When the cops finally raided the now-convicted killer’s house, he wasn’t particularly disturbed by the intrusion. In fact, he warned police not to go in the basement. Eventually, one of them put on a Tyvek jumpsuit and descended downstairs. The basement was mostly empty, but the flea infestation was so bad the officer’s shoes and pants turned black from the swarm that descended on him. The house was cluttered and full of spoiled food, though it contained several expensive appliances, including an autoclave machine, used to sterilize medical instruments. Finally one officer “parted the cabinet doors, and saw, arrayed in a series of specimen jars, shapes that looked instantly familiar but were so out of context that he couldn’t immediately process them. Poking out, tiny and perfect. Their tips rounded like pearls. Toes. Baby feet.” While this was going on, the killer was in the other room, seated at his piano playing Chopin.

Reading about this incident as it’s described in journalist Steve Volk’s new ebook, Gosnell’s Babies: Inside the Mind of America’s Most Notorious Abortion Doctor, it would seem that there’s little separating Kermit Gosnell and, say, Hannibal Lecter. Volk’s work is based on numerous interviews with the deadly abortionist, who comes across as a criminally insane sociopath.

To this day, Gosnell insists his conscience is clear, despite having spent his career snipping the spinal cords of babies, some of them already born. Even after he was sentenced to life in prison, Gosnell was so convinced he would be exonerated he applied for jobs at the Bill and Melinda Gates Foundation and the Clinton Global Initiative from jail. He insists he was unfairly convicted but also admits he didn’t follow laws that “struck me as politically motivated.”

Specifically, Gosnell says politics were the reason he disregarded the licensing and staffing laws requiring people who administer drugs and assist in surgical procedures to have medical training, even after a woman at his clinic died as a result of being improperly administered anesthetics. As Gosnell puts it, “I am a big believer in situational ethics.” If you’re looking for more evidence that Gosnell is a warped monster, Volk has it in abundance.

Where Volk’s book becomes really unsettling is on the question of whether Gosnell is an outlier within his chosen profession. Gosnell was an activist from the early days, performing abortions back before Roe v. Wade, when they were clearly illegal. In 1972, he was chosen by abortion pioneer Harvey Karman, a hero to pro-choicers, to test a new instrument for abortions that involved spring-loaded razors. The device maimed nine women, and Gosnell fled to the Bahamas hoping that his medical license would not be suspended. It wasn’t, and he returned to Philadelphia, where he opened a practice and began his descent into madness.

He gave painkiller prescriptions to virtually anyone, including known addicts. His clinic had as many as 25 women a night seeking abortions, and he acquired a reputation up and down the East Coast as being willing to do risky and illegal abortions. According to Volk, at Gosnell’s trial, jurors were deeply troubled by one doctor—a witness for the defense—who was unable to explain why Gosnell was criminal for snipping babies’ spinal cords, killing them instantly, as opposed to the supposedly humane and legal procedure where babies accidentally born alive in abortions are given “comfort care,” i.e., wrapped in a blanket and left to die. Gosnell’s sins, heinous as they are, are an indictment of the broader culture of abortion.

Kermit Gosnell may be a uniquely disturbed individual, but his fellow abortionists likely have more in common with him than they care to admit.

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