Mind Game

Letter from New ZealandSeptember 6, 2010 Issue
Mind Game
When a murderous shrink moved to a trusting coastal town, both had a surprise in store.
By Carl Elliott

August 30, 2010

Save this story
Illustration of a man crushing pills while looking out a window
Dr. Colin Bouwer dazzled and deceived his colleagues with ease.Illustration by Andrea Ventura
Dunedin, New Zealand—the second city of the South Island, and the home of the University of Otago—is an uncommonly peaceful place. Once, at tea in the university’s Bioethics Centre (where I’ve had a visiting appointment for some years), a nurse leaned toward me and said, “In Dunedin, we have only interesting murders.” She had a point. Rates of violent crime here are similar to those in the more placid European countries, such as Denmark and the Netherlands. But, when Dunedin does have a murder, it is spectacular. In November of 1990, three months after my wife and I first arrived in Dunedin, a mentally disturbed man named David Gray shot thirteen people in a nearby village, the deadliest murder toll in New Zealand’s history. In June, 1994, a former missionary teacher named Robin Bain and his wife and three of their children were shot dead in Dunedin very early one morning. The oldest son, David, was eventually convicted of the murders, but there was never a good explanation for the crime, and the conviction was overturned last year. In July, 2009, Clayton Weatherston, a tutor in the Otago economics department, was convicted for the murder of his ex-girlfriend, a recent graduate. She had been stabbed two hundred and sixteen times.

Even in Dunedin, however, a psychopathic psychiatrist stands out. What is striking about the case of Colin Bouwer, who was once the head of psychiatry at the University of Otago Medical School and is now a convicted murderer, was the man’s ability to fool his colleagues, many of whom would have studied psychopaths in their medical training. It’s hard to say whether his success reveals more about the nature of psychopathy or more about the character of New Zealanders.

In November of 1999, an internist at a New Zealand hospital faced two mysteries. One had to do with Colin Bouwer’s ailing wife, Annette. A forty-seven-year-old physiotherapist, she had been in good health until a few weeks earlier, when she began experiencing dizziness, blurred vision, and problems with coördination. She made an appointment with an optician and got a prescription for glasses. Annette’s symptoms did not seem especially alarming, until the morning of November 20th, when Bouwer reported that he had awoken to find her unconscious in bed. An ambulance took Annette to Dunedin Hospital, the main teaching hospital for the University of Otago.

It was quickly determined that she was in a hypoglycemic coma, which is most commonly caused by self-administered glucose-lowering drugs that diabetics use, such as insulin. But Annette did not have diabetes. Dr. Andrew Bowers, a specialist in internal medicine, was managing her care at the hospital, and he asked Colin Bouwer to search the house for drugs. He also ordered a lab test for the presence of such drugs in Annette’s blood. The test came back negative, and, during the next few days, Annette’s blood sugar stabilized. Why it had been so low in the first place remained baffling.

The other mystery was Colin Bouwer’s behavior. Bouwer, who had moved from South Africa two years earlier, was a stout, self-assured psychiatrist with an Afrikaans accent. “He gave me a warm, hard handshake, and said he was a physician, a psychologist, and a pharmacologist,” Andrew Bowers says. “He said it in an intimidating way, as if to establish that he was the one in charge.” Soon, though, Bouwer’s attitude shifted: “It was like hot and cold taps: He tried to overbear me at first, but that didn’t work, so then he tried being friendly.” Even more puzzling was Bouwer’s lack of medical knowledge: he had described himself as an expert in internal medicine, yet he seemed unable to discuss the diagnostic tests associated with hypoglycemia.

Four days after Annette was discharged from the hospital, she went into another coma, and was readmitted. After an extensive workup, the endocrinologists consulting on the case came to think that Annette might have an insulinoma, a rare neuroendocrine tumor, but a pathology report later revealed no sign of one, and her condition, once more, had stabilized. About a week after she was discharged again, Annette’s symptoms returned, and she was readmitted again.

Andrew Bowers is a genial, dark-haired man in his mid-forties, with the tired eyes and the slightly doughy skin of someone who has spent too much time indoors. “Annette was scared,” he says. She had lapsed into two comas in nine days, and no one could tell her why. At the time, Bowers was only three years out of training. “I was feeling insecure about what was going on,” he says. “I was thinking, Is there anything that I’m missing?” His insecurity colored his interactions with Colin Bouwer, who, as head of the Department of Psychological Medicine, was several notches higher than Bowers in the academic hierarchy.