Perfect Poison

by M. William Phelps

Judge Michael Ponsor ended up fining Gilbert $1.5 million, noting that she would also have to “reimburse her victims’ survivors for funeral expenses.”

  Based on her pay scale at the Carswell, Texas, penitentiary where she is incarcerated, working an eight-hour day, five days a week, it will take Gilbert more than thirty-five hundred years to pay off her fine.

  Several civil suits were ultimately filed by victims’ families against the Leeds VAMC. In June 2002, however, Judge Ponsor allowed a government motion to dismiss the suits filed by the families of Stanley Jagodowski, Ed Skwira, Angelo Vella, along with the families of Carl Rauch and Ralph McEwen, two veterans who were not named in the indictments against Gilbert but had also died—like many, many more—while under her care.

  The civil suits, Ponsor ruled, were filed after the statute of limitations had run out. The families argued that they didn’t know there had been malpractice because Gilbert’s crimes weren’t made public for some time after the deaths.

  “By 1996,” Ponsor wrote, “each plaintiff knew—at least—that an investigation into the unusually high number of deaths from cardiac arrests at the VAMC was under way.” The families were devastated by this.

  But Kenny Cutting’s wife, Nancy Cutting, filed a lawsuit within the time frame of the statute, Ponsor ruled.

  Her case continues.

  The United States is home to more than twenty-five million veterans of military service, about three million of whom are treated every year for various reasons at some twelve hundred government medical facilities nationwide. All fifty states have veteran patient care centers of some sort.

  With an average of twenty-five million outpatient visits and one million inpatient discharges yearly, the Department of Veterans Affairs, Veterans Health Administration, is the largest healthcare system in the world. With a budget of $20 billion, and a staff of more than one hundred and eighty thousand—sixty thousand of which are nurses—it prides itself on the quality of the people it employs.

  Practice, Quality of Care and Performance stand at the top of the VHA’s mission statement.

  To some, however, these words mean nothing. Many times, when there is a problem nurse, for example, the VA does little to discipline him or her and, like the Catholic Church, simply relocates the problem person.

  “[The VA] has a way of never getting rid of anybody,” one nurse who has worked for the VA for more than twenty years and chooses to remain anonymous for obvious reasons says. “If you’re a bad nurse, the worse I’ve ever seen them do to anybody is move them to another ward.”

  About six months after I began researching this book, I called the VAMC in Leeds and asked the Public Relations Director if I could come up to the hospital for a tour. Ward C had been dismantled by then, but I wanted to get a feel for the place, its sounds and smells, the color of the paint on the walls, the ebb and flow of the hospital, and the people who work there.

  I wanted to walk the same halls as Kristen Gilbert.

  “I’m writing a book about the Gilbert murders,” I said. “A tour of the facility would help color the background of my book.”

  After a brief silence, “Absolutely not!” she shouted.

  She was, obviously, appalled that I had the nerve even to ask.

  “Well, I would just want to look around to get a feel for the place, ma’am. I mean, a majority of the book takes place inside your facility.”

  “You are not welcome here. We would never,” she said, raising her voice again, “allow someone to come up here for that reason. It is against policy.”

  I could hear her huffing and puffing. How dare you!

  A week or so later, I had coffee with a local reporter who had covered the Gilbert story.

  “I understand you spoke to [the Public Relations Director],” he said as we sat down.

  Stymied, I looked at him. How the hell did you know?

  I didn’t say anything at first, though. Then, after collecting my thoughts, “Yes,” I said, “and boy, was she pissed.”

  “I saw her yesterday,” he said, leaning back in his chair, smiling, gloating. “She said that if I were to write the Gilbert book she would have no trouble allowing me full access to the hospital.”

  He took a bite of his bagel, eyeing at me the entire time.

  “Do you think that I didn’t go up there already and poke around before calling her?” I asked.

  “What?”

  “I’ve been up there two times,” I said. “Inside the hospital, looking around, asking questions, taking notes . . .”

  “How did you get in?”

  “I walked.”

  As the weeks went by and I began to make my way through town, visiting all of the locations involved in this story, beginning the process of interviewing people, I learned quickly that the VAMC in Leeds would rather wish away the fact that Kristen Gilbert went on a murderous rampage under its nose for—as some have suggested—seven years, rather than confront it.

  “Push it all underneath a very large rug,” one nurse told me.

  Ever since coming forward with their allegations, the three nurses responsible for initiating the investigation into the deaths at the Leeds VAMC—Renee Walsh, Kathy Rix and John Wall—have been treated as if they have broken some sort of sacred vow.

  Wall, Walsh and Rix did something many of their coworkers, for years, had the opportunity to do, but, for whatever reason, chose not to. Their photographs should be on the walls in the entrances of all the VA medical centers throughout the country, visible as soon as you walk in. A caption above each photo should praise their integrity, their courage, their honesty. These people are heroes.

  Throughout Renee Walsh’s VA career, she has received several monetary awards for, she told a reporter one day, “just doing her job.” One time, she received a $250 award for attending a meeting to help a ward merger; a second time, she was awarded $500 for working with two younger nurses, helping them deal with hospice patients who were dying.

  Yet though Walsh stuck her neck and career on the line and turned in Gilbert, to this day, neither she—nor Kathy Rix nor John Wall—has received anything from the Leeds VAMC other than animosity and silence.

  It’s not about the money, Walsh told that same reporter. It’s about being recognized for coming forward and “doing the right thing.”

  Three nurses turn in a coworker and save more lives in one day than anyone at the VAMC will save in their entire careers, and the Leeds VAMC acts as if it never happened, shunning Rix and Walsh every chance it can. (John Wall no longer works for the VA.)

  According to documents I obtained later, in late 2001, the National Forensic Nursing Conference, held yearly in Colorado, sent an e-mail notice to all of the VA medical centers across the country with instructions to notify the nursing staffs in all its facilities that the annual conference was coming up. Renee Walsh and Kathy Rix, along with former nursing manager Melodie Turner, had received similar messages about similar conferences and VA-related matters routinely throughout the years.

  The 2001 NFN conference, however, was quite a bit different from years past: The entire conference was dedicated to discussing Kristen Gilbert and, in general, serial killers in hospitals.

  Yet neither Melodie Turner, Renee Walsh nor Kathy Rix received the e-mail announcement. It was as if the Leeds VAMC didn’t want them to attend—and, more sinisterly, didn’t even want them to know about it.

  But it didn’t end there.

  The Leeds VAMC not only failed to tell Rix, Walsh or Turner about the conference, but it paid for and sent William Boutelle, Chief of Staff, and David Levin, chief of Quality Management. In fact, the two men were keynote speakers.

  Kathy Rix and Renee Walsh were directly responsible for the apprehension, and partly responsible for the conviction, of Kristen Gilbert, thus initiating the subject matter of the conference in the first place. If anyone from the Leeds VAMC should have been speaking at that conference, one would think it would have been Rix, Walsh, or both.

  I
t must be noted that US Attorney Ariane Vuono, who, in my opinion, was often treated poorly by the local press—many times being pushed to the side in post-trial stories, leaving the reader to believe that Bill Welch tried the case by himself—played as big a role in Gilbert’s conviction as any other member of the government’s team.

  In addition, Gilbert’s former attorney, David Hoose, in a post-trial newspaper story, likened US attorney Bill Welch to a “Nazi.” Hoose was upset because Welch pursued the death penalty in the Gilbert case so vigorously, and made it sound as though he had a personal vendetta against Gilbert. I spent some time with Mr. Welch, studied his entire career, reviewed hundreds of pages of documents he prepared for the Gilbert trial, and spoke to many people who know him. I can say that Bill Welch is one of the most considerate, well-spoken, truth-seeking, and justice-driven lawyers I have ever met. David Hoose could not have been more unprofessional and ridiculous with his comments.

  Nearly everyone I spoke to while writing this book asked me the same question: Why did she do it?

  There is no definitive answer to that question. There’s plenty of speculation. Rumor. Gossip. Theories. But it is all spin. My answer, after spending years studying the minds of the criminally insane and more than a year and half researching Kristen Gilbert’s entire life, is still the same as it was from day one: Adults don’t one day wake up and decide to become serial killers; they are wired at some point—usually during childhood—so that they might later cultivate a malevolence and perpetrate crimes based on what they have been taught. Only Kristen Gilbert knows when, where and by whom that evil seed was planted. She is the only person on this earth who can honestly say if there even was a reason behind her brutality—and to this day, Gilbert continues to deny having anything to do with the VAMC murders for which she was convicted.

  —M. William Phelps

  October 21, 2002

  UPDATE 2014

  Female serial killers are rare. In the United States, according to the most recent (separate) studies by criminologist Eric Hickey and the Bureau of Justice, females account for only 8 percent of all serial killers. American female serial killers, on the other hand, out of all female serial killers throughout the world, make up 76 percent.

  It’s a good thing the female serial killer is a rare breed: both studies bear out the fact that although females make up a small percentage of the serial killers roaming the earth, they are—these same experts claim—as much as two times more dangerous than males. The reason for this is, of course, the stealthy, devious methods they use to kill, and how long they can kill before being detected and/or found out.

  It’s been well over a decade now since I published the book you have just read, my first. Since its publication, Perfect Poison has reached people all over the world. I’ve heard from soldiers stationed in Iraq, Afghanistan, and all throughout Europe and Asia, who have read the book and been kind enough to thank me for writing it. I am humbled greatly by this. Several told me they had become so engrossed in Kristen Gilbert’s mania and madness that for a few hours, every now and then, they were able to lose themselves in my book and forget about the battlefield or missing their family members. I consider this an honor and blessing to be allowed into the lives of these heroic and courageous men and women.

  Kristen Gilbert’s secrets were exposed to the world with the publication of this book, and her legacy as one of the most prolific female serial killers in the United States was set in stone. This could be what she wanted all along: to be famous. Who knows? To be immortalized in infamy as a legendary, notorious female serial killer, such as Aileen “Monster” Wuornos or Sister Amy Archer-Gilligan, a multiple poisoner-serial killer who ran a nursing home in Connecticut that I wrote about in my book The Devil’s Rooming House. We don’t know yet how Gilbert feels about any of the notoriety she received from the book and subsequent crime shows produced about her cases or any articles written about her. We’re not aware, of course, of how she felt about her sentence, victims, or crimes, because Gilbert has never spoken to a reporter or anyone in the media. Gilbert remains in the Federal Medical Center (FMC) Carswell, in Fort Worth, Texas. It’s a facility, I’m told, that provides its female inmates with “specialized” medical and mental-health services. She is forty-five years old, as of this writing. From what I’ve heard, Gilbert has been a good prisoner. She’s a lifer, so there is no reason for her to do anything else but settle in and come to terms with the existence she has created for herself behind bars. She is, after all, lucky to still be alive.

  On a very sad note, one of the heroic nurses in the Gilbert story, John Wall, died on November 20, 2008, after what his obituary described as “a long illness.” I liked John. We met and spent some time together in the months after the book was released. Not long after the publication of Perfect Poison, John Wall, Renee Walsh, Kathy Rix, and I were invited to Washington, DC. The three nurses accepted awards from the Veterans Affairs Administration (VAA). I’ll never forget the event, for several reasons. I had been asked to prepare a speech. They had given me a guideline, including how long it should be. I followed my orders to a tee.

  I focused my speech on heroes, hero worship, and the DNA, in my opinion, making up a true American hero. I spent weeks writing and rewriting this speech. It was extremely important to me to validate John, Kathy, and Renee’s efforts to bring Gilbert to justice. They deserved the best I had in me. My belief was (and still is) that three nurses—who turned in a serial-killing nurse, but were then shunned and ostracized during the entire process, scared the entire time they were thinking about turning Gilbert in—fit into a category we generally designate for sports figures. I believe people like John, Renee, and Kathy, schoolteachers, single mothers raising children, stay-at-home mothers and fathers, men and women who choose to work fulltime and raise a family, civil rights leaders, and many other everyday people we interact with throughout our daily routine are true American heroes. Heroes are not the men who can bat .425 as an average, or score forty points in a basketball game, or pass or run the most touchdowns into the end zone.

  You see, I prepared this speech showcasing these heroic nurses’ work and heroism. I was proud of what I had written. I had captured my feelings on paper—which, any writer can agree, is a hard thing to accomplish. As I began to give the speech to a large, well-dressed, well-fed audience of Washington socialites, folks of all political stripes and politicians at the National Republican Club on Capitol Hill, only a few minutes into it, the director of the program, who had brought me and the nurses to Washington, cut me off. I literally felt as though she had one of those old-school vaudeville hooked canes and was pulling me off the stage. It was humiliating, honestly. I was angry.

  And confused.

  As she walked up and stood next to me, she and everyone else started clapping.

  And that was it.

  I felt dissed!

  And quite used.

  The look on the faces of Kathy, John, and Renee telegraphed: Now you personally understand how it works here in the VAA!

  I recall the Veterans Affairs commissioner coming in with his posse (including a photographer, who obviously traveled with him). The commissioner posed for a few pictures with the group of nurses and then walked out of the room, waving at everyone. It happened all in one, well-choreographed motion.

  But, hey, the night was not about me—and politics being what they are in DC, I got it. Nevertheless, Kathy, Renee, and John all received a copy of my speech in the lobby of our hotel the following morning and they were able to read it on their own time in its entirety. I was happy they were recognized—finally.

  As the years pass and my work on Dark Minds, the Investigation Discovery channel series about serial killer cold cases I created and star in, takes me into the depths of my serial killer research, I get deeper every day into the psychology behind the mind of the serial killer. I can see today how easily Gilbert fits into the textbook entry of the female serial killer and, equally, how she embodies the psycholog
y many experts agree make up the wiring of the female serial killer. Gilbert’s entire world revolved around, well . . . her. If there was a study put together to explain narcissistic personality disorder, a serious disorder I talked a lot about in Perfect Poison, Gilbert would be the poster specimen. I realize this today more than ever. Her behavior, as you have seen throughout this book, is as close to a model, archetypal narcissist as you’ll find.

  Whatever Gilbert did, she did out of an inherent need to please herself, fulfill the fantasies in her head, and live out what was a deep-seated psychopathy, which not only became her reality, but her daily life. Gilbert needed to kill to feel alive. She needed to be the center of attention, no matter what the situation. If she wasn’t, watch out; she’d lash out at you. More than that, though, I’ve also learned through my work with John Kelly—serial killer profiler, psychotherapist, social worker, certified addiction specialist, good friend, mentor, fellow at the American College of Forensic Examiners, and my mind expert extraordinaire on Dark Minds—that Kristen Gilbert was addicted to killing people. She would never have stopped.

  About six months after Perfect Poison was published in 2003, another serial-killing nurse became a household name: Charles Cullen. Recently, in a new book, the speculation is that Cullen killed more people than any other serial killer in American history. His number of kills, so say these latest claims, could be near or exceed three hundred.

  Yes, three hundred human beings murdered by one man.

  Startling. Alarming. Amazing.

  Other reports aren’t as sweeping, going only so far as to say Cullen is the most prolific serial killer in the history of New Jersey (where he did most of his killing)—and that is perhaps quite true.

  To claim Cullen is the most prolific killer in American history is a bold statement. The roughest part of stating such a thing is that with medical/nurse serial killers, proving how many they killed in a hospital or convalescent home setting becomes very tricky, to say the least. Medical records are hard to get hold of unless the suspect has been (or is being) tried for the case(s); the cause of death in someone who is already generally severely ill is normally cardiac arrest and there is hardly an autopsy ever conducted; and there is no way to pinpoint exactly when a medical serial killer began his or her killing spree. It’s almost impossible to go back and with any accuracy study all of the records from all of the facilities the killer worked at. The way it was explained to me: Medical examiners look at records and try to find that one kernel of evidence leading them to believe the patient might have been murdered—and then make a decision from there to investigate further and, perhaps, under the right circumstances, begin exhuming bodies, after alerting and asking family members. But without exhuming hundreds of bodies, conducting autopsies, reinvestigating, retesting, and reinterviewing people involved in all of the cases, it is impossible to say with certainty that a person was murdered by a particular poison, overdose of medication, smothered, asphyxiated, or even strangled.