Dee knows.

Paul couldn't shake the thought Aug. 18 as he climbed out of bed and dressed, apparently to work in the terraced garden he'd built in his Kansas City back yard."Dee knows, now. This is the day I die."

As his wife drove off to work, Paul stood waiting for her car to make the wide turn out of sight. And then, just as he had every morning for four months, he scrambled upstairs to change into something presentable.

"I have one more day to make it right."

Paul raced from his house with a checkbook. The credit cards were long since tapped out. But he could cash checks and pull together enough to give himself one last chance at the casino nestled on the Missouri River.

Like thousands of other compulsive gamblers, Paul had let the gaming tables take over his life. No one really knows for sure what drives these people, but scientists, psychologists and other groups are looking for answers.

Paul was so beaten down by his gambling that he hadn't even thought about winning for weeks. He knew he was a loser.

He wasn't really surprised this time either as his money vanished into the hands of the blackjack dealer and the black maw of a slot machine.

"But this time, Dee knows," he thought. "And I can't face her."

He headed back home, where he kept poison in the garage. He opened the bottle and breathed in deeply. He swallowed some and poured it on himself.

Make it look like an accident, he thought, so she'll at least get the insurance money to pay off the debts.

There was no pain, but instead a slight buzz - probably some alcohol in the poison, he reasoned. And, as he felt his life ebbing away, he thought again: "I can't face her with what I did. How I ruined her life."

What is it that compels reasonable men and women to so unreasonably gamble away their lives? How can someone facing physical or financial ruin not see the destruction that can accompany compulsive gambling?

And why, asks Lisa Pertzoff, board member of the National Council on Problem Gambling, can millions of Americans socially gamble and then casually leave casinos while others find themselves trapped?

"It's not about winning, and it's not about losing," she said. "It's about people who gamble because they can't not gamble. But why?"

Partly to help answer that question, the U.S. casino industry last week announced the creation in Kansas City of the National Center for Responsible Gaming to study compulsive gambling. And Monday, Harrah's Casino sponsored a seminar on compulsive gambling at the American Inn in North Kansas City.

"The problems with gambling are quite unusual," said Stan Bier, a Kansas City psychologist. "What seems to get them hooked is the action. And when they're hooked, they don't eat, they don't sleep, they don't care if they haven't got enough money left to buy gas to get home. They ruin their lives, jobs, families."

Brad Wilson, a North Kansas City psychologist trained to work with compulsive gamblers, says such questions will become increasingly familiar as casinos thrive - and construction of more continues - along Kansas City's riverbanks.

"To the problem gambler, gambling feels good, it's easy to do, it's just having fun," he said. "And the more casinos we see going up, the more problem gamblers we're going to turn up. I'm afraid that counseling those who have a problem gambling is going to be a mainstay in my profession for a long time to come here."

Dee's world turned upside down Aug. 17 after a phone call.

"I was in the back yard when my son Michael brought the phone to me," she recalled. "It was someone from Visa saying I was over my limit. I wasn't really concerned. I figured it must be a mistake.

"`What do you have as my limit?' I asked.

`Eight thousand five hundred dollars,' she told me. My limit was only supposed to be $500, I was shocked. `How much do you say I owe then?'

"Nine thousand seven hundred dollars."

Dee immediately suspected fraud. But the next day an investigator called and asked if anyone in her family had a problem with gambling. Immediately she called Paul, her husband of 10 years, and asked if he knew anything about the debt. He assured her he didn't.

"As soon as he said it, I could tell from his voice that something was really wrong. I felt as if I had a football in my throat."

Paul had handled all the finances so she had no idea of the magnitude of the problem. The Visa investigator suggested she have a credit check done on herself, so she did.

The news crushed her. Her debt was more than $32,000, maybe much more. Her savings and checking accounts were drained and she had bad checks bouncing all across Kansas City.

Dee left work 10 minutes early and beat the rush hour traffic to her Northland home. Her son was home, and Paul's car was in the garage. There was a strange smell, but it was probably just garden chemicals, she reasoned.

Then Michael told her Paul's boss was on the phone and wanted to know why he wasn't at work.

"We started searching the house, and Michael started yelling, `Mom, come here quick,' " she recalled. "By the time we got to him (Paul), he didn't have a pulse."

Emergency workers arrived swiftly and whisked him off to North Kansas City Hospital. When she next saw Paul, he was hooked up to a machine that was doing his breathing for him. Another was pumping his stomach. He was paralyzed. But he was alive.

THE JANUARY EDITION of The Harvard Mental Health Letter noted that compulsive gambling is growing nationwide.

About 1.7 percent of Iowans, for instance, were compulsive gamblers in 1989, but by 1995 that percentage had risen to 5.4 percent.

The reason is clear: The number of gambling outlets, and states that allow gambling, is increasing. Only two states don't allow any gambling: Hawaii and Utah.

In addition, the number of women compulsive gamblers is increasing. Youths are more likely to be compulsive gamblers than adults and persons with lower incomes more likely than those with higher incomes.

Howard Shaffer, director of the Harvard School of Medicine's division on addictions, noted that several studies have indicated up to 5 percent of the population has had a problem with compulsive gambling. He also said it is among the most difficult compulsions to notice.

There are no outward signs, no sights or smells to tip off family members. And, he added, pathological gamblers often are very pleasant people.

"Compulsive gamblers can act from the best intentions," he said. "Intellectually, they can explain exactly why they're doing what they're doing. But in the end gambling is a losing game."

And compulsive gambling is a difficult monster to get rid of, he said.

In part, that's because no one is really sure how it attacks. Most agree there are several key issues, and they involve both nature (genetic predisposition and biological makeup) and nurture (family, upbringing and education).

Lorrin Koran, director of Stanford Medical School's obsessive-compulsive disorder clinic, said researchers know very little about the causes.

PAUL'S DECEPTION was complete. Dee had no idea he was gambling until his world collapsed on itself.

One day last June, they had even gone to a riverboat casino together. Throughout the day, he pretended he had never before set foot in a casino. Dee believed him.

She had no reason not to believe Paul. He had a good job - as an addiction therapist, no less. Their house is crowded with books describing the warning signs and dangers of compulsive behavior.

In addition, he was handy around the house and was always busy working on some project or another.

And they had married 10 years earlier after meeting at an Alcoholics Anonymous meeting. The meetings demand honesty, and they had followed suit in their marriage, she thought.

"Every night, we'd walk and talk about our dreams and hopes and fears," she said. "I really thought we knew each other inside out.

"It's been a good marriage. But, you know, something happened. I can't say it was the devil, but I don't know what else it could have been."

Perhaps demons from within.

Eric Hollander is a professor of psychiatry at the Mount Sinai School of Medicine. Many think his area of research on compulsive gambling is a quantum leap in the field.

"Compulsive gambling is an impulse control problem," he says, voicing the accepted view. "So the problem is that once the behavior begins, these people are having a great deal of trouble delaying the impulse, to stall the impulse long enough for them to think about it."

But impulse control is more than simply a matter of willpower or training.

Hollander's research indicates that the brains of compulsive gamblers typically have two problems: an underactive frontal lobe and a deficient serotonin production mechanism.

An underactive frontal lobe causes a person to crave stimulation. The reaction is almost like a drug-induced high.

Normally, production of serotonin in the brain helps control impulses, such as a craving for stimulation. But in brains where this doesn't work well, impulses can quickly take over and turn into actions before logic can kick in.

With a problem gambler, this scenario can be circular: Cravings fed by stimulations create more cravings.

Hollander said he has treated six patients with one of two serotonin drugs, with generally good results.

"The drive is to get the high," he said. "With the medications, we allowed them to control the drive."

PAUL, WHO HAS RECOVERED from his suicide attempt, hasn't gambled in six months - a far cry from his days of sneaking off each day for six hours of small-bet wagering before he went to his night job.

But he knows he's not yet cured.

"What I was doing - or at least what I would tell my clients they're doing when they have similar behavior - was living in a fantasy world," he said. "I was hooked on the atmosphere. I thought I was in control, but I wasn't. And when I started to crash it was like one of those really large domino chains that go off in a couple dozen directions. I'd try to stop the dominoes, but there were always far too many for me to stop them all."

It was about one year ago that Paul first set foot in the casinos. Last winter he was going once a week. By summer he was waiting only for Dee to leave for work before he dashed off to the boats daily.

He said the thrill was gone, really, by midsummer. By then, even if he won big, he knew he was not only still behind but would soon be laying it back down in chips.

Today he says he still harbors fantasies of heading back to the tables, just to prove he can win and provide for the family. He knows better than to actually head back, however.

"The real danger for me - and I know this because I teach this to others - is after life settles back down and we've got the bills paid and I've stayed away for a year and my spouse relaxes," he said. "Because then you think you're through it.

"And the next thing you know, you're back on the floor setting the dominoes up again."