The Good Nurse: A True Story of Medicine, Madness, and Murder (4 page)

A
rnold and Barry had a regular monthly sit-down with the Livingston chief of police, Don Jones. The meet-up was purely a matter of practicality; Saint Barnabas was the largest employer in Livingston, the bedrock of the
township’s tax base. It was unrealistic to separate the medical center’s private corporate concerns from those of the municipality.

Chief Jones was a familiar character in Livingston, with a reputation for supplementing his salary with the sort of overtime hours usually doled out to low-wage rookies or cops expecting a new kid. With retirement on the horizon, crossing the line into the private sector for a lucrative security management position with the Saint Barnabas Corporation was a far more appealing opportunity. If Jones hoped to prove himself to the Saint Barnabas administration, one of the first chances to prove it came on March 5, 1991, when Barry and Arnold met Chief Jones at an Italian restaurant and presented their case over lunch.

They had all the fundamentals of a solid police investigation: a crime, victims, evidence, and a suspect.
⁸
They had probable homicides on at least two units. They possessed physical evidence of criminal IV tampering involving deadly drug dosages, and their investigation had yielded a strong suspect in one of the Saint Barnabas staffers. To an ex-cop like Arnold, it seemed clear that Saint Barnabas Medical Center had a serious criminal issue on its hands. But Chief Jones didn’t want to touch it. He told Barry and Arnold that he didn’t think he could do anything with the evidence they had so far. It would be best for the hospital to handle the matter internally. Barry and Arnold didn’t know whether Jones simply thought he was doing the hospital a favor, or if he truly felt incapable of attempting a complicated medical investigation with the evidence on hand. Arnold couldn’t blame the man for that—they couldn’t prove it themselves yet. Either way, the problem was still theirs.

Arnold and Barry threw every trick they had at catching Cullen in the act, even installing stop-motion cameras in the med storage room for a few weeks. They interviewed a cross-section of the physicians, staff, and even families who coursed through their patient wards, and initiated a new drug sign-out protocol for the nurses, which treated the usually common stocks of insulin with the same stringent regulation given to dangerously addictive drugs like morphine. When two more patients were discovered crashing with inexplicable hypoglycemia in the Saint Barnabas CCU that October, and found connected to IV bags that had been tainted with insulin, they had their suspicions, and even more frustrations, but still nothing they could prove.
⁹
They were still trying when, all of a sudden, Charles Cullen simply went away. The problems with the insulin spikes disappeared with him.

5

C
harlie assumed his world would fall around him like a cardboard stage prop. He felt that the Saint Barnabas people knew what he had been doing there
¹
—the hospital investigators had left him little doubt of that during their interview. Whether he’d spiked one or one hundred, or even more, it didn’t matter. They knew. They hadn’t even looked at his time working the burn unit, but they still knew. For months they’d been focused on two patients, both of whom had crashed and coded. It was easy to get confused about the other patients, and hard to sort their unusual symptoms from the usual cacophony of ailments, but these two were clear-cut. Charlie was aware that they’d cross-indexed the nurses on duty for the evenings of those two incidents, and discovered that he was the only nurse working both shifts. And then there was the matter of the IV bags he’d been spiking with insulin in the storage closet—they’d found them, analyzed them, saved them as evidence. He’d been spiking the bags at random sometimes, sending them out like grenades. Charlie was certain that his fingerprints were all over the tainted IV bags—he hadn’t bothered to wear gloves. He figured that if they wanted him, they had him.

He enjoyed the waiting, the little death of that caesura, the special tension it lent to the dark hours. It pulled everything into sharp focus, imbued every snap of a glove or sip of coffee with tragic portent and meaning. He waited all spring for a conclusion to the affair, then fall and winter, right into the New Year. When no conclusion came, he decided that either the hospital was stupid or afraid, maybe both. Charlie could only imagine the epic liability issues that rippled from his pinpricks—the big-money lawsuits like you see on TV, the sort that humble even corporate Goliaths. Whatever it was a hospital worried about, Charlie didn’t think it was patients. They lied, the way they’d lied to him when he’d looked for his mother’s body.
They covered up. They hid. And nobody ever truly treated your pain; he’d learned of that hypocrisy, too, when no one had treated his. Professionally, he found the legalistic attitude utterly galling. As a lapsed Catholic, he found it ironic; Saint Barnabas, Son of Encouragement, patron saint of the bottom line. The hospital’s failure to stop him seemed like a sort of absolution from blame. And so, when Saint Barnabas
²
finally stopped calling him in for shifts, Charlie couldn’t help but feel genuinely surprised.

6

January 10, 1992

C
harlie explained it to Adrianne as an internal political issue at the hospital, some trouble that didn’t really involve him, or shouldn’t have. He was being targeted by the nursing administration, he said, a vendetta, out of spite. Charlie told Adrianne the reason was a pending nurses’ strike. There had been talk of it on the unit, and Charlie had been one of the few voices against it. Patients would suffer, he said. It was a principled stand—Adrianne could see some of the old Charlie flaring back to life as he spoke. Charlie made it clear he’d prioritize patients over paychecks and break the picket lines if it came to that. It wasn’t a popular opinion and, as a result, he became the target of a revenge campaign within the unit. They had made him the scapegoat.

Now Adrianne was really confused. Scapegoat? A scapegoat for what? Charlie perched high on his chair like a cat, attentive and regal. Well, Charlie said, it all revolved around some strange occurrences at Saint Barnabas. There had been incidents, and an investigation into them. The incidents—well, someone had been spiking IV bags in the storerooms. Spiking them with insulin, which was dangerous, as Adrianne might imagine. It was a shocking story. Charlie laid it out calmly, in complete detail, explaining with great technical flourish how the IV ports on the saline bags are designed to be injected so you can add drugs into the mix, how it was impossible to tell an injected bag with the naked eye. Under the microscope, he said, you could see it; the plastic port punctured like a used cork, some of them punctured dozens of times. There had been crashes and codes on his units, Charlie said—that’s the only way the administration had finally figured it out. It was impossible to know exactly how many patients were affected, but possibly a great many, a truly impressive number.

It was a mystery as to who was behind it, Charlie explained, real spy stuff—the hospital had done a huge investigation but they couldn’t figure it out. Charlie thought that the whole affair had made the Saint Barnabas bosses look stupid—that was why they needed a scapegoat, a martyr. Charlie had been crucified because he had done the right thing, with the nurses’ strike. He had been made the focal point of the internal investigation at Saint Barnabas. That was why he had been let go. It wasn’t fair, Charlie said, but that was his life, unfair.

Adrianne hadn’t seen her husband so excited for a long time, and the spark in his affect somehow neutralized the horror of what he was describing. The whole story didn’t make sense to Adrianne. She let it not.

C
harlie waited for his world to fall, the crash and the hammer of air behind it, but the blast never came. Cause and effect: the cause was buried in the euphemism of “issues”; the effect was only movement and change. There were no policemen, nobody followed him, nobody called. Instead of being cast into the void, Charlie found himself two weeks later in Phillipsburg, New Jersey, sitting in a chair opposite the HR department desk at Warren Hospital,
¹
filling out the application for another full-time position.
²

Under “Work History” he listed his Navy nuclear submarine tech duties, three years cutting boxes in the stockroom of the West Orange Caldor, and nearly six years nursing at Saint Barnabas. His indicated “dates of employment” from May 1987 to January 1992 were technically true: he’d been fired from Saint Barnabas in the first days of January. It was still January now.

Do we have permission to contact your current employer?
Charlie circled Yes.
³

Professional References
: Charlie listed the Saint Barnabas phone number.

And when the lady recruiter asked why the young nurse wanted to leave his long-standing job, Charlie took a deep breath, and told her it was the commute. Warren Hospital was twenty minutes closer to his home and family. Changing jobs was a family decision, that was the sort of person he was. It just plain made sense.

Charlie wanted all the work he could get, nights, weekends, and holidays. Warren would pay $14.84 an hour, $18.30 if he stayed on Adrianne’s medical insurance, with an extra 23-cents-an-hour bump if they moved Charlie to the ICU. Charlie called Adrianne from the pay phone in the Warren
Hospital main entrance, eager to tell his wife he had the job. If Charlie had done anything wrong, would he have been able to find a new job so easily? Adrianne put down the phone and silently thanked God. To be honest, with two kids and a mortgage, it didn’t really matter whether Charlie was right or wrong, just that he was working. And what her husband was saying finally made some sense. If you couldn’t trust a hospital, what could you trust?

7

A
drianne hoped for the best. Charlie’s termination had seemed so damning that she’d at first considered it a validation of her personal concerns about her husband’s character. But then, when he’d found new work so quickly, she doubted herself again. Charlie was a union member, had been educated and tested, received degrees that required regular recertification, and was governed by state nursing boards, hospital ethics boards, supervisors, and staffing departments. If there had been no repercussions from such serious accusations, if he had been fired and quickly rehired, then this must simply be the process. It was inconceivable that at an institution entrusted with human lives, the staff weren’t at least as carefully regulated as the stocks of morphine. Adrianne didn’t know the business of medicine, but she did know the business of business; all signs indicated that Charlie’s termination and rehiring had no more moral undertone than any other corporate restructuring.

The change of jobs seemed to rejuvenate her husband. His career had a new direction and a higher rate of pay. He seemed excited by the new routine, the new technical systems to learn and new patients to master them on, and that excitement carried over into an attitude in his home life which was, if not positive, at least more animated. Charlie even agreed to start working days, so that their schedules weren’t at such absolute odds. That put added pressure on their day-care needs, but seemed like a hopeful sign for the relationship. It was only a week before their troubles began again.

She didn’t think Charlie had been a good husband for a long time, and soon after their second daughter, Saskia, was born in the middle of December 1991, she decided she didn’t like him as a father, either. Charlie’s secret drinking had finally become impossible for even Adrianne to ignore. There
was no avoiding the topic. First he denied it. Then Adrianne broke into his footlocker while he was at work, and confronted him with the bottles. Charlie made her violation of his privacy the issue, or tried to—Adrianne didn’t go for that one. Finally, he acknowledged his drinking but insisted it wasn’t a problem. He was depressed, he said, but no, he didn’t want to go on antidepressants. It was obvious to Adrianne that her depressed husband only became more depressed from his drinking, that he was caught in a spiral with her family in the center. Confronting Charlie while he was drunk was pointless. They’d fight and say things, and Adrianne would suffer a night that Charlie either didn’t acknowledge or didn’t remember the next day. Each time she tried confronting him when he was sober, Charlie would flee to the basement. Adrianne finally decided she needed outside help. The family health benefits from her employer would pay for five days in an alcohol treatment center. But Charlie didn’t actually want to stop drinking. Adrianne tried leaving his old AA books out for him on the counter, hoping maybe he’d remember his former resolutions. But the books backfired. Charlie would get angry, or ignore them, or put them away as if straightening up. Then he’d sit and drink Coke and eat potato chips until it was time for him to retreat to the basement.