro's explanation was chilling in its simplicity: children were trusting, he was close to their families, and he exploited that trust because it was convenient. He recounted luring Rima into his truck by using a secret password her parents had established to verify trusted adults, a password her stepfather had casually shared with Kondro. He described both murders in flat, procedural detail, expressed no remorse, and confirmed he would have continued killing indefinitely. Douglas identifies Kondro as the only repeat killer in his experience who specifically targeted the children of people he knew well, overturning the conventional investigative assumption that close association with a victim indicates innocence. Kondro died in prison in 2012 at age 52.
The third case profiles Donald Harvey, a hospital orderly who may have killed as many as 87 patients between 1970 and 1987. Douglas uses Harvey's case to introduce the broader category of medical murder, arguing that the most numerically devastating serial killers are healthcare workers who hide in plain sight. Harvey committed his first murder at 18, smothering an elderly stroke patient at Marymount Hospital in London, Kentucky. When no one questioned the death, he realized he could kill with impunity and expanded his methods at the Cincinnati VA Medical Center to include arsenic and cyanide before extending his killing beyond hospital walls to poison acquaintances and romantic partners. His downfall came when a forensic pathologist detected cyanide during the autopsy of John Powell, a comatose patient who died suddenly in Harvey's care. Harvey confessed to dozens of murders and received multiple life sentences. When Douglas interviewed him, Harvey insisted the killings were mercy deaths, stating he never considered his actions murder until he was arrested. He demonstrated detailed knowledge of how to exploit hospital routines and security weaknesses yet showed no genuine remorse. Harvey was beaten to death by another inmate in 2017 at age 64. Douglas also examines parallel cases, including British physician Harold Shipman, who killed at least 236 patients, and nurse Charles Cullen, who killed at least 30 across multiple hospitals, identifying pattern recognition as the key tool for detecting healthcare killers.
The fourth case examines Todd Kohlhepp, a South Carolina real estate broker who in 2003 shot four people to death at Superbike Motorsports, a motorcycle shop in Chesnee. Douglas had profiled the unknown killer as a disgruntled customer driven by retaliation, but the case went unsolved for 13 years. In November 2016, deputies investigating the disappearance of Kala Brown and her boyfriend, Charles David Carver, traced cell phone records to a property belonging to Kohlhepp, where they found Brown chained inside a locked shipping container. She had been imprisoned for over two months after Kohlhepp shot Carver. Brown told rescuers that Kohlhepp was responsible for the Superbike murders, and Kohlhepp subsequently confessed to those killings and to murdering another couple. He received seven consecutive life sentences without parole. Unable to secure an in-person interview, Douglas had Kohlhepp complete the original FBI Assessment Protocol himself, the first time a convicted killer filled out the document without an interviewer present. Kohlhepp traced his violence to parental neglect, an abusive grandfather, and a rape conviction at 15 that sent him to adult prison for 14 years. Douglas argues that Kohlhepp's initial crime was a power-reassurance offense, a category of sexual assault driven by the perpetrator's desperate need for reassurance of adequacy and the type most amenable to early therapeutic intervention, but that the justice system warehoused him rather than treating him. Despite this, Kohlhepp accepted responsibility: "My crimes are things I can control. My trigger finger, my call. No one made me do anything."
In the epilogue, Douglas addresses the central question running through all four cases: the role of choice. He contrasts Susan Smith, who murdered her two sons while clearly knowing right from wrong, with Andrea Yates, who killed her five children during genuine psychotic delusions, arguing that only Smith's actions constitute evil. Douglas concludes that a bad background is never an excuse for murder and that nearly all violent predators he has encountered made deliberate decisions to kill. He closes by quoting Holocaust survivor Viktor Frankl, who wrote that human beings are "ultimately self-determining," and reaffirms that understanding how killers make their choices remains essential to identifying, catching, and prosecuting them.