Perfect Poison

by M. William Phelps

  “Why, though?”

  “I don’t know, Kristen. Listen, I have to get going. I am not even out of my coat yet. I need to eat dinner. I’ll talk to you later.”

  “Yeah,” Gilbert said. “If I’m not in jail!”

  By March 13, all of the HCI inspectors summoned to the scene since February had been sent back to their offices in Washington, and SA Plante, now alone, was left to sift through a mountain of documents and interviews. After quickly ruling out the possibility of malpractice, improper patient care or poor ventilation, Plante carefully began to put flesh on the bones of what he now considered a criminal investigation.

  For SA Plante, as he went through the scores of interviews and studied each of them meticulously, his focus was drawn toward the many lies Gilbert had told.

  She had met with Dell Levy and Rayda Nadal between March 8 and 13, and they had asked her to explain Francis Marier’s and Thomas Callahan’s codes. On both occasions, Plante learned, Gilbert went out of her way to mislead them.

  Lie number one.

  Regarding Marier, Gilbert said that because Marier had been on a restricted diet, and on his usual dose of insulin, he was getting too much insulin for the amount of food he had been taking in, and thus he had gone into shock and coded because of that. This was in total contrast to her earlier story about Marier’s blood sugar level being at 44 when she said she checked it shortly before he coded.

  Lie number two.

  As for Callahan, Gilbert claimed she had contacted the on-call doctor, and he had come in to check on Callahan right before he coughed and coded. A quick look at Callahan’s chart told Plante that no doctor had come into the room because there was no note written by any doctor.

  On March 12, during an interview with SA Plante, after he had informed her about the “statistical analysis and the correlation between the increased number of patients’ deaths and the times she was on duty,” Gilbert said, “The deaths and codes came in spurts. It was probably just a coincidence [that I was on duty]. It was just my time to be involved.”

  Plante then grilled her about why she thought she had been around so many codes.

  “The LPNs and nursing assistants frequently called on me and reported to me crisis situations, thus increasing my numbers.”

  Plante knew already from talking to several of the LPNs and nursing assistants that this was a lie. It didn’t matter who found a patient in an emergency situation; that person would call the code. One didn’t have to be a nurse to call a code.

  This, of course, wasn’t evidence that Gilbert had killed anyone. Plante was smarter than that. But it did make it clear she was trying to hide something.

  When Dell Levy returned to Washington, she was surprised when she was given only twenty days to complete a report based on what she found at the Leeds VAMC.

  In her ten-year career working for the government, Levy had been given upward of a year or more to conclude her findings regarding cases of this magnitude. Why the change all of a sudden ?

  The VA was in a panic. It realized that the biggest problem it faced right away was that there had been zero accountability for the ampoules of epinephrine that went missing. Armed with that information, the VA sent out a memo to all of its facilities stating its concerns, making sure to let each center know to begin some sort of inventory regarding its supply of epinephrine.

  Levy said later that the simple fact the VAMC in Leeds “lacked any ability to review trends in deaths and codes on a particular ward that could be associated with a particular healthcare employee” was also of great concern to her bosses upon her return. They were afraid what happened at the VAMC in Leeds could be happening elsewhere, and no one would know about it unless a whistle-blower had come forward.

  None of this, however, was of any concern to SA Plante. His job was to catch a killer—and now, with the mounting evidence he was accumulating against Gilbert, it seemed as if it was only a matter of time.

  CHAPTER 37

  Going through boxes and boxes of medical records, SA Steve Plante’s gut instincts told him that he could be investigating the most successful serial killer the Commonwealth of Massachusetts had ever seen. During Gilbert’s seven-year tenure at the VAMC, three hundred and fifty patients had died. She hadn’t killed them all, of course. But even one, Plante thought, was enough to keep him looking for more.

  By the end of March, Plante moved his case off “the hill” and took it into town. It was time to start banging on doors.

  Back in February, Kristen had phoned her estranged husband, Glenn, and told him that an investigation by the IGO “regarding a high number of deaths on a certain ward” was under way at the VAMC. She said SA Plante would likely be calling.

  “You don’t have to say anything if you don’t want to, Glenn.”

  Knowing that Plante was sooner or later going be knocking on Glenn’s door, in a bit of a panic one afternoon in late March, Kristen called again. She wanted Glenn to be prepared.

  “You have spousal privileges, you know, Glenn,” she said.

  “What?”

  “Marriage protects one spouse from incriminating another. The privileges are there, Glenn, if you want to use them.”

  Glenn was still in the dark about a lot of things; he didn’t really understand what his soon-to-be former wife was talking about, because he didn’t really think that she was involved.

  This was the first time Kristen had flat-out asked Glenn to keep quiet. For the past six weeks or so, she would call and just express her anger toward whoever had been cooperating with the investigation—mainly John Wall, Kathy Rix, Lori Naumowitz and David Rejniak.

  Kristen felt they had betrayed her.

  Regarding Lori, she said, “How could that bitch speak to those people, Glenn?”

  But now she was telling Glenn there was going to come a time when he would have to make a decision about whose side he was on.

  “Yeah, whatever,” Glenn said and hung up. He wanted to be left alone.

  SA Plante, as Kristen had promised, paid a visit to Glenn around the first week of April, but Glenn didn’t say much. He wasn’t hostile or rude. But he made it perfectly clear that he wasn’t going to be talking about his soon-to-be ex. They had kids. The kids needed their mother, even if they were no longer living together.

  Plante didn’t push Glenn. He knew that if it came down to it, he could have him subpoenaed. Then he’d have to talk.

  SA Plante faced a number of obstacles as spring approached. Most of the people he’d reached out to were not all that thrilled about answering questions about Gilbert, yet they continued to help. But Glenn Gilbert and James Perrault—the two people he needed most, if he was going to begin to understand the kind of person Gilbert truly was—weren’t talking about their personal relationships with her. Perrault would answer any questions related to the VAMC—“He had no problem with that,” Plante later recalled—but when it came to his personal or sexual relationship with Gilbert, which was still burning strong as ever, he continually said it was off limits.

  “He knew his rights. He was being well informed.”

  What was it going to take, Plante often wondered, to get these guys to talk? He knew that ninety percent of the evidence he needed for a conviction was in the medical records at the VAMC. But he also knew that if he was going to understand that evidence, he would have to get into the minds of those who knew Gilbert best: Perrault and Glenn.

  As Plante contemplated what to do next, Gilbert went on the move.

  During one of her frequent calls to Glenn to find out what he’d heard, Kristen mentioned that the investigation had been centered on a “certain type of drug.”

  This piqued Glenn’s interest.

  “What kind of drug?”

  “Epi,” Gilbert said.

  “Epi . . . what is that?”

  Gilbert explained. Then she said, “If they’re looking for it in these bodies, well, they’re going to find it!”

  Glenn was confused.

&nb
sp; “Because,” Gilbert said. “Because . . . they’re focusing on it as the reason these people died.... [But],” she insisted, “it would be hard to prove.”

  She was correct, of course.

  All human beings have epinephrine—more commonly known as adrenaline—in their tissue. Whenever a person becomes startled or scared, his blood pressure rises and he feels anxious.

  That is adrenaline at work.

  Detecting excessive amounts of it in one’s system, however, was not clear science at the time. There was no definitive way to test for it—and any results would be vehemently challenged in court.

  Plante decided that he had to present Glenn Gilbert and James Perrault with some hard facts if he was going to convince them that Gilbert was the malicious serial killer he now thought her to be. He would have to show them in black and white the evidence he had without giving away his case. Yet, before he could do that, it was time to start thinking about getting the US Attorney’s Office involved.

  Gilbert, on the other hand, was acting stranger than ever.

  Near the end of May, as she was wandering around the grounds of the VAMC looking for Perrault one afternoon, she ran into RN Karen Abderhalden, whom she had known quite well and still considered a close friend.

  “Karen,” she said, “have you seen Jim? I have his dinner.”

  “No.”

  “Listen, Karen, do you think you can get me a needle and syringe?”

  “What? Why, Kristen?”

  “I need to draw some blood from Mindy [her and Glenn’s dog]. Glenn and I are short on cash. We need to have Mindy checked for heartworms. We can save some cash if we bring the blood to the vet ourselves.”

  “Absolutely not, Kristen. You’re crazy for even asking such a thing during the middle of an investigation like this.”

  CHAPTER 38

  Shaped like an inverted L, the US Attorney’s Office, located on the third floor of the Federal Building in downtown Springfield, is a stuffy office space tucked into the northeastern corner of the building. About the size of a gas station kiosk, the reception area of the office sports an American flag, a rather large picture of the attorney general and, next to that, a picture of the president of the United States.

  On June 21, 1996, Assistant United States Attorney William Welch, after coming in from one of his semi-daily jogs around downtown, sat down to man the “duty” phone, or whistle-blower hotline that handles calls from citizens or law enforcement who want to report a crime, open an investigation, or need assistance in an investigation. When Bill, as everyone in the office called him, picked up the phone at around two P.M., SA Jeff Leonard, who wasn’t working with SA Plante on the Gilbert case, but had been briefed about it by Plante, was on the other end of the line.

  “I’m with the VA-IGO in Bedford. How are you, Mr. Welch?”

  “Fine. What’s up?”

  “We have an agent in Northampton right now investigating some suspicious deaths up at one of our medical centers, and we believe we have a serial killer on our hands. We’d like to maybe open up a grand jury investigation.”

  Bill Welch, himself a Northampton resident, was stunned. It was, up until that point, a casual Friday afternoon. Watching the clock tick down all day, Welch sometimes cut out early and had a few beers with his friends at a local bar. US attorneys worked exhausting hours. There were many times when fifteen-hour days turned into ten-hour nights and sleep came in the form of a nap in the conference room.

  “Can you come in—or have your agent on scene come in—today?” Welch asked.

  “Sure.”

  A graduate of Princeton University and Northwestern University Law School—where Welch, at six-two, two hundred and twenty pounds, felt more comfortable on the football field than he did stuffed inside a classroom—he joined the Springfield US Attorney’s Office early in 1995. He was sworn in as US attorney in 1991 and worked in Reno, Nevada. For the most part, he was assigned criminal tax section cases, but soon got involved with major drug cases. In one case, Welch tried several defendants who had a major methamphetamine and cocaine distribution center in northern Nevada. The case, which garnered national attention, took thirteen months to try.

  Two of the defendants got mandatory life sentences.

  Law was injected into attorney Welch’s blood, from as far back as he can remember, by his father, the honorable Massachusetts Superior Court Judge William H. Welch.

  When SAs Leonard and Plante showed up at the US Attorney’s Office that Friday, they brought with them memos from Plante’s interviews with Kathy Rix, John Wall and Renee Walsh.

  Welch was overwhelmed by the allegations. Trying drug, murder-for-hire, fraud, extortion and mob cases was one thing, but going after a nurse for the deaths of her patients was something Welch had never imagined. It didn’t seem possible. Welch lived in Northampton. He had driven by the VAMC and gone mountain biking in the hills just beyond it ever since moving into town. To think that a nurse had killed multiple patients was incredible. Yet, he told himself after reading the notes from the interviews, there had to be something to it, seeing that the three nurses had more than five decades of experience among them, which alone gave the substance of their allegations credibility.

  “What is your biggest concern right now?” Welch wanted to know.

  “Well,” Plante said, “it’s the boyfriend, James Perrault. He’s a cop up there. He hasn’t been all that cooperative. . . .”

  The first thing Bill Welch did, after deciding they might have a case, was open up a grand jury investigation.

  The next thing he did was issue a subpoena for James Perrault.

  Days later, Plante and Welch met again.

  “We have to review each death and come up with, as morbid as it sounds, a Top Ten list of suspicious deaths,” Welch advised.

  “Dr. Mike Baden,” Plante said, “has been doing that for the past few days. He’s on the scene now, going through the medical records.”

  Along with renowned forensic pathologist Dr. Baden, Welch made a few calls and enlisted the help of Dr. Mark Nelson, a VA doctor who had reviewed records in a couple dozen deaths that occurred between March and August 1992 at the Harry S. Truman Memorial Veterans Hospital in Missouri.

  Dr. Michael Baden, a product of the 1930s Bronx, had a career as a forensic pathologist spanning some four decades. By the time he was called in to study the medical records in the Gilbert case, working on VA poisoning cases had become a forte of his. Resident Agent Bruce Sackman, the top dog himself, in charge of IG offices in Boston, New York and New Jersey, had taken an aggressive position in the Dr. Michael Swango murder case and the Missouri VA hospital murders.

  In March, when the Gilbert case was put in front of Sackman, he took the same stance, knowing exactly whom to call.

  “We have this funny case up in the Northampton, Massachusetts, VA hospital,” Sackman told Baden during that first phone call. “We think one of the nurses may have been doing harm to the patients. We need you to take a look.”

  Baden’s expertise had been instrumental in helping to get the US Attorney’s Office in New York to open a case against Dr. Michael Swango, the debonair, blond-haired, blue-eyed doctor who was ultimately convicted of murdering three patients in a New York VA hospital and one woman while he was an intern at Ohio State University Hospital.

  It was because of Bruce Sackman, Baden recalled, that Swango was brought to justice. The former US attorney in New York, who had refused the case several times before she took another job in the private sector, had for years failed to see what Sackman had. But as soon as she left her post, the US attorney who took her place jumped right on the case and pursued it.

  “As much as everybody wanted that case to go away,” Baden recalled, “the IGO—Bruce Sackman in particular—didn’t. If it weren’t for Bruce’s persistence . . . nothing would have happened to Swango.”

  In his book Dead Reckoning: The New Science of Catching Killers, cowritten with Marion Roach, Baden labeled himself an at
heist.

  “It’s hard for me to believe in a God who would not only tolerate Hitler but also allow people to do the horrible things they do to one another,” he wrote.

  When he enters the “autopsy suite” to look into a person’s life and death, Baden wrote, he has to leave God at the door and rely on science. It’s the only way to get through it all.

  Conducting more than thirty thousand autopsies throughout his career, working part of his career in the Office of the Chief Medical Examiner in New York City, Baden has no doubt seen everything imaginable.

  Sporting a partially receding swath of wiry gray hair, at seventy, Baden was reminded daily of how cruel the human race can be to one another—an issue that started for him shortly after he was born, when fourteen of his mother’s siblings were murdered in Auschwitz.

  Baden’s credentials spoke for themselves. He had been involved in O.J. Simpson’s defense; the autopsy of actor John Belushi; the re-autopsy of Medgar Evers; the autopsy of New York Yankee Billy Martin; the autopsies of Mary Beth Tinning’s nine kids; the re-examination of the Lindbergh kidnapping and murder; and the investigation by the Congressional Select Committee on Assassinations into the deaths of JFK and Martin Luther King, Jr.

  Married, with three grown children, he lived in New York City, where he hosted a show on cable’s Home Box Office called Autopsy.

  Bruce Sackman knew he was calling in the best when he got Baden involved in the Gilbert case. If the truth was there, Baden would find it.

  Within a few days after arriving at the VAMC and reviewing one tedious medical file after the next, Baden realized that several of the patients under suspicion had suffered unexpected sudden deaths. SA Plante had already narrowed the initial list of the three hundred and fifty deaths down to three dozen. A lot of the records in question, Baden noticed, were from patients who were either expected to be released from the VAMC in a matter of days, or who had been receiving treatment for conditions unrelated to their hearts.