The Good Nurse: A True Story of Medicine, Madness, and Murder

by Charles Graeber

  “They didn’t tell you about Pyxis?” Amy said. “But you—”

  “We knew about it. We just had, uh, a problem getting the records for a while.”

  “How about Cerner?”

  Tim looked over at Danny. “I’m not sure what—who’s Cerner?”

  Amy couldn’t believe it. They didn’t have the Cerner data? Neither Tim nor Danny had heard of it. Lund had never mentioned it; nobody at the hospital had. Amy had to wonder, What the heck have they been investigating with?

  Amy explained that if you wanted to learn about patients, Cerner was the tool. It was a computer system that kept patient records, the way Pyxis did with drug orders. Pull the Cerner data and they’d have a running time-line record of every patient’s progress on the CCU and a time-stamped record of every time Charlie had ever looked at a chart. They didn’t know that?

  “See, that right there,” Danny said, writing it down. “That’s why we’re trusting you. But if we’re going to be able to do this, you’re going to need to keep the relationship, um, separate from the hospital.”

  “Don’t tell them shit,” Tim said, “would be the idea.”

  “Okay,” Amy said. “I won’t say anything.”

  “Good,” Danny said. “I know we’re putting you in a difficult situation—”

  “I won’t say anything, really,” Amy said. “Swear.”

  “Look, Amy, here’s—let me say this,” Tim said. “We wouldn’t be taking a risk showing you all this, if we didn’t think it’s important.”

  “It’s clear to us—and I think it’s clear to you, too—that Charles Cullen was doing something wrong at the hospital,” Danny added.

  “We think he killed a patient. Maybe more than one. And we think he may have been killing patients for a long time.”

  “Oh God,” Amy said.

  “And, see Amy, here’s the thing. If we don’t stop him, he’s going to kill patients again, somewhere else.”

  “My God,” Amy said. “I screwed up! I told him I’d help him get a job—I’m his reference…”

  “It’s okay,” Tim said. “That means you’ve got a reason to talk to him. Because, here’s the thing.”

  “We need your help,” Danny said.

  “You can help us stop Cullen. We want you to work with us.”

  “Keep up with Charlie, see how he’s doing.”

  “Be our eyes and ears.”

  “Wait—what?” Amy said. She pushed back from the table. “You tell me he’s killing people, but you want me to stay friends with the guy?”

  “I know, I know, I know,” Tim said. “But, yeah.”

  “Not friends,” Danny said. “You don’t have to be friends. Just—keep in touch.”

  “Like, undercover.”

  “You can’t tell anybody at work, Amy.”

  “Not even your friends.”

  “Nobody.”

  “Yeah, I…” Amy wasn’t saying no, but she started shaking her head that way.

  “I know, it’s a lot to process.”

  “Yeah, no,” Amy said. “I’ll—need to think about it—”

  “Think about it.”

  “I will, I—” Rrring! The telephone shocked her. Amy reflexively put a hand over her heart in protection.

  “Please,” Tim said, “if you want to get that, or—”

  “Yeah, hold on, hold on,” Amy said. “It might be my daughter, from school.” She leaned to check the caller ID. “Oh, God.” She triggered Talk on the cordless, glanced hard at the detectives, waving them closer. Tim and Danny leaned in.

  “Hi Mar-ryy,” Amy said, sounding singsong casual. It was Mary Lund.1 Tim looked at Danny. They were busted.

  Amy held the receiver away from her ear so they all could hear. Mary Lund said hello, and that she was just following up after the police interview last night. Mary wanted to know: how did Amy think it went?

  “Fine,” Amy said. “It was fine.”

  “Fine,” Mary repeated. She sounded too quick, nervous. Amy popped her eyes at the detective, shaking her head in slow motion and silently mouthing Whatthefuck…

  “Well, I’m sure you’re glad it’s over,” Mary said. “If the police ask for anything else, or if you plan on making any kind of statement, maybe you’d better just go ahead and make sure that you have the hospital attorney with you. For your own protection.”

  “Um, really?” Amy said. “I don’t think that’s necessary, Mary. Is it? I mean, I’m not the target of their investigation or anything.”

  “Amy, that’s not a good idea,” Mary said. “If the police try to contact you again, you should tell them to speak directly with one of our attorneys. We have a—”

  “I appreciate your call, Mary, but really, I feel fine. This really isn’t about me, they said I’m not a suspect.”

  “Amy,” Mary said, “I strongly suggest that you have a Somerset Medical Center lawyer with you if you speak to the police again. Their investigation has… stepped up a notch.”

  Amy finished the call and dropped the phone. What the hell was going on? It was like someone had changed the channel in the middle of her life and switched to some detective story.

  “See, that’s what we’re talking about,” Danny said.

  “They’re covering their asses,” Tim said. “We’re trying to catch a killer.”

  Amy reached over for a cigarette and threw herself back into the groaning wicker. How weird was that? It was too much to process, but at least Lund’s call had made one thing clear:2 the hospital was concerned for themselves. Amy would have to look after herself. Right now, having two big homicide cops in her living room made her feel like the safest girl on earth.

  “Okay,” Amy said, snubbing her cigarette. “Turn on your tape recorder, boys, and tell me what you want to know.”

  47

  Amy had to rethink Charlie Cullen’s eccentricities and quirks in this new light. Why was he so secretive with his patients? Why was he early to work? Why did he only sometimes wear glasses, and why was he always typing away on the Cerner computer? It seemed paranoid associating his every personality trait with sinister intent, and naïve to at least consider the possibility.

  With so many questions to explore, it felt good to talk freely to the detectives. She wasn’t afraid, she wasn’t careful. Amy learned in her teenage penny-paid therapy not to be crippled by the truth. When she’d come to her family and told them the truth about her molester, they’d acted as if Amy was the problem. It had taken years of therapy to see it otherwise.

  She talked for an hour, lighting and smoking and stubbing her butts in the little glass ashtray, her painted nails waving the smoke away toward the screened porch windows. This was her guilty pleasure, heavy on the guilt; she recognized how stupid she was, smoking and partying despite her heart condition. Sometimes she could feel it stop beating until her pacemaker kicked in. Somehow death didn’t scare her like it was supposed to.

  But to risk her job as an undercover agent, lie to Charlie, lie to her employer, to everybody? Could she? There was real risk in that. The detectives could be wrong, or they could be tricking her. They were strangers. Charlie was her friend. Shouldn’t she take his side, no matter what?

  Amy leaned back to the sofa and folded her arms. Maybe getting more involved was a bad idea. “What, exactly, are you asking me for here?” she said. “Like, what would I do?”

  “Small things, small things,” Tim said. “Nothing dangerous.”

  “Phone calls, mostly,” Danny said. “Make some calls for us.”

  “Maybe, down the road, wear a wire.”

  “You mean I’d have to see him?” Amy said. “In person?”

  “Maybe, just—just forget about that right now,” Tim said. “Did Cullen ever talk about euthanasia, or anything like that or—”

  “Huh? No. No. I don’t think so. No, I—”

  “Okay, okay,” Tim said. “Well, what we’re asking is for you to help us.”

  “Really,” Danny said. “It’
s that simple.”

  Amy said she’d have to think about it. “I’ll call you tonight,” she told them. “There’s someone I need to talk to before I can definitely say yes.”

  The old house was frighteningly quiet with the detectives gone. Amy1 sat thinking in her kitchen, listening to the fridge tick until the school bus arrived. She heard the porch boards croak, the screen slap metal, her daughter running up the stairs with her oversized book bag, then stamping back down. Alex walked into the kitchen for a juice box and found her mother at the table, trying too hard not to look serious.

  Alex could see that something was wrong. She figured it was something with the school play. Her mom was directing it this year, a story about aliens landing in a boring small town and making it fun. Invasion from Planet Zorgon. Alex thought it was a pretty good play because kids who didn’t want speaking parts could just play the townspeople of Humdrum Falls. All you had to do for that was look surprised, which was mostly just pointing with your mouth open.

  But, Amy told Alex, this was way weirder than anything on Zorgon. Someone she knew in the hospital, another nurse, might have killed a patient. It might have been on purpose. And maybe he’d done it more than once. Okay, so her daughter was eleven years old, she knew what a serial killer was, of course she did. Policemen had come to the house. They wanted her mom’s help to catch the bad nurse. Alex sat across from her mom, never taking her eyes off her but never releasing the juice box straw either.

  Amy wanted Alex to know that this decision might change their lives. The detectives were asking her to buddy up to a man they accused of murder. People might talk. It might even be dangerous—Amy didn’t think so, but she couldn’t be totally certain. Amy was sensitive to how something at this age could change you forever. Her daughter was closer by the day to becoming a teenager. Wow, Amy thought, talk about social suicide.

  “So, it’s a family decision,” she told Alex. “We need to figure out, as a family, are we going to be able to, you know—can you handle this?”

  “Is that going to happen? That stuff?”

  “I don’t know honey. That’s the thing—I don’t know.”

  “But it might happen.”

  “Yes.”

  Alex wound the straw around her finger like a ring. “Is there a best-case?”

  “Well, if it works, the man goes to jail.”

  “Forever, right?”

  “I don’t know what’s going to happen,” Amy said. “If there isn’t enough evidence to put him in jail, or if he gets out—I don’t know if we’ll be in danger.”

  Amy watched her daughter taking this in. A serial killer, her mom as an undercover spy, the potential delay of Planet Zorgon. Amy knew how weird this must all be to Alex. It was that weird for her, too.

  “So, Mom, this guy is really killing people?”

  “He might be, honey. Yes.”

  “Well,” Alex said. “Then you have to find out, right?”

  48

  Danny settled into a sweatshirt and jeans before spreading out on the living room floor with his growing stack of paperwork, including the new information he’d requested from Lund. One stack of paper contained the mortality records from the Somerset Medical Center CCU for the time Charles Cullen worked there. The other stack listed Cullen’s shifts during that time. Danny cross-indexed the two, looking for a pattern.

  He’d tried indexing patient deaths against Cullen’s birthday, those of his children and ex-wives and girlfriends, his parents and known siblings. Then Danny tried wedding anniversaries, divorce anniversaries, feast days, and holidays—anything that might correlate with the deaths, some rule of murder. The more items he added, the more ideas came to mind. Soon he was comparing the names of the deceased with Cullen’s family’s names, then comparing initials, then using the initials to spell words… Danny put the pad down and rubbed his eyes. It was four o’clock in the morning. What was the point? You throw enough variables into the mix, you can find a pattern in anything. The whole world was a code to the paranoid, but that didn’t give it meaning.

  It was nearly dawn by the time Danny finally crawled into bed. He lay there for a few hours, awake behind his eyelids, still scrambling the numbers and letters to find a reason, as if reasons were what mattered.

  Tim didn’t have the same responsibility for marshaling all the mind-numbing drugs and dates and details that Danny did as lead detective on this thing, but his head was still busy, doing the math on murder, the odds on catching their guy. They’d been grinding away on this thing for months already, but they were still feeling their way in the dark. Adding it up, Charles Cullen had been doing exactly this for sixteen years at ten different hospitals. The guy was a veteran in a field of homicide in which the detectives were just rookies.

  Tim Braun had read up on the Internet about the medical murderer type—the two lady nurses who did it as a sexual thing, the orderly who killed patients to decrease his workload, the Kevorkian types, mercy killers, psychopaths, who knew what else. The FBI had specialists in Quantico who dealt with nothing else, agents and shrinks and guys who were both. Maybe the FBI had a whole file on guys like Cullen, a recipe box they could look at, with tips on how to catch one. Tim knew an FBI guy, maybe he could put them in touch with the Quantico experts. He didn’t know if it would help, but could it hurt? The promise let him get some sleep at least.

  But when he brought the FBI idea up at the morning meeting, Prosecutor Forrest shot it down—they weren’t going to bring in anyone. Tim understood the ambition—you didn’t succeed as prosecutor by giving away your cases—but that didn’t mean he agreed with it. This close to retirement, Tim had the luxury of taking orders as suggestions, anyway.

  Charlie had been out of work for a month already, his girlfriend was pregnant but wanted him to move out of her house, and he was in no mood to answer the phone. But then the voice on the machine was Amy’s, sympathetic Amy. She knew how he was, knew he was too spent to pick up, and knew to call back anyway. This time he picked up with a knowing “Hi.”

  “Hi honey,” Amy said.

  “Hi,” Charlie said.

  “How are you?”

  “Oh, good,” he sighed. “All right. Um, you know how it is… I applied for unemployment but they denied that.”

  “Why? Why would they deny it?”

  “Well,” Charlie said, “they’re saying, ah—because I put—I’m gonna appeal it but—”

  “Yeah,” Amy said, “but if you’re terminated, can’t you get—I mean, that doesn’t make any sense.”

  “Yeah,” Charlie said. “Well, I wasn’t employed for that long.”

  “Well,” Amy said, “I’ll write you a reference, you know that. But what—you know, I, yeah, I was calling too because they’ve been asking weird questions. At the hospital.”

  “Mmm,” Charlie said.

  “And it’s like they’ve been, they’ve been kind of calling people in for, like, internal stuff? And, um, you know, somebody had, asked me about you.”

  “Okay,” Charlie said. Waiting to hear where this was going.

  “And, you know. I kind of—I kind of wanted to give you the heads-up about that.” Amy waited, hearing only breath on the other side of the phone, so she continued, “And they asked me, they were just asking me shit about certain patients and I can’t, you know, I can’t remember any of ’em, I can’t remember any of their names or… you know. And I was… I didn’t know. I didn’t know if they had been questioning you…”

  “Right,” Charlie said. “Well, they…”

  “ ’Cause I’m kind of… honestly, Charles, I’m a little bit nervous, that’s all,” Amy said. “Asking me just like stupid shit like, certain medications, and, you know, asking me about dig…”

  “Well,” Charlie said, “there’s the one patient I recall, a Reverend something.”

  “Right.”

  “They had asked me about that patient, too. Ah, but again, I… I didn’t know anything about the patient. I had heard, ah, yo
u know, ah, ah, Joan talk about it the following day or two—”

  “Right.”

  “But, um, you know, I—”

  Amy cut him off. “I mean, is this something I should worry about or—”

  “I—I don’t, I don’t think so,” Charlie said. “I mean, I think they’re probably talking to other people. I mean—I know the insulin thing, it’s going, it’s ongoing, so… I don’t know what’s happening with that.”

  “They’ve really been talking,” Amy said. “And I know they’ve asked about you. I wanted you to be aware of that, because—I know that they’ve questioned other people and your name has come up. And, I, and, ah, you know—and I was mad. That’s when they put—when they pulled me in.”

  “Right,” Charlie said.

  “But you know me, I’m freaking nervous! I’m a worrywart. And I don’t have you around to make me feel better.”

  “Yeah. Well, um, I don’t know if I’m the focus of their investigation,” Charlie says. “I mean… like I said, I’m terminated.”

  Amy laughed, “Yeah, you’re already gone, dumbass!”

  Listening in on a headset from the next room in the prosecutor’s office, Danny had to admit the girl was really a natural on the wire.

  49

  Tim was concerned that Lund might suspect Amy was talking, and try and shut her down, so he and Danny devised a strategy for protecting their source. That December, Danny told Colucci and Percell to continue their interviews at Somerset, to keep getting any information they could. And to ask each CCU staffer pointed and incriminating questions about nurse Amy Loughren.

  The questions would shift the focus away from Charlie Cullen, and help preserve the anonymity of their confidential informant. But it would also make life that much more difficult for Amy. As far as her coworkers could tell, she was now the target of a murder investigation.

  Amy learned about it almost right away, not from the detectives directly but by a phone call from her friend Annie, the health care aide’s thick Jamaican identifying her from the first ’ello…