The Good Nurse: A True Story of Medicine, Madness, and Murder (46 page)

1
Details of Cullen’s application process and the events at Warren Hospital come from Warren Hospital’s file on Charles Cullen, police investigation documents, police witness statements, and court records.

2
The exact dates of Cullen’s termination at Saint Barnabas are unclear, but his interview at Warren Hospital occurred January 21, 1992.

3
The available records from this time contain Cullen’s inclusion of these references and numbers, but leave it unclear as to whether anyone from the Warren Hospital HR department did call to confirm references at Saint Barnabas Medical Center or Medical Center Health Care Services.

1
Details from court documents, interviews with Adrianne Baum, and police reports.

2
He’d learn later that his mother’s body was still there.

3
Charlie turned eighteen three months after his mother’s death, and at the Navy recruiter’s suggestion he got his GED. He enlisted in April 1978 for eight weeks of basic training at the Great Lakes training facility in Illinois, then seven months at the Naval Guided Missile School in Virginia Beach, Virginia, followed by three months of submarine school in Groton, Connecticut. He would ultimately be stationed in Charleston, South Carolina.

4
Several captain’s masts, or disciplinary hearings, stemmed from his refusal to urinate in front of another sailor for the mandatory drug tests; Charlie maintained that while marijuana use was common in the Navy, he never personally tried it or any other illicit substance, and he bristled at the humiliation of exposing himself during public urination. His inability to void publicly would cause him conflict for his whole life.

5
This included an incident, reported later but unverified, in which one of Cullen’s shipmates reported finding him at the nuclear controls in a full gown and surgical mask from the medical supply closet.

6
Finally, Cullen was transferred off the sub to a supply ship, the USS
Canopus
.

7
Cullen was anxious about his upcoming discharge from service, which was expected to be dishonorable; he told Navy psychiatrists that he wanted to kill himself because he “didn’t want to return home a failure.” In previous alcoholic suicide attempts, the Navy doctors had found him to be sane and fit for service, and they prescribed alcohol counseling and Antabuse. Charlie had used the drug to attempt suicide again.

8
He was treated for methyl salicylate poisoning.

9
“Eye contact poor and voice soft,” the physician noted. “Verbalizations concise and evasive.” The physician also noted that Cullen showed poor insight as to his alcoholism, and was passive-aggressive and resistant of ward routine and rules. But soon he became more verbal, particularly about his sense of loss of his mother (with whom Cullen was “unusually close”) and an unnamed fiancée. “He has always been shy with few friends,” the report noted. “He has shown dependency, particularly in relationships with females, becoming intensely involved in a short time.”

10
Cullen’s older brother, James, who died of a drug overdose in 1986 at the age of thirty-six, had been an apparent suicide.

11
January 31, 1993.

12
Civil Action docket no. FM-21-229-93, Superior Court of New Jersey, Warren County, October 19, 1994.

13
It was located at 263 Shafer Avenue.

1
Phillipsburg, Pennsylvania, police records.

1
All quotes come either from my interviews with Charles Cullen, from his confession to police, or from Pennsylvania State Police transcripts.

1
Of course, Greystone was the “State Asylum for the Insane,” itself an updated version of the “New Jersey State Lunatic Asylum at Morristown.” The name changes provided a coded history of the public perception and private care of diseases of the mind (the term itself a more modern take); it was, by the time of Cullen’s incarceration there, a “psychiatric hospital.”

2
Sources conflict as to the exact dates of his treatment. On March 24, Cullen was first checked into the Carrier Clinic, in Belle Mead, New Jersey; he was then transferred to Greystone Psychiatric Hospital in mid-April.

1
There are other vital signs telemetry can monitor—blood pressure, blood oxygen level, temperature—but the electrocardiogram is the most common.

2
In Cullen’s accounting, the judge who had ordered him to pay for this was responsible for forcing him back into nursing. Given a free hand, Cullen maintains, he would have quit.

3
Cullen would later characterize the relationship as romantic but not sexual.

1
Statements by Larry Dean and police investigative records.

2
Larry Dean would die in 2001, still attempting to prove his contention that his mother had been murdered. After his death, his late mother’s blood and tissue samples would be found in his home freezer.

3
Cullen had given Helen Dean an intramuscular injection that should have taken maximum effect in three to four hours. But Mrs. Dean died the next day, nearly twenty-four hours later and shortly after her release from the hospital.

4
Det. Richard Clayton and Lt. G. Dundon.

5
The results of the autopsy of Helen Dean, as written by Dr. M. L. Cowen, Warren County medical examiner: “The injection site was examined for chemicals and toxic substances… the chemistry evaluation was negative… The male nurse suspected of injecting an unknown substance into Mrs. Dean’s anterior left thigh successfully passed a polygraph test indicating that he was truthfully stating that he did not inject Mrs. Dean with a needle.”

1
Fair Oaks Hospital (formerly Summit Hospital), Summit, New Jersey.

2
Police investigative report.

3
It appears that the Saint Barnabas Human Resources department was never reached by anyone at Hunterdon, but several Warren Hospital employees vouched for him, including Charlie’s nurse supervisor, and the ICU nursing manager. Both gave Cullen positive remarks, his ICU manager adding only that Cullen had left their hospital for “personal reasons.”

4
Charles Cullen has changed his accounting many times. After his initial confession, he would go back and decide that in terms of actual deaths, he probably was responsible for at least one patient in January. Also, definitely one in April, and yes, another about a week later, then two weeks after that, then two weeks after that—not able to really keep the details, knowing only that all of them would have been injections while he was working in the ICU.

5
Police investigative records and witness statements, in addition to Cullen’s personnel file.

6
One patient was later discovered in a room strewn with bloody cloths and empty bottles, naked and oxygen-starved and staring at the ceiling. Physicians contended that these factors contributed to, if they were not responsible for, the patient later suffering a stroke.

7
The spellings and spacings herein are from the original letter.

1
Carco Research.

2
Police investigation records. The Hunterdon and Warren HR departments both confirmed that Cullen had been employed by them; Medical Center Health Care Services, the staffing agency owned by Saint Barnabas Health Care Corporation, indicated that they could vouch for Cullen being employed there from 1990, but Saint Barnabas itself could not locate a file for Charles Cullen.

3
From Cullen’s Morristown personnel file and documents from court records.

4
A short-acting sedative, usually used to initiate anesthesia.

5
This was Cullen’s recollection, as stated to detectives on December 14, 2003. Cullen believed “there could have been one or two at Morristown,” and that while he “didn’t remember specifics,” he “could have been involved in something there.” Cullen did not provide any further details at that time, and during the subsequent investigation he failed to identify victims among the Morristown Memorial Hospital patient records.

6
April 7, 1997: “Tammy, I really don’t want to write this, but for the patient’s sake and safety, as well as for the unit’s reputation. This is just one of many patients who verbalized the same thing. Call me.” This was but one of the handwritten notes, presumably from Cullen’s supervisor or colleagues, found jotted on paperwork relating to Cullen’s employment at Morristown.

7
This and all subsequent details taken from police investigation report.

8
$500, according to Cullen’s testimony in police investigation.

9
This was to be a serious review, and lawyers for Morristown Memorial and the American Arbitration Association exchanged letters in preparation.

1
A company called Medical Staffing Network took over for the Health Force staffing agency in 2000, at which point all old employee records were purged from their system.

2
It is impossible to say exactly when the problems started at Liberty, but Mr. Henry was the earliest Liberty patient with whom Charles Cullen would admit to having “intervened.”

3
Police investigative records and Pennsylvania State Nursing Board investigative reports.

4
According to the brief filed by Kimberly Pepe in her lawsuit against Liberty, Henry was taken to nearby Lehigh Valley Hospital after he began having respiratory problems that morning. Hospital officials discovered the insulin overdose. Henry was later returned to Liberty, placed on a morphine drip, and subsequently died. Liberty’s records don’t say if his death was a result of the insulin overdose. Charles Cullen would ultimately confess to being responsible for Henry’s overdose.

5
Pepe’s suit alleged that administrators at Liberty “intentionally chose to ignore and overlook any evidence pointing to the fact that Cullen may have been the nurse who administered insulin” despite the fact that Charles Cullen’s repeated medication issues had put him under “a cloud of suspicion.” Charles Cullen was not Henry’s nurse that night, but he was in and out of the room frequently for another patient. Pepe also filed a complaint with the Equal Employment Opportunity Commission.

6
According to a February 29, 2004,
New York Times
article (“Death on the Night Shift: 16 Years, Dozens of Bodies; Through Gaps in System, Nurse Left Trail of Grief,” by Richard Pérez-Peña, David Kocieniewski, and Jason George), Julie Beckert, spokeswoman for HCR Manor Care (which owns Liberty), would not discuss Mr. Henry’s case, but she denied that Mr. Cullen had been under investigation for stealing drugs. Liberty settled Ms. Pepe’s lawsuit on terms that both sides have kept secret.

7
Four years later, in January 2002, the Pennsylvania State Nursing Board would initiate a background investigation into Charles Cullen in response to complaints from another incident. At that time, Liberty Nursing and Rehabilitation Center nursing director Dawn Costello was interviewed and asked whether “any drugs or unexplained deaths had occurred during his [Cullen’s] employment.” Ms. Costello replied “No.”

8
Liberty admitted their investigation into the patient’s death was inconclusive, according to Pepe’s 1998 lawsuit.

9
A Liberty spokesman stated that Charles Cullen’s infractions were reported to the Pennsylvania Department of Health, which oversees hospitals but not nursing personnel.

10
Internally, Liberty listed the reason for dismissal as “failure to follow drug protocol.” In 2003, the
Express-Times
of Easton, Pennsylvania, quoted Liberty spokeswoman Julie Beckert as saying that Cullen was fired in 1998 after he was accused of giving patients drugs at unscheduled times. Beckert said there was no evidence that Cullen, who worked at the center for eight months, had given patients medications they had not been prescribed.