By Chet Yarbrough
By: Charles Graeber
Narrated by Will Collyer
The Good Nurse recounts a true story about guilt–the obvious legal guilt of a psychopathic murderer and, less obvious, self-assessment guilt; i.e. the guilt of hospital attorneys, doctors, owners, and administrators. Legal guilt is defined by a “court of law” as a criminal law violation determined by judge or jury. Self-assessment guilt is the guilt of violating parental or social expectation (defined by Aphrodite Matsakis, Ph.D).
Charles Cullen confesses to murdering patients in several hospitals and at least one extended care facility as a licensed nurse in New Jersey and Pennsylvania. His murder spree lasts for 16 years and is estimated to have taken the lives of 40 to 400 people between 1987 and 2003. Cullen is sentenced to life in prison for his confessed crimes. Charles Graeber recounts the story of Cullen’s confessed murders, the hospital and police investigations, and Cullen’s ultimate confession.
There are many villains and three heroes in Graeber’s story; i.e. two detectives and a nurse expose a murderer. Detectives Daniel Baldwin and Timothy Braun, with Braun as lead investigator, and Amy Ridgway (aka Amy Loughren), a friend and fellow nurse of the killer, unravel Cullen’s murderous scheme. No less than nine hospital administrations either willfully or tacitly ignore “The Good Nurse’s” murders.
Graber, through Amy’s observation of Cullen, posits Cullen’s motive for murder. She surmises that Cullen is playing a game, a game of life and death. Cullen became an expert nurse by arbitrarily injecting various drugs in arms, legs, butts, and I.V. dispensers to entertain himself.
The injections are determined by Cullen’s perceived or conceived opportunity. It made no difference whether the patient was young or old, expected to live or die, in pain or comatose. Cullen’s objective is to play a game and satisfy a thrill; i.e. the thrill of a drugs’ delayed and damaging effect on human beings.
One surmises Cullen’s murders begin with rationalization about patient’ pain or imminent demise. It grows into an obsession, with Cullen playing truth-or-consequences with patient’s lives. Cullen creates drug cocktails, and plans different ways to have patients injected with potentially lethal medications. At the end of Cullen’s shifts, he leaves the hospital with excitement of discovery. Every return to the hospital becomes a thrilling adventure. Did the patient die that night or would the patient “code” and give him an opportunity to save a life; to be a hero; to be the center of attention?
After reading The Good Nurse, it seems a primary goal of medical care facility managers is to protect corporate’ reputation and financial interest; not patient life. Institution’ management is intent on making a profit and maintaining reputation, or if a non-profit, to remain in business to maintain and create jobs.
Graeber’s story does not suggest all medical facilities are corrupt but it exposes a mismatch between institutional medicine and medical profession’ goals of curing patients and “doing no harm”. The victims of Cullen’s murders are unquestionably families that lost love ones, but there are other victims; i.e. uninformed medical employees, people employed in the profession of medicine, and all medical patients that trust people in suits and white uniforms. When a person knows something is wrong but chooses to ignore obvious evidence of guilt, they are guilty of complicity. In the Cullen’ case, a statistically improbable increase in medical patient deaths from drugs, drugs not naturally produced by the human body, seems like murder; or at least, gross malfeasance.
Charles Cullen begins his career at St. Barnabas Medical Center in Livingston, NJ, in 1987. Cullen later admits to murdering 11 patients at St. Barnabas. Cullen quits his job at St. Barnabas when an investigation finds that I.V. bags have microscopic needle penetrations that result in 3 elderly women’s deaths from digoxin overdoses. St. Barnabas suspects Cullen but takes no action against the murderer and leaves no report-trail for investigation of suspicious behavior by The Good Nurse. This medical establishment’s behavior is repeated by eight more medical facilities in New Jersey and Pennsylvania. Cullen’s last employer is Somerset Medical Center in Somerville, New Jersey.
Each new employer is either negligent in Cullen’s background check, or each new employer is purposely stonewalled by previous employers that ignore requests for information. Some previous employers allege Human Resources’ privacy concerns but all fail to offer any investigation reports.
Graeber’s story of Cullen infers an uglier truth about medical facility’ management; i.e. what is good for a medical facility is not necessarily good for a patient. Greed and self-interest appear more important than patient care.
A fundamental truth in life is that death is a surety; the only difference is in when you die and by what means. It may be death at the hand of a murderer like Cullen, but more ominously by someone in a doctor’s coat, a nurse’s uniform, a manager’s tie, or lawyer’s suit.
There may be deaths without guilt but all unnatural deaths are deeply burdened with guilt. Cullen is guilty of murder but how many white coats, white uniforms, and suits in this case are also guilty? Were the Cullen murders a game of “Truth or Consequences” or “Monopoly” with “Get-Out-of-Jail-Free” cards?