by Peter Elkind
The doctors had also decided that it was time to bring others into the matter. Packard called the Texas Board of Medical Examiners to report Holland’s involvement in the emergencies. Hall called the Austin office of the Texas Board of Vocational Nurse Examiners, the state agency that licenses LVNs. He spoke to the nursing board’s investigator, Ferris Aldridge, who wrote a note after the conversation and placed it in Genene Jones’s file. “Mr. Hall advised of drastic increases respiratory and cardiac arrests in Kerrville and suspicious deaths in San Antonio, stating that a child killer was suspected,” the note reads. “Told him that this was not a matter for board investigation, but would locate the proper authority for him.” Aldridge picked up the phone and called Texas Ranger Joe Davis in Kerrville. Davis said he would investigate. After more than a year of suspicions in two different counties, someone had finally notified a law-enforcement agency.
When Kathy Holland returned to the clinic from her meeting with the executive committee, Genene Jones asked what all the fuss was about. Holland told Genene that the committee had questioned her treatment philosophy and her use of drugs. The doctors had asked specifically about succinylcholine, she explained—whether she had it in her office and whether she had ever used it. The doctors had also asked her whether she trusted her nurse. Genene appeared upset. “Somebody is spreading rumors,” the nurse said.
By Friday afternoon, Sid Peterson was indeed buzzing with suspicion. When the pediatrician returned to the ICU that afternoon, the head nurse, on orders from a doctor, shadowed Holland every moment she was near a patient. It would not be long, however, before Holland didn’t have any patients left. Hours after her daughter’s arrest, Clarabelle Ruff had heeded advice from several physicians that she find another doctor for Rolinda; a Kerrville family practitioner took over her care. Mary Ann Parker, offered similar counsel, had decided to transfer Chris to a hospital in Lubbock, where a family friend practiced pediatrics. Dr. Holland fought the move, telling Mrs. Parker that her son wouldn’t be stable enough to move for days. But Mrs. Parker insisted, and signed papers to transfer Chris against Holland’s medical advice.
Both children would recover with no further medical problems.
Sunday, September 26
Kathy Holland returned to 1524 Nixon Lane about noon, after having spent the weekend with her husband in Centerpoint. On Sunday evening, Genene approached her: Did she remember that bottle of succinylcholine that had turned up missing a few weeks before? Yes. Genene had found it, lying in a drawer of the examining table in the crash room. Good. There was just one problem, said Genene: The plastic safety cap had been popped. How had the cap been removed? Genene didn’t know. But it was nothing to worry about, she added. She had gotten out the other bottle of succinylcholine—the one they’d ordered when they’d thought the first one was lost—and checked it against the bottle she’d found in the crash room. Both were completely full, said Genene. Anyone could see the missing vial had never been used; there were no syringe holes in the rubber top.
First the questions about succinylcholine from the executive committee at the hospital; now Genene’s labored explanation of the fate of the missing bottle. Kathy Holland went to sleep wondering.
Seventeen
Monday, September 27
In the morning, Kathy Holland went to see Dr. Packard in his office at the hospital. The executive committee seemed concerned that her medical approach was too aggressive, said Holland; she would be glad to bring medical faculty from San Antonio to vouch for her philosophy. Packard shook his head. Aggressive medicine was no longer the issue. “I’m concerned about your nurse,” said Packard. There was going to be an investigation. “In the meantime,” he said, “you’d better tell that nurse that if she cares about you, she’d better make sure your office runs as tight as a ship.”
Holland returned to her clinic about 11:30 A.M. Genene and Debbie Sultenfuss were getting ready to leave for lunch. After they were gone, Holland went to her small office refrigerator to look for the succinylcholine. There were two vials in the refrigerator. One had a plastic safety cap on it; the other did not. So far, it was just as Genene had said. Holland pulled out the bottles and held them up to the light. They contained almost exactly the same amount of clear fluid. Then she looked at the tops of the vials and noticed: There were large needle holes in the rubber stopper of the uncapped bottle. “At that point,” said Holland, “I damn near freaked out.”
For weeks, Kathy Holland had not merely failed to suspect; it seemed as though she had refused to suspect. Now she had no choice. Genene returned from lunch about 1:30 P.M., carrying a bow in her hand. She had been to see Chelsea McClellan, she explained, and found the bow at the cemetery. It was on this visit that Petti McClellan had spotted Genene, sobbing and moaning on her knees at the foot of Chelsea’s grave. Back in the clinic, Holland led her nurse to the refrigerator. She told her to remove the two bottles of succinylcholine and look at the top of each. “How’d the needle holes get there?” Holland asked.
“I don’t know,” said Genene. “There were a lot of people in the room that day.”
What day?
The day of Misty Reichenau’s seizure, said Genene. Didn’t Holland remember? While they were having trouble getting the breathing tube down Misty’s throat, Debbie had gotten the succinylcholine out of the refrigerator.
“But I didn’t use any succinylcholine on Misty,” said Holland. “How’d the holes get there?”
“I don’t know,” said Genene.
The doctor called out to Nixon Lane and summoned Debbie. When Sultenfuss arrived, Holland questioned her. Genene said she had gotten the succinylcholine out of the refrigerator and brought it into the crash room. What had Debbie done with it? Sultenfuss retraced her steps. She was ready to draw up some succinylcholine for Misty, she said, but no one could agree on the dose. So she had placed the bottle behind the cotton-ball dispenser in the crash room.
After Debbie left the office, Holland resumed her discussion with Genene. The doctor later gave the following account of the rest of the conversation.
“That still doesn’t explain the holes.” Holland said. “How’d the holes get there? How am I going to explain the holes in the bottle?”
“I don’t think we should explain them at all,” Genene told her. “We thought the bottle was lost. We should say we never found it. Just throw it away.”
Holland left her office in a panic. What should she do? She had to tell someone—but who? She thought of Joe Vinas; he was young and approachable, and he had trained at Medical Center Hospital. She called his office, but he was in surgery. She left a message. In the meantime, Kathy Holland had to deal with her nurse once again; they had a patient to see in the clinic. Afterward, about 4:15 P.M., Genene approached her. “I did a stupid thing over lunch,” she told Holland. “I took a bunch of doxepin.” Genene had been taking the anti-anxiety drug for her ulcers, but now she was saying she had taken an overdose.
How many had she taken?
“I don’t know—a handful,” Genene told Holland; she had thrown the rest away.
“How many, Genene?”
“I don’t know—not many.”
Where had she left the bottle?
Genene said it was at home. Holland called the house and had the children look for it in the medicine cabinet. The bottle wasn’t there. She searched Genene’s purse and found it; the bottle was empty. It had originally contained thirty pills. Genene said she’d taken five before that day; that left twenty-five missing.
Genene looked woozy; she settled onto a couch in the office hallway. “I just need to lie down for a while,” she said.
“You’re going to the hospital, Genene,” said Holland.
Frantic, Holland told Gwen to call an ambulance, then burst into Dr. Webb’s office next door. “My nurse has just told me she has taken an overdose of doxepin,” she announced. “Number one, I am not an adult doctor. Number two, I wash my hands of this.”
Genene’s overdos
e was a theatrical gesture. She later said she had taken four 50-milligram pills—an amount that could do her no harm—but the paramedics who arrived at Holland’s office one final time reported finding her semiconscious and fed her oxygen on the way to Sid Peterson Hospital. Genene was taken to the emergency room, where doctors pumped her stomach and admitted her to the hospital. She had planned to take a lot of pills, Genene said later, but she had decided at the last minute to face her problems head-on, just as she had in San Antonio. Said Genene: “I figured if I could live the nightmare once, I could live it again.”
Joe Vinas called back about 7 P.M., and Holland asked him to come over. “I’ve got something important to show you,” she told him. When the surgeon arrived, Holland led him back to her private office. She showed Vinas the bottle of succinylcholine. He looked at the vial and its orange rubber top. “It’s full,” said Vinas. “It’s full, and it’s got holes in it. That doesn’t make a whole lot of sense.” Holland related her conversation that afternoon with Genene—the discussion of Misty Reichenau’s arrest and Jones’s suggestion that they throw away the tainted bottle. Vinas, anxious to find someone who knew more about succinylcholine, suggested they call an anesthesiologist, Dr. Rex Thomas, who served on the hospital executive committee. But Thomas was out of town. Vinas phoned Kerrville’s other anesthesiologist, Frank Bradley. It was Bradley who had observed Rolinda Ruff in the Sid Peterson emergency room and raised the possibility that the child had received succinylcholine; Joe Vinas had made the critical discovery of the suspicions about Jones in San Antonio. Holland did not know it, but she was meeting with the two doctors who had done the most to focus suspicion on her and Genene.
Holland asked how her patients could have had seizures after receiving succinylcholine, a drug that causes paralysis. Given low doses of the muscle relaxant, Bradley explained, children might look as if they were experiencing seizures. There also might be twitching as the drug took effect and at the time it started to wear off. Holland showed Bradley the vials and asked what she should do with them. Bradley didn’t want the responsibility, so they decided to call Tony Hall at home. The hospital administrator explained that he was in the middle of dinner with out-of-town guests. “I have found the Anectine,” Holland told him. Hall said he would be right over.
Together, the four of them searched through office records for invoices documenting purchases of succinylcholine. They found three: one bottle had been purchased on August 18, when Holland ordered her initial stock of drugs from Pampell’s Pharmacy; one bottle had been purchased on September 7 from the Sid Peterson Hospital pharmacy, to replace the bottle Genene had said was missing; and one had been purchased from the hospital pharmacy on September 20. But there were only two bottles in the office refrigerator, and Holland had not ordered a third. Where was it? Who had ordered it? They looked closely at the September 20 invoice. It was unsigned.
Searching the office for the third bottle, they found a syringe full of clear liquid in the bathroom and five uncapped vials of saline in the crash room. But there was no sign of the missing muscle relaxant. Hall placed the two bottles of succinylcholine, one capped, one uncapped, in a white envelope and sealed it. Vinas and Bradley scribbled their signatures across the flap, and Hall covered the signatures with clear tape. Hall would take it to Texas Ranger Joe Davis the next morning.
As the doctors prepared to leave, Holland noticed three paper bags in a corner of the office, stuffed with baby clothes and toys. They had belonged to Chelsea McClellan; Petti had dropped them off for Holland to give to charity. Now Holland pointed them out, as tears streamed down her face. “If that child died because of something Genene did,” she said, “I’ll never forgive myself.”
Tuesday, September 28
When Joe Davis heard that Genene Jones had taken a drug overdose, he decided to have a talk with her. As part of the ninety-four-man Texas Ranger Force, Davis worked for the most fabled group of state lawmen in the nation. Dating back to 1835, the Rangers built their legend in the days of the Wild West, corralling cattle rustlers, bank robbers, and gunmen. The old-time Ranger tracked his prey on horseback, with a western hat on his head, cowboy boots on his feet, a silver star on his chest, and a Colt .45 on his hip. The Rangers prided themselves on embodying a slogan once uttered by one of their own: “No man in the wrong can stand up against a man in the right who keeps on a-comin’.”
By the late twentieth century, some Texans had come to regard the Rangers as little more than a quaint anachronism, a vestige of rural life in a newly urban state, ill equipped to battle sophisticated modern criminals. But most Texans still embraced the Texas Rangers; when one candidate for governor proposed their abolition, it was the political equivalent of committing hara-kiri. In modern Texas, urban police departments tackled the crime that plagued Texas cities. But in rural counties and small towns, such as Kerrville, it was the local Texas Ranger who was called in to handle the toughest cases.
The legend of the Texas Rangers was larger than life, but Joe Bailey Davis measured up to the myth. Based in Kerrville, Davis was a hillock of a man, round-faced and bull-shouldered. While modern Rangers were issued the more powerful .357 Magnum, Davis favored the old Colt .45 automatic. He was a crack shot, a trained hypnotist, and a rugged gentleman who carried out his duties with the élan of Rangers of old. After collaring a twenty-four-year-old suspected of sexual assault in Fredricksburg, a Hill Country town fabled for handing out long sentences, Davis told him: “Boy, you picked the wrong town and the wrong girl. By the time you get out of the penitentiary, girls will be the last thing on your mind.”
After Davis received the September 24 phone call from the LVN board in Austin, Tony Hall had briefed him on the strange rash of emergencies at Dr. Holland’s pediatric clinic. The clinic had been open only a month, said Hall, and there had already been eight incidents there, involving seven different children. When Genene Jones was released from the hospital on the morning after her drug overdose, Davis asked to speak with her. She readily agreed.
They sat down in the Sid Peterson conference room, and Davis read Jones her rights. Then he asked her why so many children had experienced seizures in Dr. Holland’s office. Such episodes were quite common with children, Genene explained; if the doctors and nurses at Sid Peterson were concerned, it was because they didn’t know much about pediatrics. Davis questioned her about Anectine. Genene told the lawman she had never used it. She hadn’t harmed a soul, Jones declared, and she would take a polygraph exam to prove it, if Kathy Holland would.
At 10 A.M., Dr. Holland was startled to see Genene Jones walk in, dressed for work. “Genene, I hate to say this,” Holland told her, “but I think with all the things that have happened, it would be better for you and me both if you didn’t work here anymore.” Genene was angry. She challenged Holland to take a lie detector test; Holland said she would. “There’s only one thing I’m really sorry for,” Genene told her. “Someone convinced you that I’m guilty.” She stormed out of the office.
A short time later, Joe Davis arrived at the clinic with Tony Hall to question Dr. Holland. While they were there, Genene called, pleading to speak with Kathy. But the doctor refused to take the call. Genene left word with Gwen that there was a letter for Holland in a drawer in the office. It was a one-page handwritten suicide note, apparently left the day before, when Genene had taken the pills:
There isn’t anyway to explain to you why things are going to change. Sometimes, as wrong as it may seem, you have to except what life dishes out.
When your older, and I know your tired of hearing that, but you will be able to understand why, why I have to go away. It doesn’t mean I don’t love you. Please believe that. No amount of money or worldly goods could ever buy my love. It is so deep + strong, it will last for all eternity.
Please explain if you can to Crystal + Edward how much I love them. It’s such a strong love, I can’t put it on paper. I know I’m asking alot, but I realy feel your the only one who could do it.
/> I’m not guilty of murder, + I hope you believe that. But Daddy’s way is right. It takes all the pressure off you and the seven people, whose life I have altered.
No one can hurt me with my Daddy. He’ll straighten this whole thing out + then we’ll go home and everything will be alright. No more problems for you, no more nightmares for me.
Please make sure Edward + Crystal are not separated. I know how my mother feels about Crystal, but I also know how she feels about Edward. If Debbie or you can’t take them together, please be sure whoever does are good people. People with lots of love.
Please don’t be angry. I’m going with Daddy because I miss him + I want to be with him. He’ll take care of both of us.
You’ll be fine. Please believe that.
I love you,
Genene
As with so much about Genene, the letter was both suggestive and misleading. Although Genene was vigorously protesting her innocence, the reference to “the seven people, whose life I have altered” seemed a virtual confession. Excluding Anthony Winn—whose apparent crisis was mere theater—seven children had suffered emergencies in Genene’s care. And why the remark about following “Daddy’s way”? Dick Jones had died a natural death from cancer. Genene characteristically spoke as the voice of experience, writing that Holland would understand better “when your older”; in fact, the doctor was Genene’s senior by four years. And finally there were Genene’s references to her “love” for Kathy Holland. Did it merely reflect the close friendship that had existed between the two women? Or was it calculated to smear her boss?