Self Induced Berserker Syndrome

Um yeah.   People driving down the street knew the Van Guy was a dangerous obsessive maniac.

His teeth actually aren't that bad, but his skull is Mediterranean, not the pinched shape of a northern European.  He's got a bad bicuspid on the upper left that makes that side droop, but mostly he's a big bag of rage because of the long term steroid abuse.
I would guess he has an almost total insensitivity to pain.

The only mystery here is why he wasn't already fitted with a permanent ankle bracelet.