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The classroom of law enforcement officers all donned headphones and pushed “play” on the attached MP3 player.

What they heard was a staticky background noise, overlaid with snatches of conversation, and punctuated with random bursts of words—“disGUSting!” “stop it! Stop it now!”—along with giddy giggles and eerie, guttural growls.

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My first significant exposure to the “criminally insane” came many years ago when I was a physician assistant student in Baltimore, Maryland.