by Peter Elkind
The DA’s visit did not represent Kagen-Hallet’s first encounter with Genene Jones. In addition to examining brain tissue, Kagen-Hallet handled most of the autopsies performed on children who had died at Medical Center Hospital. While a nurse in the pediatric ICU, Jones had shown up for several of them. Kagen-Hallet had no trouble remembering her; she had stuck out because she asked so many good questions. Kagen-Hallet recalled something else about that period: a couple of pediatric ICU autopsies that had drawn unusually large and tearful crowds. Perplexed by the sudden death of their patients, nurses, pediatricians, and surgeons had sat in on the postmortems.
After Ron Sutton’s visit, Kagen-Hallet could not resist the temptation to make a few discreet inquiries about Genene Jones. A friendly pediatrics resident told her that the LVN had a reputation for being strange—that she told dirty jokes at inappropriate times. The resident added that everyone was relieved when Jones quit.
For a month, Kagen-Hallet went quietly about her duties. On January 11, she left work early to attend the monthly afternoon meeting of the San Antonio Society of Pathologists. Held in a medical school auditorium, the session drew a crowd of fifty or sixty doctors for a slide presentation by the Bexar County chief medical examiner, Dr. Vincent DiMaio. Afterward, Kagen-Hallet chatted with a professional acquaintance, Dr. Corrie May, a deputy medical examiner. While she and May cleaned up the darkened auditorium, unplugging coffeepots and gathering slides, Kagen-Hallet related what she knew about the death of Chelsea McClellan.
Kagen-Hallet revealed that the DA in Kerrville suspected murder. She mentioned Ron Sutton’s inquiries about succinylcholine, and the two pathologists discussed the difficulty of tracing the drug. Kagen-Hallet told May that the targets of the investigation were Kathy Holland and Genene Jones, a doctor and nurse who had both worked at Medical Center Hospital, and that Jones had a reputation for being odd. May recalled that Dr. Holland had phoned when Chelsea died, asking if the medical examiner’s office would perform the autopsy; May had told Holland that because there was no suspicion of wrongdoing, it was not a medical examiner’s case.
According to Kagen-Hallet, the conversation ended there, and both women went home. But according to Dr. Corrie May, Kagen-Hallet went on to make a startling revelation: There also had been suspicious baby deaths in San Antonio—a number of babies had died mysteriously at Medical Center Hospital.
When she arrived at work the following morning, May passed this news on to her boss, Dr. DiMaio. Bexar County’s forty-one-year-old chief coroner was a famous pathologist, known nationally in medical circles for his expertise on gunshot wounds. He had recently been summoned to participate in the celebrated exhumation of the body of presidential assassin Lee Harvey Oswald. At the moment, however, DiMaio was in the midst of a feud close to home. Several months earlier, the UT medical school had failed to renew the employment contract of his wife, also a pathologist; DiMaio had responded by resigning his own part-time faculty appointment. DiMaio had also been complaining that doctors at Medical Center Hospital were ignoring state laws requiring them to report all questionable deaths to his office. Corrie May’s information was thus grease on a burning fire.
Several hours after speaking with his deputy, DiMaio dictated a memo for his files detailing the information she had provided:
At 9:15 this morning Dr. Corrie May informed me of a conversation she had with a Dr. Kagen-Hallet of the University of Texas Health Science Center at San Antonio. This latter physician informed Dr. May that she was currently involved in a case in Kerrville involving the suspected murder of two children. The suspects in this case are a physician and a nurse. During this conversation Dr. Kagen-Hallet informed Dr. May that these two individuals have formerly worked at the Bexar County Hospital. During the time they were at the hospital, there were approximately eight suspicious deaths of infants. Because of these deaths the hospital ordered an investigation. Subsequently the nurse and doctor were given an opportunity to resign. From what she could gather from the conversation, the investigation of these deaths were conducted by members of the University staff and possibly some outside physicians.
As in a children’s game of telephone, the relayed information—from Sutton to Kagen-Hallet to May to DiMaio—had strayed on two important points of fact. The Kerrville investigation involved only one suspicious death. And Kathy Holland had never been suspected of wrongdoing while working in San Antonio; she had completed her residency to everyone’s satisfaction. But the information spurred DiMaio to do what doctors and administrators at Medical Center Hospital fervently hoped would never happen. Two hours after speaking to Corrie May, DiMaio drove from his office on the edge of downtown San Antonio to the Bexar County courthouse. There, he rode up to the third floor, entered the district attorney’s office, and revealed everything he knew.
Twenty
When Sam D. Millsap Jr., learned of suspicions that babies had been murdered at Medical Center Hospital, he had served as district attorney for Bexar County for only twelve days. Yet he had already revealed a hearty appetite for conflict and a lust for the public stage. The youngest DA in Texas, Millsap, thirty-five, had won office in a bitter campaign against an incumbent. Unwilling to let his vanquished opponent remain in power any longer than necessary, Millsap declared that he would heave him out the window if he found him in the DA’s office a single minute after his term expired. The incumbent vacated the premises. Millsap and his chief deputies were sworn in at 12:01 A.M. New Year’s Day, before a covey of television cameras and a crowd of four hundred.
Sam Millsap grew up in San Antonio, the eldest child in a family of scrappers. His father, legally blind since childhood, had begun in business running a snack bar in a refrigeration plant, while his family lived in public housing. By the time Sam junior entered college, his parents owned a comfortable home in the suburbs and operated a chain of office cafeterias. The younger Millsap was consumed with politics. At the University of Texas in Austin, where the state’s future leaders learned to wheel and deal, Millsap was the master strategist of a potent campus political machine. Based in a men’s social club, Millsap’s organization fielded slates of short-haired moderates who seized control of student government in the mid-1960s, postponing the inevitable rise of antiwar radicals. Millsap remained at UT three more years for law school. Then, gravitating naturally toward power, he joined Texas’s preeminent corporate law firm, Baker & Botts in Houston. Finding the atmosphere stultifying, he returned after a year to San Antonio, where he worked as an aide to a Democratic congressman between stints in civil law practice. Millsap began to specialize in defending claims against railroads. But his passion remained politics. In 1978, Millsap organized the Bexar County campaign of the Democratic candidate for governor, a job that honed his reputation as a skillful back-room operative. But by then he was already planning his own campaign for public office.
Bored with private practice, Millsap had decided that the job of district attorney was the one he had been “born and bred for.” Opponents would later note that Millsap had never tried a criminal case. But the young attorney didn’t envision his role as that of courtroom prosecutor. While most DAs limited their public comment to cases before their office, Millsap viewed the job as a bully pulpit—a platform to create issues by speaking out. Millsap had opinions he wanted to voice, on everything from crime and sentencing to the performance of judges and the county sheriff. He wanted to be one of the people defining the public debate.
Ever the political strategist, Millsap was also drawn to the job because its occupant was an inviting target. The incumbent was Bill White, a lumbering former football player who was part of the old Democratic courthouse crowd in Bexar County. A Romanesque red sandstone building in downtown San Antonio, the Bexar County courthouse had a long reputation as a place where those with connections could get a sweet deal. Judges, prosecutors, and certain defense attorneys had close relationships. Plea bargaining was endemic; even serious felonies like rape were being downgraded to misdeme
anors. To Millsap, White was a hack who was part of the problem. Planning to campaign as a reformer, he felt confident he could beat the DA in a head-to-head race.
But there was another attorney mulling over the same idea: Courand Nicholas Rothe, Jr. Part of an eminent San Antonio family, Nick Rothe was one of the savviest criminal lawyers in town. When Millsap heard reports that Rothe was thinking of jumping into the race, he invited him to lunch at the exclusive San Antonio Club. The two potential adversaries worked in different worlds. As a corporate lawyer, Millsap hobnobbed with executives and wore Brooks Brothers clothes. Rothe, two years Millsap’s senior, dealt with less ambiguous rogues; he drew his clients from the ranks of murderers and thieves. Rothe was a dapper, round-faced man with silver hair and a neat mustache, but his contact with the lawless had worn a few rugged edges. Rothe could be both eloquent and gruff, a dichotomy reflected in his wardrobe; he often showed up in court wearing a Bill Blass suit and black cowboy boots.
Sam Millsap was familiar with one other element of Rothe’s background: The criminal attorney had no experience in politics. Although the two men seated for lunch were little better than acquaintances, Millsap wasted no time laying his cards on the linen-draped table. “I understand you’re thinking of running for DA,” he told Rothe. “There are two major differences between me and you. The first is that you’re competent to be DA and I’m not. The second is that I can win and you can’t.”
“I was a railroad lawyer,” Millsap later explained. “I had a lot of ideas about how the DA’s office should be structured—and they were good ideas. But I didn’t know anything about criminal law.” Millsap and Rothe reached an accommodation. Rothe promised not to run and agreed to serve as Millsap’s secret campaign adviser. Millsap committed, if elected, to instituting the kind of reforms Rothe felt the DA’s office needed.
The road was clear for a mano a mano battle royal, but Millsap transformed the May 1982 Democratic primary campaign into nothing short of a mugging. Knowing White was more accustomed to argument in the courthouse than in the media, Millsap shrewdly went on the attack. He produced statistics suggesting that White was letting violent criminals and drunk drivers off easy, and he pledged to cut back sharply on plea bargaining. In 1978, when two of the DA’s investigators drew guns on a pair of kids they suspected of tearing down his campaign posters, White had backed up his men’s actions. In 1982, Millsap used the incident to dub his opponent “Shoot-to-Kill Bill.” “My goal was to keep jabbing at him to the point that he would take a swing at me in public,” said Millsap. That didn’t happen, but White did stage a last-minute round of massage-parlor raids that made him look foolish and desperate. Attracting a peculiar coalition of reformers and hard-line conservatives, Millsap took 61 percent of the primary vote and faced no Republican opposition in the general election.
Early in the DA’s term, a local magazine profile of Millsap used the word “mean” thirteen times. But mean was not a word that came to mind when one met him. Blond-haired, with a boyish face and a toothy grin, Millsap looked more like an overgrown Eagle Scout than the sort to inspire terror. His views toward criminal justice, however, were anything but gentle. No soft-headed talk about rehabilitation from this DA; Sam Millsap didn’t believe it worked. He wanted to lock criminals up and throw away the key. “People who commit crimes of violence and people who commit economic crimes and are repeat offenders need to be sentenced to long periods of time in the penitentiary. Period.” As for nonviolent criminals: “The typical burglar or auto thief is a bum; the overwhelming majority are strung out on some sort of dope.” If Millsap seemed inclined to tough talk and confrontation, it was because such tactics were central to his strategy. The DA had run for office embracing the philosophy of “political jujitsu”—a phrase coined in Playing to Win, a 1980 book by national political analyst Jeff Greenfield. The practitioner of political jujitsu would do and say the unthinkable, wrote Greenfield; by keeping opponents constantly off balance, a politician could make others respond to his agenda. “I read that, and said, ‘This is me,’” recalled Millsap. The young attorney relished the prospect of being feared, like a rocket-armed pitcher willing to throw at the head of an opposing batter. “The other guy thinks you’re nuts—but he doesn’t want to fuck with you.”
When medical examiner Vincent DiMaio arrived at the Bexar County courthouse on January 12, 1983, he first visited Sam Millsap’s newly appointed chief deputy for felony cases: Nick Rothe. Stepping into Rothe’s tiny, windowless office, DiMaio asked if he might shut the door.
“Sure,” said Rothe.
“Can I lock it?” asked DiMaio.
After the medical examiner laid out his story, Rothe took him to repeat the tale to Millsap. When DiMaio had left, Millsap summoned a handful of his top subordinates, and threw the questions at hand to the group: Could this really be true? If so, where did they start? Unlike Ron Sutton, the district attorney of Bexar County had vast resources at his command: seventy-one attorneys, nineteen investigators, a support staff of fifty-five, and an annual budget of $3.5 million. Nonetheless, Millsap—uncharacteristically—decided to proceed slowly. If true, the baby-deaths story was dynamite. But at this point, he had only scuttlebutt.
Millsap also knew that he was playing with fire. DiMaio’s tip involved not only Medical Center Hospital but the UT medical school as well. The DA did not want to erode public trust in the county hospital needlessly. And to an ambitious young politician, the prospect of taking on UT could not be regarded lightly. The University of Texas System, which included eight universities and four medical schools, had a combined annual budget of $1.6 billion. It controlled an endowment portfolio worth another $2 billion—including 2.1 million acres of land. UT institutions enrolled more than 100,000 students and conferred almost 20,000 degrees annually. In Texas, its loyal graduates—doctors, lawyers, politicians, and executives—were everywhere. A seat on the nine-member board of regents, which ruled over the entire empire, was the most coveted political appointment in Texas. There was no greater amalgamation of wealth, connections, and power in the state.
One of Millsap’s lieutenants began by phoning Ron Sutton to see what the Kerrville DA knew. Sutton relayed the information that had emanated from Kerrville doctor Joe Vinas—that a surgeon in San Antonio had identified Genene Jones as a baby-killer. Sutton also buttressed DiMaio’s belief that someone at Medical Center Hospital had conducted an in-house investigation. Investigations, Millsap knew, usually led to reports. The DA decided to try to get his hands on such a document.
Millsap was nervous that informal inquiries at the hospital and the medical school might prompt destruction of important evidence. He wanted to swoop down with subpoenas and physically seize everything he needed before anybody knew what was going on. Uncertain where to begin, the DA decided to go fishing. On February 3, he hauled before a grand jury six officials he suspected would know if an investigative report existed. In response to a subpoena, medical school dean Marvin Dunn appeared at 9:45 A.M. With special crimes deputy DA Luis Vallejo conducting the questioning, Millsap’s strategy struck pay dirt:
VALLEJO: My name is Luis Vallejo, and as I told you, I work for the district attorney’s office, and you do understand that this is an official meeting of the Grand Jury of Bexar County, Texas?
DUNN: Yes, sir.
VALLEJO: I will get straight to the point so we don’t waste your time and we can hopefully expedite the matter. We are interested in specific information that we have received concerning a possible investigation by a team of doctors, either from out of state or out of the country, into an unusually large number or inordinate amount of deaths in the pediatric ICU, and we understand that there was an investigation done and there was a report made. Are you familiar with this report?
DUNN: Yes, sir.
VALLEJO: Are you familiar with the investigation?
DUNN: Yes, sir.
VALLEJO: Could you please tell us what prompted the investigation?
DUNN: I will be gl
ad to.
During the remainder of the morning, Dunn revealed that there had been not one, but two formal investigations of the ICU—the first by Dr. Conn, the second by Dr. Mangos—each resulting in a written report. Millsap dispatched an investigator to seize both of them later that day; Mangos’s report was still in second-draft form.
Millsap now knew: The scuttlebutt was for real. The Mangos report confirmed the suspicion of Genene Jones—and even detailed the unexpected deaths of individual children. Dunn also had made it clear that top officials at the medical school and the hospital had harbored fears about the LVN for more than a year—an astonishingly long time, thought Millsap. There were not merely vague suspicions; there had been blunt accusations.
DUNN:…There had been comments made about one or two of the LVNs as being individuals who might have done something wrong. We couldn’t get any hard evidence that anyone really could point their finger.
VALLEJO: Could you elaborate on that, sir, that there might have been instances?
DUNN: Yes. We heard from one nurse that one of the LVNs was killing babies, okay.
While the dean asserted that there was insufficient evidence “to say that somebody had done something wrong,” the LVNs had been removed, he testified, because “one should not take a chance.” Dunn acknowledged that the departure of Genene Jones and the other LVNS had brought an end to the “unexplained and untoward events.” Yet even then, no one had notified law-enforcement authorities. How many babies might have been murdered? The Mangos report discussed ten unexplained deaths. Dunn estimated a dozen. Clearly, the answer to that question remained to be found.