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But Barbara Lang says she had started to see cracks in her friend's normally even-keeled demeanor.

"We'd usually speak every day even before Kevin got into the office," she says, "and he always was a self-critic, even though he was the smartest man I've ever known. But he'd become really unsure of himself, shaky."

Lang recalls that "Kevin did a presentation for a ratings agency, and afterward he told me that he'd slipped, made a mistake. That really bothered him. Then around November, he started becoming paranoid, increasingly so."

As for the MRI, Keogh's earlier experiences with the high-tech machine had left him feeling claustrophobic, and he awaited his appointment with trepidation.

A doctor wrote a prescription for Valium, the bottle of which police found in Keogh's Mercedes after he died. But the anti-anxiety pill didn't help, and Keogh asked the MRI operator to stop the test soon after it started.

A medical dictionary says a psychotic person may suffer from agitation, anxiety, panic attacks, delusions, paranoia, difficulty concentrating and altered sleep patterns.

All that defined Kevin Keogh's state of mind in late 2004.

"He was constantly telling me that he was going to lose his job," Karlene Keogh says, "and that there was a conspiracy to get rid of him. He wasn't eating much, and he wasn't sleeping much, either. But he was very, very convincing about what he said was going on down at City Hall."

That Thanksgiving, Keogh and his wife went to a party hosted by friends. He seemed distracted and distant during the entire evening.

Some of the guests asked Mrs. Keogh if the couple had been fighting.

She explained that he just wasn't feeling well.

Kevin Keogh drove home on the afternoon of Friday, December 3, 2004, utterly spent from his workweek.

Mrs. Keogh says he continued to obsess over that weekend about his job status, apparently convinced he was going to get fired that Monday.

The couple spoke of trying a fresh start in California, with new jobs and a new life. In the short term, they were looking forward to that needed vacation together in Italy.

Mrs. Keogh says she persuaded her husband to make an appointment with local psychologist Dr. Dawn Noggle.

In a letter to Mrs. Keogh, Dr. Noggle later described the hourlong phone conversation she'd had with Keogh that Saturday:

"He related a number of concerns about his [job] regarding performance, others' perceptions of his performance, pressure he was under given the nature of some of the projects he was working on and, most importantly, his concern and belief that he was going to be fired."

But Dr. Noggle noted that "at no time did he indicate that he was hopeless or even helpless. He did not appear to have chaotic thoughts, but did seem somewhat [persevering] in his thinking and speech. There was nothing in his presentation to me to indicate he was severely depressed nor that he was suicidal."

The two planned to meet in person that Wednesday, December 8.

Keogh didn't go to work on Monday, December 6. That day, he phoned city manager Frank Fairbanks to say he was quitting. Keogh told his wife that Fairbanks had asked him to just take the day off and relax.

She says she tried to reach Dr. Robert Clark, who had treated her husband in 2002.

"I called him because it was as if the worms were back inside Kevin," Karlene Keogh says, though she never did get to speak with the doctor until after her husband died.

She is adamant that Keogh had continued to take his anti-seizure meds to the end.

But the county's postmortem toxicology test results said otherwise, and didn't detect any Dilantin in his blood or urine, just a therapeutic dose of allergy medicine.

The importance of that is that experts say it can be dangerous to quit Dilantin improperly, especially when combined with an increased stress load and lack of sleep and food.

"[That] can lead to the onset of an episode in someone with a latent seizure disorder," writes Washington, D.C., neurologist and psychiatrist Dr. Richard Restak, sounding as if he's describing Kevin Keogh.

Keogh returned to City Hall for half a day December 7. He phoned his wife from there several times, she says, unable to cope.

"Everyone just thought he was tired because of all the work," Mrs. Keogh says. "But he was hallucinating, paranoid, very, very ill."

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Paul Rubin
Contact: Paul Rubin