Two internal inquiries yielded no firm conclusions, but a common thread surfaced: Nurse Genene Jones’s name kept coming up. A dark portrait began to emerge.
Genene Jones was born in San Antonio on July 13, 1950, and was immediately given up for adoption. She grew up short and chubby, felt ugly, and had few friends because she was a drama queen who lied chronically, yelled a lot, and was unpleasant to be around. Throughout her life, she occasionally told stories of sexual and physical abuse as a child, although the stories were always a little fuzzy, and after an endless string of lies, nobody took her seriously anyway. She also began to feign sickness as a way to get attention.
At sixteen, her younger brother was killed when a homemade pipe bomb exploded in his face. A year later, her slightly shady father died of cancer. Acquaintances say she was devastated, even though Genene was fond of saying she grew up unwanted and unloved. Her adoptive mother became her sole supporter.
After high school, Genene reportedly pretended to be pregnant to force her slacker boyfriend to marry her. But within a few months, he joined the Navy, and between affairs with a string of married men, Genene took beauty school classes.
When her husband returned from the Navy, they had a child, but they divorced after only four years of marriage. Soon she was genuinely pregnant, so she began to look for a better job that would pay more than she was making as a beautician (and would salve her unnatural fear of getting cancer from hair chemicals).
She’d once worked in a hospital beauty salon, and she’d developed a special attraction to doctors. A lightbulb switched on. Genene dumped her son on her mother and enrolled in classes to become a licensed vocational nurse. Shortly after graduation in 1977, she had another child, who also was dumped in her mother’s care, and Genene began her new career.
Surprisingly, Genene proved to be a pretty good nurse, although she hated being just one cut above a candy striper. She believed deeply she should be in charge. She became obsessed with diagnosing people, even though it wasn’t her job.
Now twenty-seven, she lost her first job at San Antonio’s Methodist Hospital after only eight months when she was fired for being too bossy, too rough, and too eager to make decisions that were well above her pay grade. Her next job, at the small, private Community Hospital in San Antonio, was also brief.
In 1978, she was hired to work in the pediatric intensive care unit at Bexar County Hospital, a fairly new facility that largely served the poorest citizens in America’s fifteenth largest city at the time. But the job didn’t start well. Genene’s tendency to boss people around—even though she was the lowest on the totem pole in rank and experience—chafed. Besides being her abrasive self, she habitually second-guessed and overruled doctors’ orders. She also liked to brag about her sexual conquests, which she’d often describe in lurid detail. To make matters worse, she was brassy and openly libidinous around male physicians.
Early on, she imploded over the first child who died in her care, perplexing other nurses with an excessive and bizarre kind of public grief. She dragged a stool into the dead baby’s cubby and stared at the body for a long time. At other times, she’d insist on escorting the bodies of dead babies to the hospital morgue, singing to them on their way … but she also participated in a kind of “dead pool,” in which she’d bet on the next child to go.
Although her job was normally to provide basic bedside care, Genene developed a talent for inserting needles. She also seemed extraordinarily interested in various drugs and their effects. It all seemed natural, even praiseworthy, for a caregiver to want to know these things.
Just after Christmas in 1981, four-week-old Rolando Santos arrived at the ICU with pneumonia and was immediately placed on a respirator. Three days later, he started having unexplained seizures. Two days after that, his heart stopped as he bled from several needle punctures on his body. When the bleeding restarted a few days later, a test showed he’d been injected with heparin, an anticoagulant drug for heart patients.
When the bleeding started yet again, it was stanched with a drug designed to reverse heparin’s effects, and Rolando’s suspicious doctor immediately transferred Rolando out of the ICU, even though he was still too sick. The ICU was apparently just too dangerous for the child.
Within four days, Rolando Santos had recovered enough to go home.
Armed with solid evidence that somebody had administered an overdose of heparin to a child who didn’t need the drug, a hospital official described the “purposeful nursing misadventure” in a memo to the dean of the medical school. He promised to keep an eye on the ICU’s dark and disturbing trend in unexplained deaths and near-fatal episodes.
Genene Jones worried some people in the ICU, but she wasn’t immediately suspected in Rolando Santos’s case, or in any of the other questionable cases that were piling up. In her four years on the ICU floor, she proved to be a divisive figure but was never fired, even though some of her colleagues sent up several red flags about the number of inexplicable tragedies.
And those numbers didn’t look good. During Jones’s time in the hospital’s pediatric ward, forty-two babies died. Thirty-four of them—four out of every five of the hospital’s dead babies—died while Jones was on duty. Other nurses began calling Jones’s three-to-eleven tour the “death shift.” Jones herself worried out loud that she’d be known as the “death nurse.” And maybe for good reason: Overall, the hospital’s infant mortality rate almost tripled during her tenure there.
Yet despite the hospital’s growing concern, nobody ever reported any questionable deaths to me, the county medical examiner whose job it was to determine how and why people die.
By 1982, unable to prove anything and unwilling to set off a public spectacle, the hospital literally cut its losses in a brilliant PR stroke. It announced a plan to “upgrade” its pediatric ICU staff with more experienced registered nurses and quietly let two nurses go: licensed vocational nurse Genene Jones and the nurse who voiced suspicions that Jones was killing babies.
Armed with good recommendations from her bosses, Genene was quickly recruited by Dr. Kathy Holland, who’d just finished her residency at Bexar County Hospital, to work at a new pediatrics clinic in Kerrville, Texas,
Thus it was that a few months later, one of the San Antonio hospital’s former nurses (and, at the moment, one of the doctors it trained) was embroiled in a death investigation in Kerrville, the San Antonio DA was snooping around about other deaths, and I was bringing pressure on the hospital’s administration to be more transparent. A destructive perfect storm was about to break.
But even after Chelsea McClellan died, children continued to have unexplained and frightening episodes of seizures, respiratory failure, and unconsciousness at Dr. Holland’s Kerrville clinic. Incredibly, in the afternoon after Chelsea’s death, another child lapsed into a similar spell after an injection by Jones, who was staffing the clinic alone while Dr. Holland was busy arranging for Chelsea’s autopsy.
When the flaccid child was rushed to the Kerrville hospital, an anesthesiologist there recognized the telltale symptoms of succinylcholine, a fast-acting drug that paralyzes all the body’s muscles. He reported his suspicions to the little hospital’s administrator, who eventually shared them with Kerrville’s DA, Ron Sutton.
Suddenly, suspicion focused on Dr. Kathy Holland, her nurse Genene Jones, and a drug called succinylcholine.
* * *
Used since the 1950s, succinylcholine—commonly called “sux” by medical personnel—is a synthetic paralytic drug often used to relax clenched throat muscles when inserting emergency breathing tubes. It takes effect within seconds but lasts only a few minutes, long enough to intubate a struggling patient.
The human body quickly breaks it down into natural by-products normally found inside us, even when we haven’t been injected with the drug. A routine autopsy would miss it. Up to the early 1980s, the only slightly abnormal blood chemistry was easily overlooked, and even when its use was suspected, it left no clear
evidence on which to base a murder charge. Thus, famous defense lawyer F. Lee Bailey once called sux “the perfect murder weapon” because it vanishes without much of a trace.
An overdose of succinylcholine is a bad way to die. The unlucky victim will be completely conscious as all the muscles in his body—including his heart and diaphragm—seize up. Breathing stops and he suffocates.
This perfect poison is found in emergency and operating rooms, and is used almost exclusively by anesthesiologists and ER docs, at least when it’s not part of the three-drug cocktail used in lethal injections of condemned killers. Ordinary people don’t have access to sux. There’s almost no reason it’d be found on the shelf in a small-town pediatrics clinic unless a doctor expected a child to suddenly crash and need emergency intubation. Not a likelihood.
Early in the Kerrville investigation, suspicion shifted away from Dr. Holland, who was now helping prosecutors connect all the dots in a horrid line that pointed straight to her nurse, Genene Jones.
Dr. Holland’s clinic had two vials of succinylcholine, and Genene Jones had the primary responsibility for ordering the office’s pharmaceuticals. One of those vials was briefly missing after Chelsea’s death, but when Genene Jones reported finding it, it had been opened and two needle punctures were visible in its rubber seal. However, both vials appeared full.
Dr. Holland fired Jones shortly after the succinylcholine incident. The doctor was shaken to see needle marks in the seal of one of the vials, even though she had never prescribed it for any of her patients. Later, a chemical analysis showed that the open vial had been diluted with saline solution.
At the same time, the Bexar County Hospital in San Antonio was ramping up its third investigation into the higher-than-ordinary number of deaths in its pediatric ICU during nurse Genene Jones’s time there. And a San Antonio grand jury was separately examining the records of more than 120 child deaths in the ICU between 1978 to early 1982—the period of Jones’s employment.
Ultimately, the grand jury focused on about a dozen of those questionable deaths, all patients of Genene Jones and only one ever reported to my medical examiner’s office. Autopsies were done by students in the medical school and all were certified as attended deaths. Suffice it to say, no suspicious evidence was found in any of them, much less succinylcholine.
But by 1983, we had a new tool. Renowned Swedish toxicologist Dr. Bo Holmstedt, who helped select Nobel Prize winners in the Royal Academy of Sciences, had developed a new method to detect succinylcholine in dead humans. Problem was, his method had not yet been tested in any court anywhere.
As we suspected that Genene Jones was a killer nurse who might be using succinylcholine to kill innocent children, we reached out to Dr. Holmstedt, who was eager to help. But he had one condition: He would not testify in court if the State of Texas sought the death penalty for the nurse.
Faced with letting a possible killer go free or seeking a lesser penalty, DA Sutton took the latter. He agreed to Holmstedt’s deal. If Genene Jones were eventually indicted, the death penalty was off the table.
But a big question remained before any charges could be filed: Could a little girl speak to us from the grave?
* * *
On a still, clear Saturday morning, May 7, 1983, we exhumed Chelsea McClellan.
Before the gravedigger disinterred her little casket, buried just three feet down, we set up our makeshift morgue—a canvas tent—around the grave itself to block the view of gawkers and media people who had flocked just outside the cemetery gates. Her parents had permitted the exhumation, but they wanted to know nothing about it. The thought of it turned their stomachs, but they knew it might be our only chance of getting justice for Chelsea.
We shouldn’t have been here at all. Her original autopsy, done in the back room of the Kerrville funeral home, hadn’t been performed by a forensic pathologist, but by a private pathology lab and a doctor at the University of Texas at San Antonio medical school—that same neuropathologist who first told Corrie May about this case and who personally knew Genene Jones. They were all stumped. They found nothing and their tissue samples hadn’t been preserved well enough to avoid digging up a child’s grave. But here we were, digging up a child’s grave.
I knew this: SIDS probably didn’t kill Chelsea McClellan. She was too old and the circumstances didn’t fit. Typically, SIDS described the unexplainable crib death of a child under a year old, and such a death usually happened during sleep times. Fifteen-month-old Chelsea died in a doctor’s office during a period of vigorous activity. After an injection. By a nurse.
Now she lay inside her casket just as the world had last seen her eight months before, pretty in her pink dress, with her knitted blanket and toy close. Wearing a pink bow in her blond hair, she was well preserved, like a delicate porcelain doll, and it seemed a shame to disturb her with our grim business.
Just a husk, I reminded myself.
After the mortician from the funeral home positively ID’d Chelsea, I undressed her and examined her legs closely for needle marks, but not surprisingly, I found none. I cut a small sample of the muscle in each of her thighs where she might have been injected with the succinylcholine. After taking both of her kidneys and pieces of her liver, bladder, and gallbladder, I closed her up. The mortician redressed her and gently laid her back in her casket, where she was again swathed in her blanket and reunited with her doll while I said a little prayer for her soul.
Just a husk.
It had all taken less than an hour.
I froze the samples, and to maintain the chain of evidence, they were escorted by a toxicologist to Dr. Holmstedt in Stockholm, more than five thousand miles away. Eleven days after the exhumation, we received Holmstedt’s report: His new tests had found traces of succinylcholine in Chelsea’s tissues.
The linchpin in the case against Genene Jones had fallen into place. On May 25, she was indicted by a grand jury in Kerrville on one count of murder and seven counts of injuring children, including Chelsea, in various near-fatal incidents at the clinic. Each charge alleged Genene Jones had injected the children with succinylcholine or a similar drug—although her motive remained murky.
Jones was arrested in Odessa, where she and a new husband were visiting relatives. She pleaded not guilty, and a judge set her bond at $225,000 before assigning her a public defender. A couple of weeks later, she made bail and walked free until her trial began.
If convicted, she faced from five years to life in prison on each of the eight charges.
Now the hard part started.
* * *
On January 19, 1984, almost a year and a half after Chelsea McClellan died, seven women and five men somberly took their seats in a Georgetown, Texas, jury box. They would decide if nurse Genene Jones was a cold-blooded baby killer or a falsely accused patsy for inept doctors. Was Chelsea McClellan murdered or did she die of tragically natural causes?
Reporters from all over America, including the New York Times, had flocked to this historic Austin suburb for a trial that promised some graphic copy. For almost a year, Americans had stolen brief glimpses of this gut-wrenching, sensational story in the media as it inched closer to trial, and they had a lot of questions. It wasn’t just the unsavory details of infanticide they wanted. They still didn’t know how or why any human could kill one baby, let alone dozens.
Kerrville DA Ron Sutton’s case was largely circumstantial, but as he told the jury in his unusually brief opening statement, “there are an awful lot of circumstances here.” Without the customary summation of the witnesses they would hear, he promised only to deliver all the pieces in a “strange and complex” puzzle.
The first week’s witnesses established the prosecution’s sad narrative: The Kerrville hospital’s ER nurse who’d seen Chelsea after both of her traumatic visits to Dr. Holland’s office; the anesthesiologist who thought the baby’s clumsy movements resembled succinylcholine recovery; the ambulance driver who thought everything was going well until Genene Jon
es gave the little girl a shot; and the original autopsy pathologist, who admitted openly that Chelsea didn’t fit the profile of a SIDS death, but until she heard about the succinylcholine, she’d had no clue what killed the little girl.
As I took the stand that first day, I flashed back to Martha Woods. Twelve years had passed, yet here we were debating SIDS and another child’s death at the hands of another woman who’d also witnessed an extraordinary number of babies dying. History was, in a way, repeating itself.
“The child was too old [for SIDS],” I told the jury, adding, “SIDS is a fancy way of saying we don’t know why the kid died.”
They sat stone-faced as I described, in sanitized terms, the exhumation. They seemed to see it as I did: a gruesome but necessary indignity.
Then came Petti McClellan, Chelsea’s twenty-eight-year-old mother. Tense and weepy from the start, she described Chelsea’s life from birth to death, just fifteen short months, sometimes so softly the judge asked her a few times to speak up.
The courtroom was deathly silent as she described Chelsea’s first breathing spell at Dr. Holland’s office. She told how Chelsea had weakly whimpered, her eyes filled with fear as Genene Jones said the baby was “just mad” about getting a shot.
“And what did Genene do after she said that?” Sutton asked Petti.
“Gave her another shot.”
“And then?”
“She went limp like a rag doll,” Petti wept. “She was just like a rag doll.”
Sutton led her through the last, fatal visit to the clinic and the desperate ambulance ride that ended, unexpectedly for Petti, in the parking lot of a small-town clinic where her husband talked to the ambulance driver and tried to prepare her for the worst news she’d ever hear.
Morgue Page 15