Jory F. Goodman, MD
I believe that Nikolas Cruz has a form of fetal alcohol/drug syndrome, a diagnosis that can be readily made by his facial characteristics.
I am an experienced neuropsychiatrist. From the information available, we know that Mr. Cruz was adopted at birth or as a small child. While his genetic history is not available to us, it is certainly possible that the mother had a drug and/or alcohol problem.
The facial characteristics Mr. Cruz evidences are not a birth trauma issue. Intrauterine development was affected all along the way by drugs or alcohol. An outlying possibility would be an infectious process, but this is not likely.
The physiognomy is classic for fetal alcohol/drug syndrome. Mr. Cruz’s eyes are slanted downward, towards the nose. His ears are lower set and protruding.
Individuals with fetal alcohol/drug syndrome have characteristic behavioral and emotional problems. Usually they have learning disabilities and, frequently, features of attention deficit disorder. They do not fit in well, socially or academically, and tend to be frustrated and angry. They sometimes become increasingly sociopathic, in the sense that they are amoral; they have little or no sense of guilt. As they get older, the world becomes more difficult for them. They have no insight into this and become increasingly angry and frustrated and lash out. Almost always, it is in a small way. But, not this time (if my theory is correct).
Clinically, I see patients like this every day, brought into the hospital because of behavior that is dangerous to self or others. Substance abuse is very common. And, as described in the literature and clinical experience, they are not treatable, in any meaningful way.
It troubles me greatly that, during Mr. Cruz’s life, no one was able to put the pieces together: adoption, psychosocial problems and increasing dysfunction are all textbook. Yet, all it really takes is one look at his face. The first time I saw Mr. Cruz on television, I felt comfortable making the diagnosis.
Jory F. Goodman, M.D. is a practicing psychiatrist and noted diagnostician in Beverly Hills, California