Barney Matthews was the Head Orderly for the maximum security wing of the Baltimore State Mental Hospital for the Criminally Insane. He was the primary handler and caregiver to Dr. Hannibal Lecter for six of the eight years of the latter's incarceration, working under the authority of Dr. Frederick Chilton.
Barney was noted for the extreme competence and professionalism he showed while running the wing of the asylum in which Lecter, "Multiple" Miggs, Sammie, and a number of other patients were held. Barney was in charge of cleaning and searching the cells and also handling Lecter's elaborate restraint-procedure after the latter savagely mauled a nurse. Barney was so thorough in his duties that the only two minuscule mistakes made in handling Lecter were both made on Barney's days off, years apart. These two incidences Lecter acquired the materials needed to make a handcuff key, the tube of a ballpoint pen and a paper clip.
Despite the fact that Barney was responsible for keeping Lecter imprisoned, he was liked and respected by the notorious cannibal for always treating him with courtesy and decency. Lecter did not begrudge Barney for doing his job, which included searching his cell for contraband and making it virtually impossible to steal items that could aid in an escape or attack (such as pens, paperclips, staples and anything made from metal or hard materials). Dr. Lecter would also converse with Barney over the intercom during the evenings, introducing "whole new ideas" and knowledge relating to matters of psychiatry, philosophy, arts, culture, and science (which Barney was studying via correspondence courses).
When Lecter was set to be transferred to a different facility, Barney expresses his concerns to Dr. Chilton about the skill of Lecter's new handlers, but was rebuffed. Following Lecter's bloody escape in Memphis, Tennessee and subsequent life on the run, Barney received a generous monetary tip and a thank-you note from Lecter for the courtesy shown to him during his years of imprisonment.
Barney continued to work as an orderly elsewhere after the closure of the Baltimore State Hospital for the Criminally Insane. At some point either before or during 1990, he was employed by Mason Verger, a survivor of Hannibal Lecter. Barney supplemented his income on occasion by selling pieces of discarded "memorabilia" from the asylum, such as Lecter's bite-proof facial restraints and forms bearing his autograph. He would discuss information about Lecter and Starling with Verger. Barney later told Clarice Starling about the pettiness, unprofessional cruelty and wrongdoings made by Dr. Chilton, which earned Lecter's enmity and lead to Chilton's eventual disappearance and presumed murder at the latter's hand. Barney also developed a friendship and one way unrequited romantic feelings for Verger’s sister Margot.
Barney eventually went on to travel the world with his girlfriend, intent on seeing every known painting by the Dutch master artist Johannes Vermeer - an interest that Lecter himself fostered in Barney during their conversations in prison. However, despite his good relationship with Lecter, he was terrified when he spotted the doctor in Argentina and fled, never to return.
