Ultimately, that's what makes the drugs explanation, on its own, unsatisfying. After all, the same description fit him even during the long periods in his life when he was clearly not using drugs. Friends were often driven to distraction by Arndt's sense of invulnerability and need for control. But they also saw how those traits could be attractive, especially for patients in need-spurring him to take on the most challenging cases, to fight the toughest battles on their behalf.

But what happens if that need to be in control becomes more important than anything else? "David wanted people to pay attention to him and notice him," says Saiya Remmler, the psychiatrist and former med school friend. "To me, it sounds like a gradual, maybe even lifelong, struggle between greatness and tragic flaws." And what might be at the center of this Greek tragedy? She and other physicians who knew Arndt but haven't seen him in years suggest narcissistic personality disorder, where an exaggerated sense of self-importance masks a chronic emptiness. Then again, only the star of this drama knows the full story.

You do as he tells you. And he is right. The Journalist and the Murderer is a gripping piece of nonfiction. (The original New Yorker piece was published in book form in 1990.) It examines the dance between a controversial figure and a journalist trying to persuade him to share his story-one that is always something of a tango through a minefield. The relationship at the center of Janet Malcolm's book is the one between Fatal Vision author Joe McGin-niss and convicted murderer Jeffrey MacDonald. The first sentence of the book is a pretty clear preview of the analysis Malcolm will render: "Every journalist who is not too stupid or too full of himself to notice what is going on knows that what he does is morally indefensible." To be sure, the field of journalism is ill served by the selection of McGinniss as its emissary. This, after all, is a writer who, according to Malcolm, entered into a revenue-sharing arrangement with his subject and then peppered him for years with flattering, deceptive letters before crucifying him in the pages of his book.

The Journalist and the Murderer, David Arndt tells you, provides insight into his decision not to speak to you at length. It's hard to miss the casting choice he is suggesting for you in the role of this ethically challenged journalist. But his literary reference cuts both ways. After all, the other part to be cast is that of MacDonald, the physician convicted of murdering his wife, two daughters, and unborn son and implausibly blaming the carnage on a band of marauding drugged-out hippies.

In a way, the most thought-provoking portions of Malcolm's book do not involve her indictment of McGinniss but rather her own admissions. She concedes that it was easier to come down hard on McGinniss after he shut off communication with her early on.

Your own mind returns to the conversations you had with Arndt before he, too, stopped talking. "You have no idea what my life is like now," he says in the hall of the Cambridge court. "If you talk to anyone who knew me after residency, you know I am an excellent surgeon. I can no longer do what I do best, through a series of circumstances, some of them perhaps my own doing."

And then, as if on cue, his call for compassion is dislodged by a reassertion of control. "You must not do this story," he says. When you remind him that he can't control whether the story is written, but only how complete it is, he shakes his head. "You can control anything you want," he says.

How?

"Don't turn it in."

Neil Swidey is a staff writer for the Boston Globe Magazine.Hi's assignments have included reporting on the Arab world during the run-up to the Iraq war. His previous profile subjects have ranged from former Red Sox shortstop Nomar Garciaparra to the general manager who traded him, from the brother of Osama bin Laden to the one American charged with putting a price tag on each of the lives lost on September 11.

Spend enough time with David Arndt's story, and you feel as if nothing could surprise you.

His downfall has a cinematic quality to it. After being away from his story for awhile, I was curious to see how it had continued to unfold. The dramatic turns just kept coming.

Arrogant, compassionate, and reckless, David Arndt seems incapable of living his life in anything but capital letters.

Not long after this piece was published, federal prosecutors swooped in and took over the county drug case against him. They alleged Arndt was a serious drug dealer, part of a wider ring, and that the undercover sting at the Chandler Inn exposed just a glimpse of his illegal activity.

To support their case, they produced testimony in court papers from several unnamed witnesses. The most sensational allegation: that Arndt was supplementing his income by practicing "back-alley medicine." This image of Arndt, the once-rising star in the dazzling constellation of Boston medicine, furtively sewing up bullet holes in drug-trade players unwilling to go to the hospital might be dismissed as too implausible by even immoderate screenwriters. But for people who lived through Arndt's real-life fall, nothing could be considered too over the top. Even the language attributed to Arndt fits the part. One witness said the former surgeon had boasted he would have no problem "disemboweling," with just a "quick swipe of the scalpel," anyone who "ratted" on him about his drug deals.

With the new federal charges, Arndt was ordered held without bail. In the Middlesex County case involving charges of statutory child rape, a trial date was set for the fall of 2005.

Meanwhile,Arndt's malpractice insurer agreed to pay $1.25 mil-ion to Charles Algeri, the former cab driver Arndt left anesthetized on the operating table while he ran out to the bank. Algeri says Arndt botched his surgery so badly that he was left with excruciating pain and had to undergo two additional operations to try to correct the damage.

Having battled his own drug addiction years ago, Algeri says he often finds himself replaying in his mind the fateful morning when he went under the knife with Arndt. "The day he showed up, I should have known better. I said to myself, 'There's something wrong with this guy.' Dark circles under his eyes, unshaven-he was a mess. But what am I supposed to do? Ask him to pee in a cup? Piss off the guy who's about to cut me open?"

On June 29, 2005, after spending nearly a year in jail, Arndt walked into a courtroom and pleaded guilty to a host of federal drug charges, including conspiracy to distribute methamphetamine.

He did so knowing that sentencing guidelines will require him to spend a minimum of ten years in prison. The prosecutor said she will recommend a sentence of fifteen to nineteen years.

In court, Arndt was unusually contrite, telling the judge he had been addicted to drugs. "I was out of my mind," Arndt said, "and being incarcerated probably saved my life."