Doctors Who Kill
Page 24
Meanwhile, Bobby Joe began to sketch out a plan to escape from prison, and, when this was discovered, he was moved to a higher-security cell.
In April 1985, he went to court in Pascoe County for the New Port Richey rape; the jury took under forty minutes to find him guilty. Later that month, he was convicted of Virginia Lee Johnson’s murder and sentenced to death by electrocution. He remained unmoved.
A month later, he agreed to a plea bargain, whereby he’d serve a minimum of fifty years for seven of the murders, rather than go to court for all eight murders, but the death penalty was still on the table, as the murder of Michelle Simms would go through to the sentencing phase. Always one to play devil’s advocate, Bobby Joe repeatedly changed his mind about the plea bargain and also changed his legal team.
To everyone’s surprise, his new attorney introduced Bobby Joe’s confession to his first murder, that of Artis Wick. He said that Bobby Joe’s traumatic childhood and head injuries meant that he was a sick man, out of control, and was not responsible for his actions. The jury remained unconvinced and, on 25th July 1986, voted that he be put to death by electrocution for the murder of Michelle Simms.
Games people play
Since sentencing, Bobby Joe Long has issued appeals from Florida’s Death Row and managed to get a retrial for the Virginia Lee Johnson case, arguing that he hadn’t been given an attorney. He was again found guilty in 1988 and sentenced to death, but this was overturned in 1992. He was tried yet again in 1994 and again sentenced to death, each appeal being heard at the taxpayer’s expense.
Bobby Joe went on to do the same thing with the Michelle Simms case, and was given a new sentencing hearing. The death sentence was upheld but has yet to be carried out. Although he took the lives of at least ten women – and ruined the lives of his numerous rape victims – Bobby Joe Long is still alive today.
PART EIGHT
WHY THEY KILL
Why does a respected paramedic turn into a crazed, lust-driven killer? What makes a nurse suddenly start murdering the children in her care? The final section looks at the various motives of lethal doctors and other healthcare staff and includes an illuminating interview with a forensic psychologist.
35 Typologies of Medical Killers
As the previous chapters have delineated, doctors, nurses and paramedics kill for a wide variety of motives. In some instances, the killer has two or even three motives – Kristin Gilbert, for example, enjoyed the excitement when a patient went into cardiac arrest but also used a sudden death on the ward as an excuse to leave work early to be with her new lover. There may also have been a Munchausen’s syndrome by proxy element to some of her murders. Most healthcare killers were motivated by one or more of the following:
Hero on the ward
This type of killer – often a nurse – gains a sense of purpose and satisfaction through reviving a seriously ill patient. This would be laudable if they hadn’t originally caused the life-threatening attack by administering a near-fatal medicinal dose. Such medics invariably suffer from one or more personality disorders and don’t really care if the patient dies prematurely or in great pain – but, if he or she lives, they will bask in the compliments from their fellow nurses and will often boast about their medical knowledge and years of experience.
Munchausen’s syndrome by proxy
Again, these killers are often nurses. Most start off as Munchausen’s syndrome sufferers, harming themselves in a myriad of ways in order to get treatment from their doctor or the outpatient department of the local hospital. When one hospital becomes suspicious, they will move to another in a different area. Upon becoming nurses or paramedics, they will transfer their obsession with injury and symptoms onto their hapless patients, with sometimes fatal results.
Thrill killers
Such murderers get a charge from watching someone die. They invariably discuss the deaths at length with other nurses or even try to engage the bereaved relatives in conversation. Such killers sometimes insist on accompanying the corpse to the mortuary. They often become addicted to murder – and to fooling the authorities – and kill with increasing frequency.
Lust killers
Most of the lust killers in this book were male doctors, powerful men who thought that they should have anything – and anyone – they wanted. Their female victims either died of a bad reaction to the date rape drug that had been callously administered to them, or were killed after threatening to report the attacker to the authorities. Anthony Joyner, a modest diet technician at a nursing home, was the exception. He was also atypical in that he clearly meant to kill his patients (after all, he had the option of letting one rape victim go after she fled to the bathroom), despite his claims that they died of accidental suffocation during the rapes.
Resentment
There have been several instances of male nurses who hated elderly women and were incensed at having to bathe and clothe them. They expressed their hostility verbally before starting their killing sprees. These men really wanted to be doctors and resented having to do basic bodily care as opposed to administering medication and checking on the patient’s vital signs. As such, they would have felt a level of resentment towards anyone who required help with feeding and washing tasks.
Financial gain
Several of the medics profiled in this book would have benefited from insurance policies if they’d eluded a murder charge. Despite their high earnings, some had amassed considerable debt. Though the main motive was financial, the murders also provided secondary satisfaction by getting rid of a prodigal son or unwanted wife.
Other motives
Katherine Ramsland, who teaches forensic psychology at DeSales University, Pennsylvania, has identified more complex motives, from perverted compassion (euthanasia) to necrophilous voyeurism, where the medic holds values that makes him or her embrace death over life. She details those in her landmark book, Inside the Minds of Healthcare Serial Killers, which covers cases from 1910 to the present day.
In June 2009, I interviewed this criminologist and frequent contributor to Court TV’s Crime Library, asking her to comment on notable cases and suggest why such killers remained at large for so long. My questions and her replies are preceded by our initials.
CAD: Charles Cullen features on the front of Inside the Minds of Healthcare Serial Killers. Is he the most prolific American healthcare killer that you’ve written about? If not, who claimed the most known victims? And what was his or her motivation? Here in Britain we have Harold Shipman, who appears to have broken all UK records.
KR: Shipman currently holds the world’s record for documented healthcare serial killers, I believe. The record in the US goes to Donald Harvey, since Cullen stopped short of his prediction by admitting to 29 murders and 6 attempts. He’s probably responsible for more, and he did claim the number could be as high as 40, but he stopped talking, and so far, nothing more has been proven. Harvey made extravagant claims for his victim count, reportedly into the 80s, but he pleaded guilty to one manslaughter and 36 murders over the course of 18 years – he even kept a journal. A few were acquaintances, not patients. Harvey killed for petty reasons as well as mercy, he says. One man he just didn’t like; another he killed out of revenge. And then there were the acquaintances he poisoned with arsenic who had just annoyed him. His attorney thought Harvey was projecting his depression onto his potential victims – a psychologist said the same thing about Cullen – but Harvey also dabbled in the occult, so it’s possible he was experimenting with substances as well. Often, there’s more than a single motive for these crimes, especially if the killer has years to evolve. Some even begin with mercy and then find they like the sense of power. They change as people, and so, they change as killers.
CAD: Many homicidal nurses have a history of suicide attempts yet hospitals hesitate to fire them. Have you any thoughts on why hospitals don’t sack staff who are so obviously mentally ill?
KR: It’s difficult to fire someone, especially for mental health re
asons, because the institution could be sued. They would have to prove that the person’s condition negatively affected his or her work performance, and that’s tough to do. Many of those who were mentally ill actually had good work records. Each situation is different, however, so I hesitate to say that there’s a general reason for this that covers all, or even most cases. I can’t really speak for hospital administrators.
CAD: Similarly, homicidal healthcare staff often have a medical history which points to Munchausen’s syndrome. Why, do you think, is this so frequently overlooked?
KR: It’s easy in retrospect, after a suspect’s defence is pieced together, to acknowledge the pattern of this illness, but it’s not as easy to recognise it in a day-to-day situation. Munchausen patients are typically secretive about their manipulations. They want attention, but they don’t want anyone to know how they’re faking their illness to get it. That’s a difficult diagnosis to make, along with its associated diagnosis Munchausen’s syndrome by proxy, and it requires seeing the patterns over the course of a person’s medical history. However, I might also say that just because someone is claiming to suffer from either of these conditions doesn’t make it true; this particular syndrome has become an effective way for females to mitigate their guilt and get a lesser sentence.
CAD: I note that various healthcare killers, including Charles Cullen, Bev Allitt and Kristen Gilbert, had a history of hurting and killing animals. Is there scope for hospitals to approach ‘prevention of cruelty to animals’ organisations and ask if a prospective nurse has a record of animal maltreatment? Or does the US legal system prohibit this?
KR: Often, this comes out only during an investigation, but cruelty to animals is rarely on the record anywhere, especially if it occurred when the suspect was a kid. Cullen, for example, was cited for neglect of his dog, but he did spare the dog when he prepared to fill his apartment with poisonous fumes during a suicide attempt. So is he cruel or kind? The neglect could have been the result of his depression or debt, so it wouldn’t necessarily be defined as aggressive cruelty. This is a difficult issue, because cruelty to animals does not necessarily evolve into murder or serial killing; second, plenty of serial killers have not been cruel to animals; and third, just because there’s a record of animal cruelty with some agency, what can you really do with it? It’s not predictive; it’s only valuable as part of the whole package when pondering criminal behaviour. To identify a possible healthcare serial killer requires a number of different ‘red flag’ behaviours, collectively, not just one, and others are easier to connect to murder.
But back to your question: think of all the many things an employer has to do to process a person’s application to be a nurse. Checking all possible animal welfare agencies for a violation would be both burdensome and impossible. You’d have to find a practical and efficient way to do this, as well as ensure that it’s not an invasion of privacy, and even then, you couldn’t prove anything about the person’s work competence with an animal cruelty charge. Things we know in retrospect are not necessarily practical ways to identify a person’s capacity for murder. I think there are more obvious behavioural signals that can be documented.
CAD: I take your point – Britain is a much smaller country so animal cruelty and child cruelty agencies are beginning to communicate, as there’s an increasing awareness that the man who is taken to court for torturing his dog is often also abusing his wife and children.
Can we do anything, in both the US and the UK, to spot psychopathy in healthcare workers? I’m thinking of Chante Mallard, whose actions after accidentally hitting a man with her car were sociopathic. Had she shown such psychopathy in her everyday life or in her work as a nurse’s aid?
KR: I wouldn’t call it psychopathic, since I think she was scared, high, and hysterical that night. She apologised over and over to her dying victim, and then gave control of the situation to others as she lay crying on the floor. This incident had not been a cold-blooded, calculated or predatory act. Granted, she talked about it later in a way that gave the impression that she had no remorse, but from the testimony of others involved on that night, she would not fit the cold and manipulative behaviour of a psychopath.
Mallard did have a problem with substance abuse and she also tried to destroy evidence, but she wasn’t out to target helpless people for her own benefit. It was intentional murder only in that she did not get the help her victim needed, but that was more about being emotionally unable to cope with the consequences of hitting someone while driving under the influence. I would call her behaviour unprincipled, ignorant and immature, like a self-centred adolescent, but I wouldn’t say she was psychopathic. At her trial, no one said that she was generally an uncaring or cruel person.
CAD: So what do you make of smooth talkers such as nurse Orville Lynn Majors, who was so plausible when he appeared on The Montel Williams Show that he convinced a top criminologist of his innocence? Do such men – and women – ever end up in a quasi-medical role in prison or are they automatically forbidden from working in the prison sick bay?
KR: It depends on their skill in convincing others of their competence, as well as on the type of prison they’re in and the personalities of the people they encounter. Edmund Kemper, who killed both of his grandparents when he was 15, ended up giving the psychiatric assessments to other troubled kids in psychiatric detention because he figured out how to pass them himself. Once released, he killed a number of young women before murdering his mother. Truthfully, it really depends on how much sympathy they’re able to garner or how well they can win the trust of the warden. Some can, others can’t. As years pass, their crimes have less impact and their present manipulative charm has more. In addition, if prisons are understaffed, they might be allowed into supervised situations that tap their training and skills. I didn’t study these people in prison, so I can’t say with authority what would happen, but I can see how it might be possible.
CAD: Finally, is there anything else that you particularly want to say about healthcare serial killers or the hospitals which employ them?
KR: Too often, hospitals have protected themselves first, patients second. Over and over, these killers have been allowed to drift from one hospital to another, fired or let go under a cloud of suspicion, but rarely brought to justice until after incriminating evidence has reached alarming levels. While there is no distinct psychological type, there are important signals: secretive behaviour, missing medications associated with the person, a preference for the shift with the least number of co-workers or supervisors, statistically significant spikes in deaths on a certain person’s shift – especially unexpected deaths, moving around from one facility to another and spotty past work records can be troublesome signals.
Once such a person is investigated, other signals have frequently popped up. Notably, there are several suspicious incidents associated with this person at different institutions, some of the lethal substance was found in the person’s home or on the person for no good reason, and there are inconsistencies in their statements when questioned. In addition, they often have lied about something on their application or in their job interview. While none of these items is in itself sufficient to place someone under suspicion, a number of them together in constellation should be sufficiently alarming to colleagues and facility administrators to keep closer watch for solid evidence of lethal behaviour.
Acknowledgements
My grateful thanks go to criminologist Katherine Ramsland for her invaluable contribution to the Typologies of Medical Killers chapter. Katherine teaches Forensic Psychology at DeSales University and is the author of more than twenty crime books including The Human Predator: A Historical Chronicle of Serial Murder and Forensic Investigation, The Devil’s Dozen: How Cutting-edge Forensics Took Down 12 Notorious Serial Killers, Inside the Minds of Serial Killers and The Criminal Mind.
I’m equally indebted to Dr David A Holmes, senior lecturer at the Department of Psychology and Social Care at Manchester Metropolitan Un
iversity, author of The Essence of Abnormal Psychology and a contributor to numerous forensic research projects and crime documentaries.
I’d also like to acknowledge Caitlin Rother’s contribution to the Kristin Rossum profile. Caitlin, an investigative journalist and Pulitzer Prize nominee, attended most of Rossum’s trial and wrote an incisive book, Poisoned Love, about this complex case. She is also the author of Body Parts, which examines the inner world of serial killer Wayne Adam Ford, and Twisted Triangle, a former FBI agent’s account of her ex-husband’s attempt to take her life.
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