Cole's case is notable partly for what it reveals about the limits of mid-twentieth-century psychiatric intervention — he was evaluated, diagnosed, and released multiple times despite documented homicidal ideation, and continued killing across several states over roughly a decade. He claimed his victims reminded him of his mother, and investigators believed his actual count far exceeded the murders to which he was formally convicted. That he was ultimately caught not through investigative work but through his own confession, while a suspect in a killing police were ready to attribute to natural causes, underscores how long he operated without detection.