A man who borrowed cars.

robbery when his wife came to the neurology department at our hospital, in May, 1997, to ask for advice. At the age of 33, her husband had had a subarachnoid haemorrhage due to a ruptured aneurysm of the anterior communicating artery, and had undergone surgery a few days later. Up to then, he had no medical or psychiatric history, and had never been in trouble. He was married, had a daughter, and had been working for 10 years as a test driver in the same car factory. During the operation, his aneurysm ruptured again and the right pericallosal artery had to be clipped. He was discharged from hospital 1 month later, apparently well. Because of the aneurysm, he was not allowed to resume his previous work and was given an administrative job, in an office above the car park. A few weeks later, he took one of the cars, which were routinely kept with the keys in the ignition, drove to his home, and parked close by. He repeated this behaviour several times over the next few weeks, accumulating borrowed cars in the vicinity of his house. He apparently thought he was playing some kind of joke on his employer. He was arrested by the police. This was the first incident of its kind in a long series. Over the next 17 years, he spent about 8 locked up, during more than a dozen stays in prison. His misdemeanours were stereotyped. During periods of idleness and depression, he suffered from a compulsive urge to borrow a car. He would then drink some alcohol and go out looking for a car with the keys left in the ignition, which he took for only a short ride. Although he was well aware that this was illegal, borrowing cars gave him a kind of pleasurable relief. He never tried to sell the cars, but simply abandoned them in isolated places. He estimated that over the years he had borrowed close to 100 cars. Since his haemorrhage, he had become incapable of holding a job for more than a few weeks or months at a time, owing to his unpunctuality and the consequences of his compulsion. He also had periods of reactive depression. He was given psychotherapy, and was treated variously with clomipramine, valpromide, paroxetine, and bromazepam for brief periods. Neither medication or psychotherapy had clear-cut benefits. After his release from prison, he was …