Benjamin Gilmer was finishing his training to be a doctor and he was applying for jobs. And there was this one job that he was really excited about at a small rural clinic in North Carolina, a place called Cane Creek, about 15 miles outside of Asheville. But there were two slightly strange things about this job. The first was that his predecessor at the position-- who was the guy who started the clinic-- had left the job after murdering his own father, strangling him and sawing off his fingers. And the other strange thing? At first I didn't make the connection that his name was the same as mine. This is Benjamin Gilmer. And then during my interview, they reminded me, well, his name was actually Dr. Gilmer. That's right. The murderer was Dr. Vince Gilmer. He was Dr. Benjamin Gilmer, no relation at all. And there was concern from the boards my presence out there might potentially even be harmful, because I share the same name. You know, whether some patients would just elect not to come. I mean, there was confusion. People think it's strange, just very-- it's very strange. This is Robin Whiteside, who works at the clinic. Benjamin Gilmer must be a very qualified young man, because they did give him the job. And sure enough, it did cause confusion among the patients, freaked a few out. A patient called. I said, I can schedule you with Dr. Gilmer. Terry Ippilito sits at the front desk of the clinic. And they said, is this a-- it was near Halloween. And they said, is this a Halloween joke? As if there is such a thing as a Halloween joke. Anyway, one patient, Benjamin was meeting her for the very first time. He walks into the exam room. And she literally was having a panic attack. Hyperventilating, heart palpitations. She thought maybe the other Dr. Gilmer, the murderer, was going to be seeing her. But as Benjamin settled in at the clinic and people got to know him, something interesting happened. Many of Vince's former patients, who were now Benjamin's patients, started talking to him about Vince. Each one of them felt like they needed to say something to clear the-- clear the air, I suppose. But they wanted me to know who he was, who was absolutely not what the papers were describing or just an ax murderer. Which was the thought that I had going into this job was that I'm following the footsteps of an ax murderer. But that's not the story that increasingly was being described his patients. For instance, Ruth Tracy. When she first came to Vince for treatment, she had just lost her job. Her husband wasn't working either. No insurance. She told Vince, don't do tests. I can't afford it. Vince wouldn't hear of it. And he did not charge me for my appointments for almost six months. He gave me my medication out of samples. And he listened to me. I could cry on his shoulder. He would give me a hug. I mean, he always made me feel better. I'd say, how can you treat me like this and not collect money? And he said, we have to help each other out. This is not an exceptional story about Vince Gilmer. Lots of people would tell you what a great guy he was. Generous to a fault, he'd help you pay to get your car repaired, buy you a present for no reason. If you had no money, he would take a bushel of corn as payment. He was a big, burly man. His nickname was Bear. He hugged everybody. He was a solid guy, a gentle guy. He gave free annual checkups to the local firefighters. He made house calls. House calls! Didn't charge for them. And when one of our producers, Sarah Koenig, went around asking about Vince, she heard that some people still had a hard time believing that Vince would be capable of cold-blooded murder, even though he's serving in prison for it-- like Jerol Davis, one of his former patients. He told Sarah it made no sense. And thinking back, see, his father had Alzheimer's. And I wondered if he didn't kinda consider it a mercy killing. Oh, really? To get his father out of his misery. That's the only answer I could think of. If it was a mercy killing, doesn't it seem strange that he would strangle him? Because if he's a doctor, he would have access to whatever drugs you would need to-- I didn't say he strangled him. I have no idea how he died. Oh, he strangled him. Oh? I didn't know that. You didn't? No. I didn't know how he killed him. I did not. Does it-- does that make you think differently about maybe why he did it, knowing that he strangled him? Well, not necessarily. So Benjamin's doing this job. And, like, every few weeks, somebody is telling him some glowing story about Vince. I don't know. I don't know why I started identifying with him, but I couldn't help myself. I mean, I feel like I'm sort of a continuation of him, which I didn't expect to experience at all. He and Vince Gilmer had the same specialty, same job, same clinic, same last name. They were even the same age. Vince Gilmer was 41 when he murdered his father, the same age as Benjamin when he came to work at the clinic. And at some point-- and maybe you see where this is going-- Dr. Benjamin Gilmer started to get very curious about the murder that Dr. Vincent Gilmer committed. He began asking questions, poking around, talking to people. He developed his own theories, theories to explain the murder that had never come up at Vince's trial. He gets pulled in deeper and deeper. And by the end-- and I don't think this is a spoiler alert-- things are very, very different from the way they look here at the beginning of the story. It is an amazing story. From WEBC Chicago, it's This American Life. I'm Ira Glass. We're rerunning the show this week-- it was first broadcast five years ago-- because I have been thinking about it so much lately. The third season of the podcast Serial just ended, where Sarah Koenig looked into everyday cases in the court system and found, I'd say, amazing and compelling stories. Just one after another, stories that make your blood boil. It's infuriating what happens every day, all over the country, in our courts. If you haven't heard it, serialpodcast.org. Anyway, as we were finishing season three, I thought a lot about this episode of This American Life, this one we're playing now, which we made before Sarah ever started Serial. And the thing I keep thinking about is, like, how the murder case in this episode is so far from ordinary. But how certain things about the tone and approach of Serial you can hear in nascent form in the story she did about Dr. Gilmer five years ago. OK. So with that, I will pass things off to Sarah Koenig, who went to North Carolina and watched things unfold with Dr. Gilmer. Here's Sarah. When Benjamin first told me that he identified with Vince Gilmer, felt connected to him, I didn't really get it until I went there to the Cane Creek Clinic and hung around and watched Benjamin with his patients. What I hadn't understood is that Benjamin is the same kind of doctor Vince was. I don't know how else to say this, but he cares about his patients, really cares. And they can tell, so they confess things. The morning I spent there, a pregnant woman told him she did not want the baby's grandfather at the hospital when she gave birth. And so, they crafted a plan for how to keep him at bay. A young mother of two said she'd just left her husband, which is better for everyone, even though she now had to work all the time and put her kids in daycare. You are doing good work with your children, Benjamin told her. And she almost started to cry. There was an older patient, who came in anxious about a lump in her groin that Benjamin had already assured her was benign. He gives her a sonogram. So see? See that black area? I do. That black area is fluid. It's not a solid mass. Masses-- for example, like cancer-- are solid and become white. So that's black, which we call anechoic. So that means-- She does not need the sonogram. And he will not charge her for the sonogram. But he knows it's the one thing that's going to make her feel better, if she can just visualize this harmless thing. And it works. By the end of the appointment, she's laughing. This doctor-patient trust, it's so intimate in a little practice like this one. And now, Benjamin Gilmer and Vince Gilmer know some of the same intimate things about the same people. And that's why Benjamin started to feel connected to Vince. And then one day, last fall, one of Vince's former patients said something that rattled Benjamin. It was an older man. He just caught me in the hall and said, hey, you know that Dr. Gilmer knows you're here? He knows-- he knows you're practicing. You know that, don't you? And at that moment, I had-- I really had never thought about that, that of course he knows exactly what my name was, where I live, and that I'm working his home. You know, this clinic was his baby. He built it. He dedicated his life to it. And my sort of neurosis was that I had taken over his life in a way that felt very new and strange. The thought of being this close to a murderer, he said, was terrifying. And Benjamin started to cook up irrational fears. He couldn't help it. He worried Vince would get out of prison and come after him in some way. At one point, a patient mentioned that Vince was, in fact, out on parole. It turned out not to be true, but for weeks afterward, Benjamin was on alert, scanning the outside of the building when he arrived. I come in right after him. And, you know, he would be, like, looking at the door, who's coming in and stuff. This is Laura Lira Hernandez, medical assistant at the clinic. And so, for like a week, we're in panic mode, thinking that somebody-- that he was going to show up here. He was telling me-- Dr. Gilmer was telling me that he was having nightmares and stuff. You were? You were having nightmares? For a few days after that, that came out. When I met Benjamin, this is where he stood, confused about the two versions of Vince Gilmer coexisting in his head, the murderer and the good doctor. I mean, he obviously was crazy when he did this act. Didn't sound like it was an intentional thing, that he was a premeditated, as I understand it. This is the trouble. Like, I'm still confused by whether he was good or not. You know, it's kind of like living with a ghost in your house. And you tell your kids it's a friendly ghost, but you never know where the ghost is coming from. So I'm planning to spend my professional life in that building. It's not going to go away. And until I know more, I'm not going to be able to let it go. Benjamin needed to sort out this mystery of how a beloved family doctor with no criminal history suddenly ups and strangles his own dad, how a good man seems to turn into a bad man. So you've never seen a picture of him before? I've never seen a picture. The only thing I've heard from a couple of patients is I kind of look like him. He started with Terry Worley. She was office manager at the Cane Creek Clinic, and good friends with Vince and his wife, Karen, who was also a physician. They'd started the clinic together and worked together. Vince and Karen didn't have kids of their own, but Vince would come to Terry's kids' basketball games. She said he was like part of their family. He's bald. There's a picture of him. That was our staff when everything happened. And that's him kneeling? That's him kneeling. Terry told us two interesting things about the year leading up to the murder. First, Vince had a bad car accident. He flipped his truck just off an exit ramp. He hit a light pole and it-- the light pole came down and kind of went across his truck. They took him to the hospital. And I guess he had ID on him, is how they knew who he was. And they called Karen. But he told me at the hospital that he was Bobby Brown. He didn't know who he was. He didn't know who Karen was when she got there. He didn't know he was married. And then, that lasted for about 24 hours. And then they let him come home and he was kind of back to himself. But I think he had a pretty good bang to the head. Here's the strangest part. Terry said she thought Vince had maybe crashed his truck on purpose. He was scheduled to take his medical board exams at that time. And he was exceedingly anxious about them. He'd always been a bad test-taker. His mother told us he had attention deficit disorder as a kid. And Terry says it occurred to her that the accident was a way to avoid taking the boards. And I think it was his way of getting out of it. Which, at the same time, he had wanted a new truck, too. And Karen-- Karen had told him he couldn't have a new truck. I mean, she was the one that kind of kept the, you know, the handle on the money. And he had his eye on this Toyota Tundra truck and a Toyota Tacoma. Anyway, he ended up with a new truck after the fact. So it could have been one of the two. I'm just saying. But that's crazy, though. That's, like, the riskiest behavior ever. It is crazy. Another friend who didn't want to go on tape also told us, unsolicited, that he thought Vince might've crashed his truck on purpose, possibly as a suicide attempt. Then, not too long after the truck accident, Vince and Karen split up, which floored their friends. Terry says it came out of nowhere. Just out of the blue, he came in one day and said him and Karen were getting a divorce. Nobody had a clue that they were even have any problems. She says, I asked him to go to counseling and everything. And he's like, no, I've already got a place to live. He went and found a place to live and moved out that weekend. So you're saying everything seemed normal until that pronouncement? Like, he comes in and says, like, Karen and I are splitting? And then things changed from that moment, it feels like? Yeah. It was just like a-- it was like a light switch. But he just-- it's-- I thought it was a mid-life crisis. You know, sometimes men go through a midlife crisis and they go out and buy a car, go out and have an affair or something. We figured it would just blow over. And then, that's when he went out and started drinking, and we saw a side of him we had not seen before. Vince's his friends said he was drinking three or four nights a week, mostly at a bar in downtown Nashville called Jack of the Wood. But Terry says he's still seemed fine at work, and that he was fine the Monday they closed the clinic early, June 28, 2004, so that Vince could go pick up his father, Dalton Gilmer. Dalton was at a psychiatric hospital. It's called Broughton Hospital. It's not clear what exactly was wrong with Dalton. But according to court records, he was taking antipsychotic medication and he needed help taking care of himself-- dressing, bathing, even eating sometimes. And he could barely walk. He needed a wheelchair or a walker. He was 60 years old. Vince had made arrangements to transfer his father from Broughton to a nursing home very close to the Cane Creek Clinic. So that Monday afternoon, he drove up to Broughton and collected his father. I had every intention of taking him to the nursing home, Vince said at trial. But Vince says he promised to first take his dad to a favorite lake, several hours out of the way. He did have a big green kayak in the back of his truck, but remember, his dad can't walk. And Vince has no walker in the truck. Plus, it's getting late. So this plan didn't make much sense. The heart of Vince's story about the crime is probably something that, if you're listening with little kids right now, you might not want them to hear. Vince says his father sexually abused him and his younger sister from the time they were 6 and three years old, respectively. The abuse he describes is maybe the most horrific I've ever heard of. Vince's sister apparently corroborated the abuse, but she disappeared just before the trial in 2005. And her family has not seen or heard from her since. Vince's mother claims she never knew about the sexual abuse, not until after the murder. She said her husband was a Vietnam vet, who came back from the war changed and sporadically violent man. Vince says his father was apt to make inappropriate sexual remarks and gropes, and that's what happened in the truck that day. He kept saying filthy, filthy things, Vince said at trial. And that's when he lost it, he says. Vince said a voice in his head, like a compulsion, was telling him to kill his father. I reach over with the rope and I place the rope around his neck and pull on it and pull on it and pull on it. Then Vince says he drove around for hours, panicked, trying to figure out what to do with the body, which he'd moved to the bed of the pickup. Eventually, he carried it onto the side of Good Hope Road, near the Virginia/Tennessee border. And he performed what the Virginia medical examiner would later describe as traumatic amputations of all 10 fingers. He cut off his father's fingers and thumbs. Vince says he used a little saw he had in the back of his truck for trees around the house. Vince said he did this to prevent the body from being identified. And then, Vince went home. The body was quickly found, still warm, and quickly identified. In the pocket of his tanned shorts, in the inside color of his polo shirt, stamped in black ink, D. Gilmer. Name tags that Vince says he himself had arranged for. After learning this much, Benjamin started conjuring a hypothesis about Vince. Benjamin did his master's thesis on traumatic brain injuries prior to Med school. To him, the truck accident was key to the whole thing. Maybe Vince had some lurking hereditary craziness that was unmasked by big bonk to the head. Or, in Benjamin's words, latent neurologic sequelae, triggered by brain trauma. He was unconscious and didn't recognize his own wife afterwards. And then, after that period, there was a demarcation between this strange behavior that started happening. I think he had to be going crazy. I think the craziness started a year before the murder. Leaving a wife who loved him after so many years and assuming that she would stay in the practice and work side by side with him? That's not rational thinking. If Vince snapped as he claimed, then it's hard to square his behavior immediately following the crime. Because from the sound of it, he told a cascade of lies coolly, no bead of sweat running down his temple. On Tuesday, the day after the murder, Vince told his office manager, Terry Worley, and everyone else that he brought his father home. And that sometime during the night, his father had wandered off. He said he had people out looking. He filled out a police report, didn't cancel any appointments. In fact, the very first patient he saw was Terry's son, for asthma. He was totally normal. He was totally normal the whole time. Really? He never broke down, seemed overly anxious because his dad was missing, nothing. Vince kept seeing patients all week. Then on Friday, Vince invited the staff out to lunch at a favorite restaurant called Iannucci's. While they were there, he got a phone call from a detective, telling him they'd found a body in Virginia. Again, Terry Worley. And he just-- all color, he lost complete color and just-- he was in shock. I mean, he literally about passed out. He had to lay down on the bench at Iannucci's. And the woman got him a cold compress for his head. I don't know what was going through his head, if he was thinking, oh, crap, I'm caught. Or, now I've got to cover my tracks. I don't know what he thought. And he just-- as he was handing me the phone, he says, you have to talk to my office manager. And kind of shoved the phone to me. Benjamin and I talked to this detective. His name is Mike Martin. Benjamin was on speaker phone. Does this case stand out to you in your professional life? It is a unique case, as in he was able to kill his father and show no remorse. Detective Martin says when he showed up at Vince's door, Vince was cordial and composed. During the interview at Mr. Gilmer's home, he told me that he had brought his father to North Carolina to stay with him. And that upon their arrival, that Daddy was so delighted to be there that he had went out into the yard and played with the dog, throwing a Frisbee. I already knew that could not be true, because the people at Broughton Hospital told me that Mr. Gilmer senior could not have walked on his own at any time. He said, you don't believe what I'm telling you. I said, no, sir. Not at all. Not in the least. I do not believe you. I said, the very questions that any person would be asking in reference to his parent death, you have not asked, which is an excellent indicator that you already know. He wasn't scared. He wasn't agitated. He told me, he said, look. He said, you do not know who you are messing with. He said, I am a doctor of medicine. I am well respected in the state of North Carolina. And I will have your damned job. I said, sir, it is my job to do the investigation. And based on what I know, I will consult with the Commonwealth attorney. And I will ask for a warrant for your arrest for murder. When we left, we said, sir, thank you for your time. And he closed the door and never said a word. Before Detective Martin could get back to Cane Creek with a warrant, Vince ran, took some camping equipment and hid out. The cops finally caught up with him in the woods near the Lowe's hardware store at the Asheville mall. Did you come away thinking this was a premeditated-- like he planned this murder in advance and then executed it? That is exactly what I think. Really? Yes, ma'am. That it wasn't a spur of the moment, he kind of lost control and years of abuse and anger welled up and overpowered him? Spur of the moment didn't buy the gloves. It didn't buy the rope. And it didn't put the pruning shears in the pickup truck. Other things Benjamin and I learned from Terry Worley. Vince was his father's guardian. He was supposed to be paying his father's bills out of his father's money, but he didn't. By the time he killed his father, he owed the psychiatric hospital where his father had been staying more than $270,000. A motive, maybe. Also, Vince had planned a two week vacation to Alaska that coincided with his father's killing. Terry says the investigators questioned her about it. They asked me if I knew it was a one way ticket. I said, no, I helped him book it. And they showed me where it had been changed to a one-way flight. So he wasn't planning on coming back. He thought he was going to get gone. By the time we'd finished talking to Terry, Benjamin was deflated. Vince was sounding more and more like this cold-blooded killer. We debriefed. It just seems like he's lying. It just seems to me like he's lying. You really believe that? I think he's lying about this having snapped. I do. I think I do. I mean it just doesn't-- it doesn't make sense with all the things that Terry said. This is a guy who had made a plan, no? It seems that way now, doesn't it? To me, it does. Yeah. That's a total game changer. That's-- that's not crazy. That is rational planning with a motive. I was kind of hoping not to hear that. Soon after Vince Gilmer was caught by the police, he confessed to strangling his father. His defense boiled down to one word, serotonin. That was his excuse, his disease, his all-purpose defect, serotonin. Or rather, lack of serotonin in his brain. Serotonin is a hormone, a neurotransmitter. If you don't have the right level of it in your brain, it can affect your mood, which is why many antidepressants increase your serotonin level. These drugs are called SSRIs, Selective Serotonin Reuptake Inhibitors. If you stop taking them abruptly, you can have suicidal thoughts, severe agitation, even psychosis. What you believe about Vince's crime depends on whether you believe he was out of his mind at the time of the killing, whether you believe that missing his SSRI pills could transform him from a loving doctor into a psycho. Here's Vince's explanation for what happened. He'd been struggling with anxiety for years. And after he and Karen split up, in the months leading up to the murder, he'd been taking Lexapro, an SSRI. He says a day or two before he went to pick up his dad, he stopped the Lexapro. Didn't taper it off like you're supposed to, he just stopped. And he reacted very badly. He became extraordinarily irritable, heard voices. His brain didn't work right. He said he felt, quote, "mentally retarded". In a letter to a doctor he wrote from jail, this is how he describes the voices he heard when he was off the Lexapro. "These are not voices that make a suggestion. This is a compulsion. The compulsion is trying to take over my consciousness. I fight the compulsion in the front part of my head. It is a hyperanxious state. Pacing becomes mandatory, trying to walk off the pressure. The battle hurts badly." One of the phrases he kept using over and over was that, my brain wasn't working right. You know, my head wasn't working right. This is reporter Matt Lakin. Back in 2004, he was covering crime for the Bristol Herald Courier. He spoke to Vince soon after the murder, both on the phone and in person. And Matt says Vince seemed like an intelligent guy, a nice guy, pleasant to talk to. Not obviously crazy, maybe just eccentric and a little manipulative. He would go into these bizarre-- he'd make these strange gestures, where he would bob his head up and down and just sort of kind of shake. He would-- it was just almost, you know, I almost had a sense that he was hamming it up sometimes. Like doing it for your benefit. Right. I mean, whenever I would point out a flaw in his story, for example, he would suddenly get emotional and start to cry. So either he was having tremendous mood swings, or he was trying to avoid the question. Which one do you think it was? This question lurked throughout Vince's initial incarceration and court appearances. Was he crazy? Or was he crazy like a fox? We asked Mike Martin, the Virginia detective in charge of the murder investigation, whether he ever saw evidence of mental illness in Vince, whether he ever questioned if the cops had gotten it wrong. I can tell you what we done for Mr. Gilmer. We got to watching him. And each time, police officers would come around him, he would-- Detective Martin said he and his fellow officers had noticed Vince shaking his arm and his head, and that he only seemed to do it around them, not around the other inmates. They were suspicious. So we set up a camera on the rec yard, and invited the inmates out on the rec yard to play. And they played basketball. Mr. Gilmer participated in play in basketball as the rest did. He participated in the walks around the yards as the rest did. And then we purposely sent the officer, James Blevins, who was assisting me in this case. When Mr. Gilmer seen the officer, he automatically started to shake the head and arm. And he did that until such time that Detective Blevins left the rec yard. Mr. Gilmer is not somebody that's been controlled by some demon. He is very self-controlled. A clinical psychologist named Jeffrey Feix came to a similar conclusion. Feix evaluated Vince to find out if he was sane at the time of the crime. He reported that Vince was agitated, quote, "spoke in a halting fashion, fidgeted while sitting, stood with a stooped posture, occasionally paced, and gesticulated broadly with his hands while talking. This presentation was very dramatic and not consistent with known anxiety or psychotic disorders." Feix went on, "it appeared that the patient was exaggerating his symptoms for the benefit of the evaluator and treatment team. It is respectfully recommended that Dr. Gilmer be considered legally sane at the time of the offense." Later that fall, another psychiatrist found Vince to be quote, "evasive, dramatic, and manipulative." And by mid-2006, the prison doctors had settled on a two-pronged diagnosis-- atypical depression and malingering. In other words, lying. From jury selection forward, the trial was a disaster for Vince. His performance, his explanations, they appeared to move no one. I talked to a man named Robert Hughes, who was called to serve on the jury, though eventually excused. When he would talk to us, Mr. Hughes said of Vince, he would act like he was nuts. Then, when he turned around to talk to his lawyers, he was as cool as anything. We argued at trial that he was planning his defense, essentially, prior to committing the crime in the first place. Nicole Price was one of the prosecutors. When she lists all the evidence, the state's case sounds pretty straightforward. Vince had made careful plans to pick his father up. He had all the materials he needed to carry out the crime right there in his truck. He mutilated the body to hide the identity, and then dumped it in Virginia, far from where he himself lived. And the other evidence that we had were conversations, recorded conversations that he had with friends. And in those conversations, he talks about using the-- you know, playing the good doctor card as hard as we can. He talks about that he would prefer to be tried in Tennessee, because he felt that his sentence would be less. And so, at different times, he advised law enforcement that the murder occurred in North Carolina, that it occurred in Virginia, and that it occurred in Tennessee. And that was calculated to let him determine where this trial would be had. So I think the evidence from his own mouth is that he was manipulating, in the hopes that he would convince a jury that he was not responsible for his criminal actions, because of some type of-- I don't know. That he was insane. And what is the craziest thing a man accused of first degree murder can do? The craziest, most stark-raving lunatic thing a man facing life in prison can do? The answer is dismiss his lawyers and choose to represent himself. And so, yes, that is what Vince Gilmer did. I used to be a court reporter. And so, I read a lot of court transcripts, but none as farcical as this one. It makes you wonder if maybe he really was crazy, because any casual watcher of Law & Order could have built a better case for himself than Vince Gilmer. His witnesses are beside the point. His own testimony favors the nonsensical. Vince can barely string together a sentence before a prosecutor objects. At one point, Vince called his ex-girlfriend, Susan Garren to the stand. He asks her, "to the best of your knowledge, have I hurt anyone or killed anyone? Just have I hurt or killed anyone that you know of?" Susan, "your father." Vince, "OK that-- have I besides what happened with my dad?" Susan, "can you repeat the question, please?" His court-appointed attorney, who was there only to answer Vince's questions about court procedure, said it was agonizing to watch, like someone trying to commit suicide with a butter knife. Toward the end of the trial, Vince Gilmer says, Your Honor, I'd like to call Vince Gilmer. He talks and he talks and he talks for nearly two hours. And by the end, he loses his thread. The prison docs have stopped his SSRIs meds, he said. "So when I came in here, I'm confused. I had trouble-- I've had trouble with the confusion all the way through this. I know you're the jury, and I know he's the judge, so that makes me in Virginia-- you're-- I'm capable to-- I'm able to say I'm competent to be here. This hasn't been the brightest of ideas, being my own lawyer." A little later, prosecutor Nicole Price interjects. "Isn't it true that you've been found competent to represent yourself?" I am, says Vince. "Are you fine right now?" Price asks. "No," says Vince. The jury took about an hour to convict Vince Gilmer of first degree murder. The judge, the Honorable C. Randall Lowe concurred. Quote, "it was clear that it was malingering and faking," he said at a post-trial hearing. "The defendant would go into an act. He would look up and see if the jury was buying it. When the jury wasn't buying it, he would go back to normal. It was clear." Judge Lowe sentenced Vince to life in prison without the possibility of parole. So that's where it ended. The entire law enforcement, medical, and legal community declared Vince a liar. He went to a maximum security prison called Wallens Ridge in the mountains of far Western Virginia. Coming up, Benjamin does not take premeditated for an answer. A hunch, a blood test, and DNA evidence. And not the kind you're thinking of. That's in a minute from Chicago Public Radio, when our program continues. This American Life. I'm Ira Glass. Today on our program, Dr. Gilmer and Mr. Hyde. If you just tuned in, Dr. Benjamin Gilmer is looking into a murder committed by Dr. Vince Gilmer, no relation. Where we left off before the break, Vince Gilmer was claiming that his brain was not functioning properly at the time of the murder. Two psychiatrists and psychologists thought he was faking his supposed symptoms of a mental disturbance. A jury thought he was faking, a judge thought he was faking. Our reporter on the case, Sarah Koenig, was inclined to think that all these people cannot probably be wrong. And the one person-- the one person-- who still thinks that maybe Vince Gilmer might not be faking is Benjamin Gilmer. He's still unconvinced. He's begun researching SSRI withdrawal, and found dozens and dozens of reports of people who've become violent or homicidal while either on or off their medication. He's also gathered more reports of personality changes following a traumatic brain injury. And he's dug up Vince's brain scan from back when he had the truck accident, and got over it with not one, but two radiologists. When Benjamin calls me to talk about what he's found, he sounds to me like he's grasping for a diagnosis. Benjamin wrote to Vince in prison. And several weeks later, he got a letter back. Vince included many pages of information about SSRI withdrawal, and had written messages on the back in a mad man's scrawl, barely comprehensible. Six years into this, I mean, the guy, he's exhibiting the same kind of behavior. Right. You'd figure if he was-- if he were faking, he'd let it go. Like, what's the point now? Yeah. Just believing he's just a pathologic, sociopathic killer who did it in cold blood and that it was-- that he's just that, that I do not believe anymore. I really-- he was a mess. Yeah. I don't know. I don't think you're going to get to the bottom of this, Benjamin. You don't think it's ever going to be-- I don't think it's ever going to be clear. I mean, I think you can end up telling yourself something about it, but I don't know that it's going to be true. I mean, I'm not trying to make him a martyr or anything. I know. I know. I'm just saying. But you want to know the truth about it, though. Yeah. Here we are. It seemed the only way to judge Vince for ourselves was to see him for ourselves. So in January, Benjamin and I drove to Wallens Ridge state prison to meet Vince. How are you feeling? I'm feeling nervous, to be honest. Never done this before. Benjamin was so nervous, he had to sit down when we were signing in at the front desk. He told me later he was imagining being face to face with a guy capable of tearing someone apart. That's the way one of the jail guards back in North Carolina had described Vince to Benjamin. Now, at Wallens Ridge, they led us to the visiting room. Several other inmates were already there. And after a while, they brought in an old man. At least, he looked like an old man, bent and shuffling. And, of course, that was Vince. He's only 50, but he looks awful. We spent four hours talking to him, asking him every question we had and continually fetching him food from the vending machines. Two pizza burgers with pepperoni, one cheddar cheese burger, two Cokes, and six of those pink Hostess snowballs, coated with coconut shavings. Ever since Vince went to jail in 2004, he has been agitating. And all this time, he has never let up. It's dizzying, the amount of paperwork he's filed, protesting what he says is inhumane treatment. Inmate request forms and civil lawsuits and motions for emergency hearings. Vince insists he has SSRI Withdrawal Syndrome, an extreme reaction to changes in his SSRI meds that can cause intolerable mood changes. If only they'd give him 60 or 80 or 100 milligrams of Celexa, uncrushed, he'd be better. A fellow inmate who tried to help Vince wrote to me. At Wallens Ridge, they call Vince Doc. The inmate wrote, quote, "when the prison doctors would not order the treatment Doc wanted based on his self-diagnosis, he would become hostile, threatening, throw tantrums, refused to comply with orders, and just yelled that all of this was caused by his serotonin-deprived brain. Needless to say, none of that plays well in prison. Sadly, Doc has been his own worst enemy." Unquote. We weren't allowed to record or take written notes when we met with Vince, but the following day, we were allowed to record a phone call. The sound quality is not good. Hello? Hello? Hi. Are you there? Yeah. Is that Vince? Yes. I can hear you. Oh, great. Good morning. Good morning. Vince is hard to take in, because he presents so many contradictory characteristics all at once. You can see he was once a handsome guy. And at times, his speech and thoughts and affect seem completely normal. He looks you straight in the eyes. And some of his answers sound utterly reasonable, too. For instance, no, he did not simply dump his wife and walk away from a happy marriage. They were having troubles, like many couples do. And they couldn't work out those troubles, so they split up, he said. End of story. We later confirmed this with Karen. But then, in a flash, he'll lose his focus, lose simple words, become weepy. His face will grimace strangely, in a way that's unconnected to what he's saying. Or he's putting his index finger on his chin or forehead and looking at the ceiling like a child. His hands are working constantly, especially his left hand, rubbing his thumb endlessly over his closed fingers. You can see the skin is red and raw from it. He's holding his arms close to his chest. He's talking and talking. And then he'll stop and say, what was the question? Vince is missing many teeth. He says that's because his serotonin-deprived brain makes him aggressive, and so he lashes out at other inmates and then gets beaten down by prison guards. I ran this by a Virginia DOC official, who said the DOC does not respond publicly to inmate allegations. Benjamin spent a lot of the conversation trying to suss out Vince's medical history. So what is the difference between a serotonin-deprived brain and depression? I'm just trying to figure out. Um, [INAUDIBLE] OK. Instead of being-- OK. Unbelievable levels of anxiety, um, uh. Like I said, ungodly anxiety, electrical jellyfish stings. It comes and goes. That was a little hard to hear. He's saying, electric jellyfish stings. He says that's what it feels like in his brain, an electric shock. Um, what was your question? Then he says there's the intermittent psychomotor agitation, meaning the uncontrolled movements in his arms and face that come and go. He knows it looks fake, he says, but it's real. And indeed, the symptoms he talks about are listed in the teeny tiny print on the back of the Lexapro insert. I asked him about what Detective Martin told us, about putting cameras in the jail rec yard, and how Vince seemed to act weird only when staff came around. That's exactly. That's intermittent psychomotor agitation, exactly. And same thing happens when I try to talk to medical people, same thing, same type of thing. I see. Or if something, like, stresses me out. It gets worse and worse and worse and worse and worse and worse and worse and worse and worse. So basically, what Detective Martin saw as evidence of you faking it, you're saying it's evidence of a real syndrome. Absolutely. And that's a documented part. No one has believed you. They don't believe your symptoms are real. Why is that? I don't know. I don't understand. Vince told us he did not plan to kill his father. He's adamant about that. He says he did not want his father dead. He'd taken care of his father on many occasions, sometimes for long stretches. The plane ticket to Alaska that Terry told us about? Vince couldn't remember it. And it never came up as evidence in court. As for the debt Vince owed to Broughton Hospital, he says he just wasn't that worried about it. Plus, it's not like the debt would have gone away if his father died. But he couldn't explain why he'd let it accrue like that, why he never paid for his father's care like he was supposed to. Also, he couldn't really explain his behavior right after the killing. I just can't bring-- come up with a good answer for it. Sorry. Because I am curious about that week. Because it seems like you were very-- you were very controlled, in fact, in that week. By that time, I was back on that medicine for a short term. So are you saying that as soon as you took the Lexapro again, your mind calmed down and you were able to kind of go about your life in a more or less normal way? Absolutely. Yes. So why, at that point, if you're on it, why not just immediately go to the police and say, like, I've done this horrible thing. And I was out of my mind and I need to-- like, we have to deal with it, you know? Why run? Why lie? Why try to cover it up then? I just didn't. I guess that's what I-- I guess I what I should've done. Prison staff at Wallens Ridge all told us the same thing, Vince is really like this. He wasn't putting it on for us. Also, he's gotten a lot worse in the last few years and months. When we saw him in prison, he spent the last 10 or 15 minutes of our meeting tearfully asking us-- especially Benjamin-- for help. He'd helped so many people as a doctor, he said. Didn't he deserve the same now? I'm begging you, he said. Back in the car, a little shaky after the interview, Benjamin had come to a decision. From our observations today, he is mentally ill. And I was trying to be discerning. I was trying to be somewhat skeptical. But I just don't think anyone could pull off what he pulled off today. If they weren't genuinely sick. Yeah. So we no longer think it was premeditated? I don't think so. OK, so we're saying we believe his story, that he snapped in the moment? That's what feels right to me. Do you feel that way, too? Because before, you were premeditation all the way. I know. I guess I do feel like that. But if that's true, then he was wrongly convicted. Yep, that's right. All over again, Benjamin turned over the possible explanations for Vince's illness. I mean, I've reviewed a bunch of cases with very, I mean, uncanny similarities to this one, all related to SSRIs. He does have-- like, there's evidence to suggest that what he's saying could possibly really be true, you know? And so, what do you do with that information? I don't know. I mean, I-- so I've wondered, obviously, what is my purpose for this? Is it my duty to do something? He directly asked you not a half hour ago. Help me. You can help me, help me. So now I'm left with what to do with this. I don't know what I'm going to do with this. Three weeks later, Benjamin was back at Wallens Ridge. This time, he brought along his friend Steve Buie, a psychiatrist. They talked to Vince for an hour. But when they were done, Dr. Buie wasn't sold on Benjamin's favorite hypothesis. Dr. Buie has seen a lot of people go through SSRI withdrawal, he said. But whatever was going on with Vince, it didn't seem like that. And ditto traumatic brain injury. Those don't usually cause the kind of deterioration Vince was experiencing. Then, as they were leaving the visitor's room, walking between the series of locked metal doors and barbed wire fencing, Dr. Buie stopped in his tracks. I turned to Benjamin and just raised the question. I said, could this be Huntington's? And he sort of looked at me with a surprised expression and sort of nodded his head that yeah, it might be. Huntington's disease is a horrible condition, one of the worst, like a cruel trifecta of Alzheimer's, Parkinson's, and Lou Gehrig's disease rolled into one. It causes severe emotional and physical symptoms. It's progressive, it's painful, and highly inheritable. If your parent has it, you've got a 50/50 chance of getting it. According to descriptions of Vince's father's mental and physical state, it's conceivable that's what Dalton Gilmer had. Typically, it starts to affect a person between the ages of 35 and 45. Vince's behavior began to change when he was about 40. And it's fatal. Once you have symptoms, the brain and body dwindle away. You usually die after about 20 years from a complication like pneumonia or choking. Dr. Buie and Benjamin went down a checklist of symptoms. Behavioral disturbances. Yeah, he murdered his father. Hallucinations. He's having-- he's hearing voices in his head. Irritability? He's continuing to attack other inmates, in spite of the consequences of being beat up afterwards. Moodiness. Moodiness, check. Restlessness or fidgeting, check. Paranoia, psychosis, abnormal and unusual movements, including facial movements, grimacing, quick sudden jerking movements, unsteady gait, disorientation or confusion, loss of judgment, loss of memory, personality changes, speech changes, anxiety and stress. Check, check, check, check, check, all the way down the list. Of course, the best way to tell is a genetic test, but none of us is a lawyer. We're not related to Vince. We have no standing with the Virginia Department of Corrections. So we weren't sure how to go about getting a test done. Then, three weeks later, on March 11, I found out from the DOC-- just by accident-- that Vince had been moved from Wallens Ridge to a psychiatric hospital within the prison system called Marion Correctional Treatment Center. A few calls later, I was speaking to a social worker there who eventually told me Vince had threatened suicide. They'd found a couple of razor blades in his room. This social worker asked me what Benjamin and I thought of Vince's condition. I told her Benjamin actually had an idea, Huntington's. Oh, she said. Interesting. We can test for that. The next day a psychiatrist at Marion met with Vince. A psychiatrist called Benjamin. And within a week, they'd drawn blood for the Huntington's test, and sent it off to a lab in Utah. It is the 28th of March. And it's 7:30 in the morning. I just got to the clinic. Benjamin recorded this on his own. And I opened the email. And the first line was, Vince Gilmer is positive for Huntington's. Allele number one sent 43 repeat CAGs, which means strongly positive. So we found it. We found an answer. I'm really excited and very sad at the same time. This is a terrifying diagnosis for Vince. I'm not sure what's worse, life in prison or dying prematurely and painfully from this disease. But we will see. I cannot believe it. Benjamin got this news from Vince's new psychiatrist, Dr. Colin Angliker. He's medical director and chief psychiatrist at the Marion Correctional Treatment Center. He's been a prison doctor for 25 years, which you think would make him a company man. But he's just the opposite, meaning he is the perfect doctor for Vince. He's one of those guys who enjoys proving the system wrong. Whenever I hear somebody is very much of a malingerer, I think, uh-uh. He ain't malingering. There's something else going on. Benjamin and I went to meet Dr. Angliker in Virginia last week, and he described what happened when Vince got the news. I was kind of nervous, you know? Because it's more or less like a death sentence that you're telling somebody. But much to my surprise and personal relief, he-- so far-- has taken it very well. Why do you think that is? Well, I think he had been trying to prove a point for some considerable time that there was something wrong with him. And nobody was paying any attention. They thought that, oh, it's all fake and he's putting it on. And that wasn't the case, isn't the case. Dr. Angliker says that since he put Vince on medication, he's feeling much better. He's walking better, talking better. He's less anxious. What medication, you ask? 80 milligrams of Celexa, uncrushed. What Vince has been asking for all along. Because it turns out Huntington's kills off brain cells, neurons which decrease production of neurotransmitters. So all this time, it's possible Vince did have a serotonin-deprived brain. It's possible he was right. All this makes you wonder, to be blunt, what the hell? Benjamin asked Dr. Angliker as respectful as he could, why did this take so long? To me, what's been so difficult to understand is that for nine years-- I mean, I'm a doctor. I'm not a psychiatrist. But after two visits with him, it was clear that he had a neurologic illness. There's obviously something going on. So it's very hard for me to appreciate that that could have been missed after numerous, numerous evaluations. Well, we're supposed to listen. And I have found so often that people don't listen to what patients are saying. They don't. They have a preconceived idea as to what's going on, and that's it. They are as inflexible sometimes as the system in which they find work. They have a stereotype of what an inmate is. And they won't budge beyond that. Do you think that's what happened in Vince's case? I'm afraid so. It was really horrendous. It just blows my mind how things went for him. And it's really sad. From what Dr. Angliker can tell, Vince was having psychiatric symptoms from Huntington's at the time of the killing. In other words, he was not himself when he strangled his father. And he never should have been allowed to represent himself in court. I mean, to me, it was a travesty. He should never be in a prison. But that's me. Of course, Dr. Angliker isn't a lawyer. So we asked one, Richard Bonnie, a professor at the University of Virginia School of Law and director of the Institute of Law, Psychiatry, and Public Policy. He says Vince's best shot might be for a lawyer to argue, probably in federal court, that Vince wasn't competent to represent himself at his trial, that he shouldn't have been allowed to do so. But really, Vince might be better off bypassing the courts and just trying to get what they call compassionate release. That is, if someone can pull the right strings in government. We hadn't spoken to Vince since January. He'd been in solitary on suicide watch at the Marion Hospital until last week. Finally, on Monday, we were able to arrange a phone call, our first contact with him since the diagnosis. It was shocking. Hello, Benjamin. How are you? I am, wow, ridiculously doing so much better, it's not even funny. You sound so different. I really and truly-- I mean, right now I'm so close to being back to normal. It's just-- So glad to hear that. It's just-- my brain's getting better. Vince was laughing. When we met him back at the prison three months earlier, that Vince? It didn't even occur to me that he could laugh. [LAUGHING] Yes, after all these years of hell and, yeah, having the DNA diagnosis that can't be argued with. And the fact that this treatment is working so well, it's just-- it's a miracle all the way around. And it's going to work out for the best. I know the diagnosis is terrifying. For me, I'm not terrified about it. To me, it was so relieved. After about a half hour of hearing how happy he was, how hopeful, it dawned on us. Vince doesn't know anything about Huntington's. We weren't prepared for that, since Vince is a doctor. But he doesn't know what's going to happen to him, and maybe to his sister and to her two kids, and to her three grandkids. Because they're all at risk for Huntington's now. So Benjamin did the hardest thing in the world. He told him. Vince's response was pragmatic. I mean, right now, there isn't-- what is the treatment now? Just symptomatic treatment. There's no-- nothing at this point that can reverse the process, unfortunately. Right. They talked for an hour. And Vince didn't seem defeated at all by this terrible news. For now, he's just so glad to be getting the Celexa, surrounded by people who believe what he says to them. By the end, Benjamin and Vince were just two doctors, talking about the Cane Creek clinic. Benjamin told him how his patients and friends were taking the news. Vince remembered working there, hanging out with the staff. How if they got paid in corn, they'd heat it in the microwave and dip it in butter. And how he missed working with the patients. It was such a-- what's the word for it-- a blessing, to be able to actually be there and share those people's lives. I'm sorry if you feel like the medical community turned their back on you. You didn't turn your backs on me. You did not. You came all the way across the mountains and came to see me in the prison. Because all those patients, patients that you took care of, that you take care of, they kept telling you, no. That's not him. And you're right. That's not who I am. And I'm becoming who I am again. And, um, thank you. Benjamin started out as Vince's freaked out replacement, but over the course of seven months, he'd become Vince's detective. And then, his physician, the physician Vince never had. Now, Benjamin wants to become his lawyer. He wants to get Vince out. Sarah Koenig, she's the host of Serial. Well, today's program first aired in 2013. Since then, there was an outpouring of public support for Dr. Vince Gilmer. A pro bono legal team formed to help Dr. Benjamin Gilmer fight for Vince's release. So far, the repeated appeals have been denied. Vince Gilmer is still in prison. Again, if you haven't heard the new season of Serial, I said this at the top of the show. I'll just say it again. If you're looking for a podcast, the whole thing takes place in the court system around Cleveland. I swear, you will get sucked in. Episode two, about this one judge, is a favorite of mine. But the last episode is also-- just gets so epic and beautiful at the end. The season just ended, so it is ready for your binge listening. Serialpodcast.org, or wherever you get your podcasts. Our program was produced today by Miki Meek and myself with Alex Bloomberg, Ben Calhoun, Sarah Koenig, Jonathan Menjivar, Brian Reed, Robyn Semien, Alissa Shipp, and Nancy Updike. Our senior producer for today's show is Julie Snyder, also the producer of Serial. Production help today from Anna Martin. Mixing by Stowe Nelson. Technical director, Matt Tierney. Music help for today's show from Damien Graef, from Rob Geddes. Special thanks today to Jonathan Milner, Larry Traylor at the Virginia Department of Corrections, Rebecca Young at the Wallens Ridge State Prison, Wayne Austin, Gloria Hitt, Fred Taubman at the Huntington's Disease Society of America, Deirdre Smith-Gilmer, Leona McKinney, Jay Leutze, Michelle Harris, Erin Brethauer, Jamie Nicholson, Johnny Irion, Sarah Lee Guthrie, Lou Teti, Frances Walker, Bulldog Studios in Sag Harbor, and all the staff at MAHEC Cane Creek. Our website, ThisAmericanLife.org. This American Life is distributed by PRX, the Public Radio Exchange. Thanks, as always, to our program's co-founder, Mr. Torey Malatia. You know, I just-- by coincidence-- ran into the guy who took over when Torey stopped running his Tupperware club. Yeah, I'm following the footsteps of an ax murderer. I'm Ira Glass. Back next week with more stories on This American Life.