My impressions of Dr. MacDonald are based on previous reports, upon three examinations of him on July 11, 12, and 16, 1979 (which lasted over two hours each and by interviews, one by telephone, and one face-to-face, with women with whom he had been intimate.  In one of these three interviews with Dr. MacDonald on July 12, 1979, his mother was present throughout.  Her presence was useful in obtaining objective data about his childhood, and about other members of his family, and in observing the manner in which he and his mother related.

First, with regard to the crime, Dr. MacDonald's recollections are basically the same as those reported to Dr. Sadoff.  I understand that Dr. MacDonald recently was able to recall many new details of the offense while under hypnosis and that some of the details may be different from those he originally recounted in the earlier part of the decade.  He is aware that there may be changes in his reporting over the years and that some of his recollections under hypnosis may result in slight changes in the nature of his future testimony.  (For example, he states his description of the intruders as described to an artist under hypnosis are different from those he described in 1970.)

It might also be worth noting, although I realize you have this information, that Kristen's bedwetting had begun only after she had been told that her mother was expecting a new baby.
     This new behavior was not according to Dr. MacDonald a major area of contention between he and his wife, although they did disagree about how it should be handled.  Dr. MacDonald had spent the previous night working in the Emergency Clinic in Hamlet, North Carolina.  He had had a relatively easy morning on the night of the killing and had napped in the afternoon.

This accounts for his having stayed up late.

Other than the above information which you are undoubtedly aware of, I have nothing to add to Dr. Sadoff's report with regard to the crime itself.

Dr. MacDonald is the second of three children born to a middle-class family in Patchogue, New York.  His father is described by both Dr. MacDonald and his mother as an extremely unusual and powerful man.  He was exceptionally bright and a voracious reader.  He was self-educated and always felt some defensiveness that his work as an electrical designer at the Brookhaven Laboratory he could not achieve the recognition he felt he deserved.  The father emerges as a complicated person.  He is primarily described as lovable, warm and charming.

But, he is also described as a very opinionated, powerful and somewhat tortured man who in his later years drank heavily.  There is no indication from his mother or Dr. MacDonald that the father was ever anything but loving towards the children.  At the same time, the children were raised strictly.  It is important to note that no parental violence was ever inflicted on Dr. MacDonald (there is much evidence that violent people were themselves once victims of violence).  The charisma of the father was enough to inculcate powerful internal controls in the children.  Dr. MacDonald is still a person highly respectful to authority and highly responsive to the demands of authority figures.

The mother is described by one of Dr. MacDonald's friends and comes across to me as a warm, giving and loving person.  Like Dr. MacDonald, she is very talkative, inquisitive and interested in detail.  She is proud of him and is obviously impressed with his capabilities.  The two of them relate in a rather warm mother-son relationship.  She still feels she must look after him.  As is appropriate for their ages, however, he is now becoming more concerned and protective of her.  He worries that she has not remarried after the death of her husband in 1966, is concerned that she worries too much about him and his brother, and is generally concerned for her welfare.  The genuine warmth which radiates between mother and son suggests that it is unlikely that he would harbor unusual hostile feelings towards women or family members.

Dr. MacDonald's older brother (18 months older) has had serious psychiatric difficulties since his youth.  He is described as having been a bright and gifted person.  But, after experiences with amphetamines and alcohol in mid-1960's, he underwent a psychotic break and has never fully recovered.  He has been hospitalized for treatment of mental illness in the past and although he currently married and is living successfully out of the hospital, he continues to have psychiatric difficulties.

His sister who is currently 18 months younger is described as a warm and passionate person (much like the father) who is prone to worry excessively.  She has had some emotional difficulties in the past, is currently divorced.

Dr. MacDonald remains close to both his brother and sister.  It is interesting to note that with all of his own troubles, as he and his mother began to talk about the older son's difficulties, they both became carried away and lost sight of Dr. MacDonald as the focus of the interview.  They repeatedly asked me for advice as to how they could be of help to him and would have talked about him for hours if I had not changed the subject.  I have a strong impression that the family has been and continues to be an extremely closely knit unit.

The mother describes Dr. MacDonald with some amazement and pride as having been a remarkably joyful and pleasant child from almost the beginning of his existence.  The main word to characterize him she used was "sunny."  Even as an infant, he was constantly inquisitive.

She reports that he was almost always happy as a child and at an early age showed signs of being exceptionally bright.  He had the capacity to make friends easily in spite of the fact that he was frequently held up to other youth as a model of good behavior.  The mother describes the "All American Boy"  behavior of her son with obvious admiration and gratitude.
     Neither she nor Dr. MacDonald can recall any major conflicts during his childhood.  (Of course, mothers would be more likely to recall the pleasant rather than unpleasant memories of their children.)  During high school he excelled academically and in athletics.  His popularity continued and his subsequent academic and social success have been well documented in previous reports.

Dr. MacDonald and his deceased wife were childhood sweethearts.  They had known each other in high school and dated intermittently up until the time of their marriage.  I spent a certain amount of time trying to gain more data about the deceased wife and her family.

According to both Dr. MacDonald and his mother, she was a bright, though somewhat unsophisticated woman, warm and giving towards the children, and fully committed to the traditional role of the doctor's wife.  By this, I mean that she was quite willing to stay home and raise the children and delay whatever career aspirations she had until the children were grown.

There is some history of emotional instability in Colette's family (she was seven when her father hung himself), but whether this has any relevance to the case is debatable.  The children are described as previously.  The eldest, Kimberly, who was six at the time of her death, was viewed by both her grandmother and Dr. MacDonald as a warm, passive, highly "feminine" girl.  The youngest, Kristen, who was three at the time of her death was viewed as more assertive, more inquisitive, more aggressive, and almost protective of the older sister.

Dr MacDonald's sexual experiences began at age fourteen.  He had several experiences before marriage and was having sexual relationship with his wife before marriage.  During his marriage he had some affairs which he refers to as "one-night stands."  He felt guilty, afterwards, but his guilt was not massive.  He would wonder afterwards why he would risk his marriage over activities that mean so little to him.  He does not consider his infidelity to be unusual or harmful to the marriage, but when asked how he would feel at that time if his wife had been engaging in similar activities, he readily admits that he would have been deeply hurt.  His extramarital affairs were according to him not discussed with his wife and not known to her.

Dr. MacDonald reports no unusual sexual proclivities.  His statements are substantiated by two of the women I have interviewed who have been intimate with him.  Most important, they report there as never been any hint of sadomasochism, cruelty, or wish to humiliate or impose helplessness upon the partner.  They emphasize his concern for women and his kindness to them.

At age thirteen or fourteen, an older man tried to seduce Dr. MacDonald.  No sexual act was consummated, but he was somewhat troubled by this experience until he had had enough successful experiences with women to feel secure about himself.  At the age of seventeen or eighteen he was a cab driver on Fire Island and had several overtures made to him by homosexuals.  He is still conventional enough to look upon gay people as aberrant, but he does not condemn them and they do not threaten him.

According to his own reports and those of his mother and girlfriends, Dr. MacDonald does not abuse drugs.  He has an occasional cocktail but no one has ever seen him drunk.  He does not use sedatives, stimulants, or non-prescription drugs.

I spent considerable time focusing upon the subject's adjustment in the last eight years.  He has been reasonably successful as an emergency room physician in California.  He works hard and takes pride in his craftsmanship as a doctor.  Indeed if there is anything he wishes to be identified as, it is a doctor.  Many people, including the women I interviewed, have remarked about his unusual interest in his patients and his unusual interest in people.  He has demonstrated considerable and impressive compassion towards patients and probably could have made a lot more money if he were less concerned with human needs and less compassionate.

It might also be noted that while Dr. MacDonald on most accounts would be viewed as having had a very successful professional career, his abilities are such that he might have done better had it not been for the murders and intervening events.  His commitment and intelligence is such that he might have made very significant contributions to academic and research medicine.

In the last eight years, Dr MacDonald has had two serious involvements with the two women I have interviewed.  In each case, the involvements were terminated when the possibility of marriage became more imminent.  In each case, Dr. MacDonald felt that he could not get married as long as the trial was hanging over his head.  When pressed on this issue, he acknowledges that he is not certain whether or not this might have been a "cop-out."  He is not sure if he avoided marriage because of the oppressive situation he finds himself in or if there is some other reason such as a wish to remain single or lack of sufficient attraction to his partners to make a permanent commitment.  Both of his former girl friends had a different theory.  They felt that he was still mourning his wife and children and still too emotionally involved with his wife to make a new marriage.

Mental Status Examination

Each time I have seen him, Dr. MacDonald has been neatly and well dressed.  He is regularly friendly and eager to talk.  His mother's description of him as a "sunny" person still remains relatively accurate today in spite of the events of the past ten years.  He is a remarkably curious person, always talkative, always active, always intense, usually effervescent and at time charming.  He has a pervasive curiosity and constantly wishes to share thoughts and ideas.  I found it rather difficult to interrupt him at times because he likes to talk and what he says is usually interesting.  His affability and charm which has impressed so many people in the past remains quite apparent in the psychiatric interview.  He also carries about him a certain amount of charisma.  He impresses me as a person who can attract others and influence them.

He is fully oriented.  There are no distortions in the content or progression of his thoughts.

Given all that has happened to him, he is remarkably non-paranoid.  This does not mean that he is not angry.  He feels that he has been treated extremely unfairly.  But, he relates this to the ineptness, stupidity, or emotional difficulties of others and does not engage in grandiose explanations for what he views as his persecution.  He also can see that his own survival and capacity to lead a relatively good life after losing his family might anger other or make them suspicious of him.

The subject is remorseful about many things.  He continues to blame himself for not having saved his wife and children.  He also feels he behaved stupidly when he told his father-in-law that he had caught and killed one of the murders in an effort to stop his father-in-law from constantly urging the subject to devote his full attention to vengeance.  He was extremely embarrassed as he related how his fabrication to his father-in-law had probably led to that person becoming suspicious of him and becoming a significant factor in persuading the government to continue prosecution.  He is correctly aware that his judgment in this instant was extremely bad.

Dr MacDonald continues to impress me as a person who has had strict codes of conduct inculcated into him and who still adheres to them.  He values qualities which lead him to do the "right thing."  While he certainly does good things in order to gain the approval of others, I suspect much of his moral behavior has at this point in his life been internalized.  By this I mean that he firmly and automatically believes it is natural to try and help others, to be kind, to be concerned, and to lead a relatively conventional life.

He also continues to value physical fitness.  His need to preserve an image as a physically powerful male may be receding somewhat as he approaches middle-age, but still engages in vigorous exercise and running on a daily basis.  He has been involved in one brief physical altercation in the last ten years.  This, according to his girl friend, involved his defending himself after having been involved in an automobile accident with a belligerent driver.  The fight terminated without anyone getting hurt.

Dr MacDonald reports that he has been chronically depressed over the last several years.  He believes that the constant threat of the trial, his inability to settle down with a woman he loves, and the psychological losses he has experienced have taken some toll.  It is my impression that he has not fully mourned the death of his wife and children and that such mourning probably will not be completed until the issue of his guilt has been decided.

While the subject doe not come across as a seriously depressed person, he does report that life is relatively joyless.  He continues to cry at times when alone.  He cried on three different occasions during the interview when discussing the death of his children.  He has not been able to cry in the presence of any other woman, but his mother reports that on one occasion since the murder of his family, he has broken down and sobbed on her shoulder for a long period of time.

The years of uncertainty in his life do seem to have taken some toll.  In comparing my impressions with those of other people who have interviewed him, I find Dr. MacDonald to be a little sadder, a little more insightful into his own motivations and perhaps a little more tolerant of others.  He is very much in fear that once the whole situation is resolved and he is exonerated that he will experience some kind of depression or mental illness.  He wonders if many of the feelings of anger and hurt he has suppressed will overwhelm him.  He continues to remain sensitive to the needs of others, but I also suspect he has recently become more introspective and sensitive to his own needs.  I do not mean to say that all of his ordeal has led him into any major existential or religious conversion, but there is clearly something changing about this man.

Some of his capacity to deal with his problems may be related to their external nature.  He can gain some comfort by explaining his current miseries in terms of what others have done for him.

His "martyred" role also gives a special status and attracts many people to him, many of whom have become his supporters and good friends.  While I am certain he would just as soon not be a "media event,"  he does gain something from being a public figure.  He acknowledges this without defensiveness.

In summary, I find Dr. MacDonald to be one of those people who was born with a temperament that allows him to use qualities of inquisitiveness, curiosity, intelligence and cheerfulness to surmount ordeals that would seriously twist or flatten ordinary people.  If one adopts a psychoanalytic theory, these traits could be explained on the basis of his having been exposed to a firm, powerful and kind father, and a warm, giving mother.  I suspect a more accurate (but not contradictory) formulation is that he was merely blessed with a stable constitution.  At any rate, he is a person who has been able to tolerate an extraordinary amount of stress and still have a highly successful career and maintain an outer semblance of being a happy and cheerful person.  The quality of his apparent cheerfulness under such adverse circumstances can certainly arouse jealousy and annoyance in those who have less sufficient coping mechanisms.  Initially, I found Dr. MacDonald's relative ease and enthusiasm somewhat disarming, but as I got to know him better, it became apparent that this characteristic had little to do with his capacity to feel and suffer.  He does feel and he does suffer, but he is less adversely influenced by noxious events than most of us.

Dr. MacDonald does not have a mental illness.  He is moderately and chronically depressed but this is understandable given what is happening to him.  His personality characteristics, while different than the average, are certainly not out of the range of normality.  By this I mean that his patterns of interaction and coping are not such as to inflict suffering on himself or others.

With the exception of a certain heightened preoccupation with his masculine image (which in many situations is quite normal), Dr. MacDonald does not show any of the traits associated with violence.  He does not have a type of personality disorder which has on occasion been seen in men who murder their families.  There is no evidence that he was psychotic preceding, during or after the murders.  There is no evidence that he had an organic syndrome of any type.  (Here, I am relying on the negative findings which were noted on an earlier examination.) There is absolutely no evidence that he has been prone to impulsive behavior or has poor ego controls.

On the basis of my clinical experience as a psychiatrist and criminologist and on the basis of my knowledge of theories and research in the area of violence, I would conclude that there is only an extremely remote possibility that a person of his type would commit a crime of this type.  Certainly, no one with Dr. MacDonald's personality organization has ever been known to commit such a crime.