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Martin Hawkins was abused by his father at a young age ; it is for this reason he went insane, destroying faces and sexual organs of his victims. Claiming to hear Virgin Mary , who told him to stop them from spreading their diseases, referring to sexualy transmitted diseases. He also cut his arms with knives claiming tha he olny wanted to feel something.
In 1920, he was caught and brought to the State Phsychiatric Hospital in Metropolis, once there he was listened by Amadeus Arkham in a single session, then he is returned to prison where he would expect his trial. Based on this case Amadeus wonders about the future of prisoners mentally ill, confined in a archaic penal system with no hope for treatment.
With a clear objective, Amadeus went back to Gotham and start to build Arkham Asylum so he will help mentally ill. At Christmas, is notified that Martin Hawkins escaped from Phsychiatric Hospital. Then in the spring of 1921 Mad Dog went to Amadeus's house and raped and killed his wife Constance and his daughter Harriet, decapitating her and finally stuck her head in a dollhouse.
At November in the same year, Arkham Asylum finally open its doors. And Hakwins was again captured, being one of the first patients at the institution. During sessions, Mad Dog delights in explaining every detail of his crime to Amadeus. He was treated by Amadeus for six months.
In 1922, April the first, is killed by Amadeus Arkham during shock treatment, arguing it was an accident.