Craiglist Killer, Philip Markoff, Suicide: Why Did He Do It?

When Philip Markoff, the med student charged with murdering an Internet escort, killed himself Sunday, a new mystery emerged: how could officials miss the suicide threat? By Wendy Murphy

When Philip Markoff, the med student charged with murdering an Internet escort, killed himself Sunday, a new mystery emerged: how could officials miss the suicide threat?

Philip Markoff, 24, the handsome Boston University Medical Student believed by authorities to be the so-called "Craigslist Killer", committed suicide in his Boston jail cell Sunday—and an awful lot of people are saying they're not surprised.

As far back as the spring of last year, Markoff was placed on suicide watch immediately after his arrest on murder charges in the shooting death of Internet "escort" Julia Brisman, 25, at a Boston hotel. Jail guards noticed markings on his neck indicating he had attempted to strangle himself with his shoelaces. He reportedly attempted suicide again a week later after his fiancé broke off their engagement. He then spent about a month in a segregated unit where he was under constant watch, but was released back into general population until he tried again to commit suicide on what would have been his wedding day, August 14, 2009.

How hard can it be to make sure a guy in a six-by-six cell—with no freedom to even use the toilet in privacy—doesn't have the time or the tools to take his own life?

Markoff was then sent to a special medical unit in the jail, but more recently, officials say, he was back in general population, seemingly doing well, and socializing with other inmates.

So the question becomes, why? Why wasn't it enough to put the guy in a secure cell for prisoners at high risk for suicide that he'd tried three times to take his own life? After all, acording to one national study, one-third of prisoners who commit suicide have a history of suicidal behavior, and almost 40 percent, like Markoff, have a history of mental illness.

Maybe Markoff felt ashamed about a crop of sexuality issues that emerged after his arrest. Maybe he felt terrible about killing a human being. Maybe he didn't want to put his family through the embarrassment of a trial—or he just couldn't handle the transition from freedom to incarceration. Lots of suicidal prisoners kill themselves as a literal form of escape.

Markoff's death also came one day after what would have been the one-year anniversary of his wedding to Megan McAllister, the woman with whom he was living and to whom he was engaged at the time of Brisman's murder. Another red flag, to be sure, because he tried to commit suicide one year ago, on the day he was to be married. One needn't be named Freud to put that one together.

Jail officials knew all this, and yet the guy was not only not being watched 24/7, he was allowed to use disposable razors—which may be how he managed to take his own life. (Reports are conflicting, with some sources saying Markoff used a pen.) Most suicidal prisoners have to be creative because responsible prisons officials don't want to make it easy—not only because it's bad for PR but also because it causes expensive lawsuits. No surprise then that 93 percent of prisoners who commit suicide do so by hanging—most often using bedding as the deadly device. If Markoff used a razor, that would be particularly problematic for a lawsuit.

Yet Markoff may have used a razor blade, from a disposable razor that non-suicidal inmates are authorized to use, to cut his wrists and a major femoral artery in his leg. According to law enforcement sources who spoke with ABC News, he wrapped a garbage bag around the wound to his leg to hide the blood, then put another garbage bag over his head and tied it around his neck. Officials at the jail said Markoff knew what he was doing and "used his medical expertise" to ensure his suicide would be successful. Sounds like the early stages of a defense strategy: "There was nothing we could do to stop him because he was so much smarter than us dumb guards." Massachusetts has had an unusually high rate of successful prisoner suicides recently and the problem has been getting worse since 2001. Fifteen prisoners committed suicide between 2005 and 2007, and nine have taken their lives already this year alone. The number of attempted suicides was a shocking 516 in 2006.

It's not that state officials haven't recognized the problem. In 2007, a consultant hired to fix this issue concluded that placing prisoners on suicide watch in empty cells, and making them wear gowns instead of regular prison garb, were part of the problem, because they "exacerbate a sense of isolation and discourage some inmates from reporting suicidal feelings."

Philip Markoff was apparently a beneficiary of these ideas as he was back in general population, not wearing a paper gown, despite multiple suicide attempts. Maybe the consultant should have explained that for some prisoners, the paper gown is a perfect fit. National studies show that comprehensive training programs in suicide prevention are an important piece of the puzzle, as is the simple act of constant monitoring. Only a tiny percentage of those who were being watched successfully completed the act.

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Mental health experts will tell you—and The Sheriff's Department will hammer this point to death in a lawsuit—that when a prisoner is hellbent on suicide, there's nothing you can do to stop him. Maybe this is true in some cases—and it is certainly true in the real world where, unless someone is committed to a mental health facility, people are free to hide themselves from others and avoid being saved.

But how hard can it be to make sure a guy in a six-by-six cell—with no freedom to even use the toilet in privacy—doesn't have the time or the tools to take his own life?

Those are the questions we're stuck with. Rather than explore if or how a man in the prime of his life—on the verge of becoming a medical doctor—and on the eve of marrying a beautiful woman—decides to become a vicious killer, and how much of a role, if any, Craigslist played, a different trial will likely take place in a few years; one where Markoff will be the sympathetic character and we'll be hearing about how much he endured—and how nobody cared, etc.

I'd have preferred to watch the guy suffer full disclosure of the whole truth—in a courtroom where he would have been made to confront the horrific reality of what he almost assuredly did.

We don't tend to give a damn about prisoners—especially the ones who kill in cold blood, or pick on the vulnerable, and Markoff fit both categories.

But maybe it's time we should give a damn. Not only because nobody deserves to die but because it's inherent in the very definition of justice that killers be forced to stay alive long enough to face their victims—and their demons.

Wendy is a former child abuse and sex crimes prosecutor who teaches at New England Law/Boston. Wendy specializes in the representation of crime victims, women and children. She also writes and lectures widely on victims' rights and criminal justice policy. Her expose of the American legal system, And Justice For Some, came out in 2007. A former NFL cheerleader and visiting scholar at Harvard Law School, Wendy lives outside Boston with her husband and five children.