For the defense, this was a good strategy. Because when it came down to it, to the jurors who had most likely never laid eyes on Gilbert before, she didn’t look any different from their next-door neighbors. If they expected to see a one-eyed, one-toothed, snarling monster in an orange jumpsuit and shackles they could identify as being a serial killer, they were disappointed. Most people equated serial killers with John Wayne Gacy in a clown suit, Ted Bundy cruising the countryside in a Volkswagon, Jeffrey Dahmer stowing his victims in a refrigerator and later cooking and eating their flesh, or Charles Manson waving his arms while shouting Nazi propaganda.
But an overweight woman in a purple blazer who had lived and worked in Northampton, Massachusetts? No way.
Indeed, no matter what picture Welch had painted in his opening statement, Hoose would have to make the jury believe they were looking at themselves, or someone they had perhaps worked with, when they stared at Gilbert.
Hoose made sure the jury knew that Gilbert was, at one time, nothing more than a quiet, professional mother of two living in a small house, with two cars in the driveway and a boat in the garage. She was a nurse. A soccer mom. For crying out loud, she helped the needy.
It was all a conspiracy arranged by her coworkers.
“The day she left, the rumors began flying. The rumor mill pushed her to a psychiatric bed,” Hoose snarled.
What about all those missing ampoules of epinephrine? Hoose had a theory.
“Epinephrine is a drug,” he said, then, using his hands like a politician to help move his point along, “and like any other drug it can be abused, and the people most likely to abuse it are other drug users.”
He then attacked Bonnie Bledsoe and John Wall, saying they could have been responsible for the missing drugs. He called Bledsoe an “asthmatic with a hundred-dollar-a-day crack habit.”
By the time he was finished, Hoose already had given the jurors plenty of reasons to doubt. He suggested that the toxicological evidence against his client was taken under erroneous circumstances, that perhaps Dr. Michael Baden and Dr. Fredrick Rieders were involved in a cover-up.
It was a compelling speech, one that had spectators on the edge of their seats the entire time.
For Vuono and Welch, however, it was a folly. They knew when the jury had a chance to see the autopsy photos of Kenny Cutting, Ed Skwira and Stanley Jagodowski, whose flesh had rotted and peeled back like paint chips in the years hence, reality would set in rather quickly. Hoose’s theatrics and conspiracy theories would be long forgotten. It didn’t matter that Gilbert was a “good nurse,” “a good mother,” and did good deeds for the needy. Or that Bonnie Bledsoe and John Wall were drug addicts who could have stolen ampoules of epinephrine. The fact was Gilbert had killed these helpless veterans to impress a man with whom she was having an adulterous affair—and the autopsy photos, together with all the other evidence, would present the end result of those crimes in a way that no one had ever seen before.
CHAPTER 84
Beverly Scott, Stanley Jagodowski’s nurse on the night he coded, took the stand and explained to the jury that Jagodowski had not been scheduled to receive any injectable medications on the night he died, and that Gilbert had walked into his room with a syringe in hand. Susan Lessard, Jagodowski’s daughter, was next, and she recalled her memories of that night.
Then the government called Dr. Thomas Rocco, the head of cardiology at the VAMC in West Roxbury, Massachusetts.
Dr. Rocco’s long list of credentials—Cornell and Harvard Medical School, the UMASS Medical Center, Massachusetts General Hospital in Boston—made it clear that if there was one person in that courtroom who knew about the condition of the patients’ hearts in question, it was Dr. Rocco. He had studied the medical records of all the victims for months and came to the conclusion that their deaths were consistent with epinephrine poisoning. Using the Power Point presentation technology to describe in detail the science of the heart and how it is affected by cardiac arrest, Rocco told the jury that coronary artery disease accounted for more than three quarters of the number of the cardiac arrests in the country. Then, after carefully explaining how he had analyzed each of the victims’ medical records, including notations made by all of the nurses and doctors involved, their autopsy reports, and any other data he could find, he said that none of the veterans had died of coronary artery disease.
Hoose took notes as Rocco explained how he had used seventy-percent blockage of an artery as a threshold for diagnosing death by coronary artery disease.
Back after a break for the Thanksgiving holiday, Rocco took the stand for a second day, Monday, November 27. Throughout the day, he further illustrated how the heart works, how it becomes diseased, and how it can, unexpectedly, stop. Welch had him go through each of the victims’ codes and explain in detail how he thought each patient had died from sudden cardiac death, not cardiac arrest.
There are basically two forms of death, Rocco explained: natural death and sudden cardiac death. Natural death occurs in someone who is ill with, say, pneumonia or kidney failure. There’s a serious illness in the body that is “not directly related to the heart, and essentially the cause of death is that problem. The body dies, and the heart follows,” Rocco said.
But sudden cardiac death, as one might assume, comes on without warning.
“It’s naturally occurring death or a natural sudden cardiac death, but the heart is the problem; something happens to the heart directly, and that causes the death of the body.”
Referring to Kenny Cutting’s code, Rocco said, “The sudden cardiac arrest described here was not normal.”
Although Thomas Callahan and Angelo Vella had respiratory diseases, Rocco insisted that those particular afflictions did not “trigger” their cardiac events.
Welch had been scheduled to conclude his direct examination of Dr. Rocco later that day, with Paul Weinberg set to begin the defense’s cross-examination soon thereafter. But David Hoose had called Welch over the weekend and said that Weinberg had been taken to Baystate Medical and wouldn’t be available until perhaps Wednesday.
“Why?” Welch asked.
Hoose began laughing. “Well, Bill, Paul had some chest pain last night. He was dizzy, sweating . . .” In other words, he had an anxiety attack.
On Tuesday, Hoose argued in front of Judge Ponsor that his team could not continue without Weinberg. Ponsor agreed, and gave them the remainder of the day off, but said they would be back in court on Wednesday—with or without Paul Weinberg.
So with Weinberg still not available, Welch agreed to bring in several more witnesses, among them, respiratory therapist Michael Krason and RN Mary O’Hanlon.
Krason and O’Hanlon went on to bolster the government’s theory that Gilbert had lied on several occasions by compromising the medical records of certain patients. Like many of the witnesses, O’Hanlon hadn’t seen Gilbert in four and a half years.
“Do you see Ms. Gilbert in the courtroom today?” Assistant U.S. Attorney Ariane Vuono asked O’Hanlon. Then, after a brief moment of silence, as O’Hanlon looked around the room, Vuono said, “If you do not recognize Ms. Gilbert, you can state that for the record, Mrs. O’Hanlon.”
“I’m having trouble recognizing her,” O’Hanlon reiterated.
Michael Krason brought to the trial its first taste of melodrama when he told the jury he had watched as Gilbert wiped the sweat off of James Perrault’s brow during a code one night.
On November 30, Dr. Rocco returned. Welch had him discuss how many of the symptoms Thomas Callahan suffered prior to his cardiac event were consistent with an injection of epinephrine. Regarding Callahan’s heart rate nearly doubling after he coughed, Rocco said, “This was a striking biological event.”
When asked about Callahan singing “Ave Maria” at the top of his lungs before his code, Rocco stated that Callahan was “improved to the point where he could sing.”
Watching the proceedings closely, with what many would later say was an “evil” gaz
e, Gilbert wrote dozens of Post-It notes and handed them to Hoose and Miles as Rocco described one code after the next, giving various reasons why he thought they were not natural events.
Rocco made a point to explain why some of the veterans hadn’t gone into cardiac arrest immediately after Gilbert had injected them with epinephrine directly, as opposed to when she injected the drug into their IV lines.
Epinephrine injected into the arm—as in Stanley Jagodowski’s case—or into the muscle tissue, Rocco said, is not only painful, but it takes longer to reach the heart and cause damage, which explained why, when Beverly Scott later asked Stanley Jagodowski if he was feeling okay, he said that besides the pain in his arm, he was fine.
By Friday, December 1, anyone sitting in the courtroom for the past week now understood completely the difference between sudden cardiac death, cardiac arrest, and death by natural causes. Entirely composed, Rocco had come across on the stand as if testifying in high-profile cases was a full-time job. Many of the jurors had scribbled notes while Rocco spoke, while others sat captivated by his obvious expertise.
Before Welch handed Rocco over to Hoose—who had since decided to take over the cross-examination from Weinberg—at about noon, he fired off his final few questions.
“. . . [A]re you a salaried employee for the VA Medical Center?” Welch asked.
“Yes, I am,” Rocco said.
“Are you receiving any extra compensation for the time, both in preparation for your testimony and your testimony in court?”
“No, I’m not.”
“Can you tell the jury whether you’ve ever testified before?”
“No, I have not.”
After trying to get Dr. Rocco to admit he had gotten involved in the Gilbert case with a bias toward a criminal investigation, and that his opinion had been tainted from the beginning by Dr. Michael Baden and Assistant U.S. Attorney Bill Welch, Hoose went right after the seventy-percent threshold the doctor had put on his diagnosing coronary artery disease.
Rocco admitted that although he chose seventy-percent blockage of an artery as the bar, most doctors chose fifty percent. But still, by his estimation, all of the victims in question had not been at risk from dying of sudden cardiac arrest, which could have been, Hoose insisted, brought on by coronary artery disease.
What about Ed Skwira?
Rocco admitted that Skwira had suffered from coronary artery disease and hypertension, two ailments that could have led to his cardiac events.
After the weekend, Hoose continued grilling Rocco about his methods of diagnosing coronary artery disease and why he had drawn the conclusions he had. But it was beginning to sound as if Hoose was just repeating himself. The jury looked restless. Bored. They had heard enough from Dr. Rocco. It was December 5, time to move on.
CHAPTER 85
Continuing with the chronology of the events and deaths, Ariane Vuono called several witnesses who explained thirty-five-year-old Air Force veteran Henry Hudon’s death. None offered a definitive smoking gun. But it was clear—especially when one took into context Dr. Rocco’s earlier testimony—that Henry Hudon, a man who, other than waging a fifteen-year battle with schizophrenia, was as healthy as an ox and, for no reason anyone could entirely explain, died of sudden cardiac death.
Special Agent Donna Neves, who had gone to the scene in late February 1996, shortly after John Wall, Kathy Rix and Renee Walsh had first turned Gilbert in, testified how she had helped locate several e-mails between Perrault and Gilbert that had been written on the night Hudon died. It was one of the first glimpses the jury got into the sexual affair that the government claimed had initiated Gilbert’s killing spree.
Since Gilbert was defended by public defenders Hoose, Miles and Weinberg, the buzz around the courtroom during the fourth week of trial was that any grandiose claims of coming from a wealthy family Gilbert had made in the past to her former colleagues had been dismantled by the testimony of her former friends and coworkers, not to mention the lack of moral support by her own family. Many thought it odd that Gilbert’s parents, Richard and Claudia Strickland, who had pledged their loyal support from day one, hadn’t been in the courtroom since the second day of proceedings.
When the trial resumed on December 11, RN Elizabeth Corey finished giving her rendition of Henry Hudon’s admittance into the VAMC on December 8, 1995, while Dr. Gregory Blackman, who followed Corey, explained how he had responded to each of Hudon’s four codes.
Next, Massachusetts state medical examiner Dr. Loren Mednick, who had conducted Henry Hudon’s autopsy, shocked the courtroom by saying he could find no natural cause of death for the thirty-five-year-old vet.
“It’s not very often I run into a case where I don’t have an answer—or even a hint of an answer.”
On December 13, being questioned by Bill Welch, Julia Hudon brought tears to the room as she recalled Henry’s final words to her as he was being wheeled into the elevator on December 8, 1995, the last time she saw her son alive.
“He said, ‘I don’t want to die, Momma,’ ” Julia Hudon explained, fighting back tears.
More than three years after Francis Marier had suffered a cardiac arrest that nearly killed him, looking pasty and weak, he was interviewed via videotape by Assistant U.S. Attorney Bill Welch. Because Marier’s health was in such a rapid decline, Welch wanted to document the Army vet’s rather extensive knowledge of diabetes, along with how the seventy-two-year-old knew what to do when his blood sugar was low.
The video was part of Dr. Margo Denke’s testimony on the afternoon of December 13. Denke was the government’s diabetes expert, having run a clinic for diabetics at a Dallas VAMC. Denke couldn’t explain, she said, Marier’s bout with low blood sugar levels on the night he coded. There was no natural cause for it, she insisted.
When further pressed by Vuono for more detail, Denke said, “The only explanation is a very large dose of long-acting insulin.”
Exactly what Vuono wanted to hear.
Pressed even further to explain why Marier’s blood sugar level, for eight hours, had hovered in the forties on that same night, Denke could only say that “there must have been something that was soaking up the blood sugar and utilizing it.”
To clear up any misconception the jury might have regarding a connection between low blood sugar and cardiac arrest, Vuono asked the doctor if it was possible one could cause the other.
“There is absolutely no proven relationship between a low blood sugar level and a cardiopulmonary arrest. It does not happen.”
After Denke left the stand, a gruff-looking, heavyset man walked through the double doors and, after being sworn in, took a seat in the witness box just in front of Gilbert.
Frank Bertrand first said he owed Gilbert for the life he now had with his wife of many years, because Gilbert had been the one to set them up on a date.
But Bertrand, who had lived in nearby Goshen all his life and worked at the VAMC for the past twelve years, had always been an honest man, and today was no exception. He was there to explain what had happened to Angelo Vella on February 4, 1996, and whatever Gilbert had done for him in the past had nothing to do with that.
As the government’s seventeenth witness, Frank Bertrand said that when he heard Vella scream out in pain, he rushed into his room only to find Gilbert standing by his side, syringe in hand.
Bertrand told the jury that Vella screamed out, “She did it.”
The courtroom went silent.
She did it.
Gilbert, staring at anything else in the room besides Bertrand, kept writing notes and handing them to Hoose and Miles as Bertrand continued to implicate her further in Vella’s code.
CHAPTER 86
Because a winter storm had arrived in Springfield on Thursday, December 14, court proceedings were canceled for the day. When things picked back up on Friday, Frank Bertrand finished David Hoose’s cross-examination and Ariane Vuono’s redirect examination. For perhaps the first time during the trial, a witness had
placed Gilbert in a patient’s room as he went into cardiac arrest. It wasn’t eye-witness testimony to murder, but the closest thing to it Welch and Vuono had to offer thus far.
After Bertrand, it was up to former Ward C nursing manager Melodie Turner to give jurors a glimpse into life on Ward C both before Gilbert had been under suspicion for murder and afterward. Since the investigation had begun in 1996, Turner had been ousted from her managerial position and placed in the outpatient clinic at the hospital as a registered nurse. It was a political move all the way. Turner hadn’t been qualified for the job as nursing manger in the first place. But her superiors, of course, had told her she was. Yet a nurse who had never even participated in a code taking a job in which she would have to supervise those who did, it was surely something that would now, as soon as Hoose got hold of her, come into question and fall on her shoulders.
First thing Monday morning, December 18, with Turner still on the stand, Welch wasted no time bringing into the record her history of letting the nurses know how important it was to document a patient’s vital signs and staple various sections of a patient’s heart monitor rhythm strips to his chart.
“Did you make [this] known to all of your nursing staff?”
“Yes.”
“Did you leave signs or messages within the ICU or out on Ward C with respect to rhythm strips and charting?”
“I had things under the glass blotters. I had blank medication sheets posted right in front of the nurse’s station and the same setup in the ICU under the glass top blotter. . . .”
Turner was explaining to the jury one of the government’s main theories: that Gilbert knew VAMC policy and procedure, yet failed to document the condition of her patients the same as the other nurses on the ward had been doing. There were many times throughout Turner’s testimony where Welch brought into the record a chart from a patient that, with the exception of Gilbert, had been documented accurately. It showed one of two things: that Gilbert had either failed to follow procedure or that she chose not to include information that might later implicate her in something that had happened to a particular patient.
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