Forensic nurses, regardless of their practice area, will at times come in contact with the same types of deviant behavior. Some of these behaviors may be considered rare or even non-existent. It is to our benefit that we share our investigative experiences with these cases. Vampirism is one such behavior.
In the modern age, vampires have become media stars. The word "vampire" became a household name in 1897 after the publication of "Dracula."1 More recently, the vampire novels by Anne Rice have become best sellers.2 Television shows such as "Buffy: The Vampire Slayer" and movies with vampire themes are increasingly popular. However the popularity of these characters can lead some people, teenagers in particular, down a dangerous road.
A 17-year-old white male was found unresponsive in his bedroom by his parents. He was on his knees, on the floor, with his head resting on the bed. A call was placed to 9-1-1 and emergency medical services (EMS) transported him to a local hospital. He was pronounced dead in the emergency room (ER). The deceased was noted to have a history of ADD and had been prescribed Prozac and Adderral. He was a very popular teenager who was active in many high school activities. He had recently lost Internet privileges and the Internet name he used was "Vampireboy."
During the scene investigation a black and white composition book was found next to his bed. In this 40-page journal, which was written in long hand, the deceased described himself as a "Vampiresis." In great detail, he described how he became a Vampiresis and instructs others to do the same. A sample bottle of Zoloft was found in his bathroom. At autopsy it was noted that the canine teeth appeared to have been filed. Sixteen ounces of blood was found in the stomach and 4 ounces of mucoid bloody fluid was found in the duodenum. There were no signs of ulceration or other cause for bleeding.
Mythical Vampires vs. Clinical Vampirism
There are beliefs and superstitions regarding vampires that date back to medieval Europe. The vampire is thought to be of Slavic origin. They are fictional characters that are believed to be evil spirits that have been refused entry into another world after death because of some unsuitable behavior. They must drink the blood of the living in order to sustain themselves. These mythical characters live in cemeteries and only leave their gravesite at night. They do not have a real identity and therefore do not cast a shadow or a reflection in a mirror. If bitten by a vampire, you could become one. Vampires are immortal beings that can only be killed with a wooden stake that must be stabbed through their heart.3
Reported in the medical literature for more than a century and named after the mythical vampire, clinical vampirism is a recognizable, although rare, clinical entity characterized by periodic compulsive blood drinking and an affinity with death.3 The cases documented in the medical literature only refer to those cases in which there is obvious psychosis. Very little has been written about vampire subcultures in which individuals pretend to be and act out vampire-like characteristics. In those cases in which there is psychosis, the patients have an irresistible urge for blood ingestion, which is a ritual that brings them relief. They are attracted to death, not because they want to bring release to any suffering, but because they wish to experience it as a "living dead" being.3
Clinical vampirism groups some of the most shocking pathological behaviors observed. It is one of the few pathological manifestations that blends myth and reality in dramatic fashion and contains many possible elements including schizophrenia, psychopathic and perverse features.4 Vampirism and sexual behavior are clearly linked. The "love bite," which is considered normal and a fairly common sign of affection, should be an interesting topic of discussion among sexual assault nurses examiners (SANEs) and other investigators who examine bite marks.4
The documented cases in the medical literature reveal similar findings. It has been noted that these individuals get sexual satisfaction from drinking blood. They believe that by drinking blood they will have an increase in strength and immunity prolonging their life. In many cases the individual enjoyed drinking their own blood, known as "auto vampirism."4 Vampirism is not thought to be the primary symptom of a psychiatric or psychopathic disorder.3 The condition is not likely to be discovered except in criminal cases where evidence is restricted by judicial ruling or by chance via psychiatric examination or surgical treatment of self-inflicted injuries. This may be the reason why so few cases are reported in the medical literature. Forensic psychiatrist Dr. R.S. McCully, at the Medical University of South Carolina, treated a 28-year-old male. It was reported that since the age of puberty he began masturbating and took erotic satisfaction in seeing his own blood. With practice he was able to direct blood spurts into his mouth.5
A case involving a woman who was four months pregnant also was reported. This patient was repeatedly hospitalized for vomiting large amounts of blood and enjoyed the sight of this blood. Blood transfusions were ordered and the patient would unhook them, stating she would rather drink the blood. Initially the cause for the bleeding was unknown. Later, a mouth exam revealed several bleeding wounds at the base of her tongue. The patient would suck at these wounds and swallow the blood. After her death, an autopsy revealed a stomach bloated with blood.2
In other documented cases, inmates in correctional institutions were caught trying to steal iron tablets. The inmates feared developing anemia, as another inmate had been trading sexual favors with the inmates for the opportunity to suck their blood.
Many criminal cases have been reported involving cases of vampirism. A few well-documented cases include the following. In 1996, a group of five teenagers from Kentucky were charged with first-degree murder in Florida, for killing the parents of one of the members. The five belonged to a cult thought to have 35 members in Kentucky. One year prior to the murder this group began playing a popular game called "Vampire, the Masquerade." This clan called themselves the "Victorian Age Masquerade Performance Society" or VAMPS. The leader engaged the group and others, in drugs, group sex and violence, which was masked by what was thought to be a theater group.6
In San Francisco in 1987 a student was jogging when he was forced into a van. The assailant slashed his cheek, drank his blood and then released him without further harm.7 In 2002, a 19-year-old in Virginia, was charged with murder after stabbing another person 30 times. In his police confession he mentioned vampirism and stated that the taste of the deceased's blood drove him into a frenzy.8
When vampirism is embedded in a psychopathic personality disorder the potential for extremely dangerous behavior is compounded as seen in the above criminal cases. Many of theses cases involve obvious psychosis, however there is a subculture of individuals who practice vampirism out of choice and preference.
Contemporary interest in vampire-like cults began out of several role-playing games such as "Masquerade" and "Dungeons & Dragons." During many of these role-playing games, the participants want to be among the chosen beings. This can lead to a far-fetched psychological dependence. These participants are often individuals who are outcasts and are looking for an opportunity to belong to a group. These "wanna-bes" believe that by sharing their blood with other participants they will become one with that person. By sharing their life source, their blood, they in essence are bound for life and become one soul. Many of these individuals have no psychiatric history, however they are seeking close relationships with other people and want to belong to a group. This behavior for many is an attention seeking behavior.
Those persons looking for others to connect with have easy access to many others via the Internet. There are hundreds of Web sites where those who are curious about vampirism can go to gain information and network with others. Many of these Web sites offer live chat rooms and bulletin boards where messages are posted by those wanting to be blood donors or those wanting to be a receiver of others blood. Many magazines focus on the paranormal and include articles on vampirism. Individuals and groups who try to educate and promote vampirism publish newsletters on the subject. Teens today are modeling themselves after media stars who engage in vampiristic practices. According to the Associated Press, actors Angelina Jolie and Bill Bob Thornton, used to wear around their necks glass vials containing each other's blood.9 Teenagers model the behavior of these personalities in the hopes of acquiring the traits of the stars and vampires in general. Vampires fascinate many adolescents.
When investigating cases with vampiristic overtones, there are a few things to look for.
"Book of Shadows." These books are blank journals in which the individual writes his or her thoughts similar to a diary. Often, black and white composition books are used; however, in some paranormal specialty stores journal books can be purchased that are titled "Book of Shadows" on the cover. The writing in the books often has to do to with paranormal activity, which may include vampirism. The owner of the book will often quote song lyrics, draw pictures and provide instruction to potential readers as to how to follow in their footsteps. The drawings may be symbols that represent vampirism.
Dental Records. Dental records can be obtained to determine whether the individual has filed his or her teeth. By obtaining dental records from the earliest known dental visit, it can be determined if the teeth have been sharpened. Unfortunately, since many of these participants are teenagers, the dental records available may be minimal.
Non-human blood tests. Blood tests can be used to determine if a blood sample is that of human blood or animal blood. Investigators need to speak directly with the laboratory technician to determine the capability of the lab in testing for the animal about which you may be concerned. During the investigation for the case study presented, a blood sample was sent to a forensic science lab with a request to determine if the blood may be pig's blood. This lab did not have the capabilities to complete that request and the sample had to be sent to another lab.
The practice of vampirism can be dangerous for those who choose to act out characteristics of these mythical characters. Vampirism can also be dangerous to others if this practice is mixed with psychosis. For many teenagers who become involved in these activities, there can be confusion when myth and reality are blended. In the aforementioned case study, it was determined that this teenager died as the result of a Prozac and Zoloft overdose. The tests to determine the source of the blood in the stomach were inconclusive. Friends of the deceased stated that this teen and others dabbled in vampirism. They said this teenager took it too far and began to believe that he was immortal.
Forensic nurse investigators may come in contact with these deviant behaviors whether the individual is seeking medical attention, enters the criminal justice system or if a victim enters one of these systems. Montaque Summers once stated, "Cases of vampirism may be said to be in our time a rare occult phenomenon. Yet whether we are justified in supposing that they are less frequent today than in past centuries I am far from certain. One thing is plain: not that they do not occur but that they are carefully hushed up and stifled."10 To investigate these cases thoroughly, we must first realize that the practice exists and where to turn for assistance.
Bobbi Jo O'Neal, RN, BSN, F-ABMDI is a deputy coroner for the Charleston County Coroner's Office in Charleston, S.C.
1. Stoker B. Dracula. New York: Modern Library, 1987.
2. Jaffe PD and DiCataldo F. (1994) Clinical vampirism: blending myth and reality. Bull Am Acad Psych Law. 22(4), 533-544.
3. Hemphill RE and Zabow T. (1983) Clinical vampirism: a presentation of 3 cases and a re-evaluation of Haigh, the "acid-bath murder." South African Med. J. 63, 278-281.
4. Prins H. (1984) Vampirism: legendary or clinical phenomenon. Med Sci Law. 24(4), 283-293.
5. McCully RS. (1964) Vampirism: historical perspective and underlying process in relation to a case or auto-vampirism. J Nerv and Ment Disease. 139, 440-452.
6. Miller T, Veltkamp L, Kraus R, Lane T and Heister T. (1999) An adolescent vampire cult in rural America: clinical issues and case study. Child Psychiatry and Human Development. 29(3), 209-219.
7. The Independent. (1987) Vampire strikes. 19 August.
8. The Post & Courier (2002) Trial looms for woman charged in father's death. 7 October.
9. The Post & Courier (2001) Actress Jolie thirsts for husband's blood. 16 June.
10. Summers M. (1928) The vampire: his kith and kin. London Routledge and Kegan Paul: Trench and Trubner.
Author: Bobbi Jo O'Neal, RN, BSN, F-ABMDI
Source: Forensic Nurse