Sunday, September 8, 2013

Charles Cullen: A Hire Too Good To Be True

Posted By on Sun, Sep 8, 2013 at 2:51 PM

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Charles Edmund Cullen was, in many ways, a good nurse. Good at working extra shifts and on holidays without complaint, good at lending a hand in the ICU or CCU, good at being first on the scene during an emergency, and good at wrapping up the bodies of the patients who happened to die on his shift. But Cullen could have been the very reason those patients died — through the giving of unprescribed medication or failure to administer prescribed medication. Some estimates put the number of patients Cullen might have killed in the hundreds over the course of 16 years in nine hospitals and one nursing home, which would make Charles Cullen damn good at being the most prolific serial killer in U.S. history. Now, he's in prison — for good.

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Experts and investigators can't be sure of the number of those killed, because the solid evidence linking Cullen to the deaths of so many is hard to come by. Journalist Charles Graeber's study of Charles Cullen, in The Good Nurse: A True Story of Medicine, Madness, and Murder (Twelve/Grand Central Publishing), can't be sure of the number either. But Graeber has done his homework (six years' worth of research and interviews, including with Cullen), and he's turned all that work into a bona-fide page-turner. Which explains why The Good Nurse was a best-seller when it appeared this past April and why 60 Minutes covered Cullen the same month. Katie Couric followed with a televised interview with some of the story's principal players in July. And now Memphians have a chance to meet Charles Graeber when he's in town to discuss and sign The Good Nurse at The Booksellers at Laurelwood on Thursday, September 12th, at 6 p.m.

Cullen told detectives of 40 "incidents" in a seven-hour statement inside an interrogation room in late 2003. He didn't use the word "kill." And they weren't — mercy killings, if that's what you're thinking. It may even be a mistake to label the official statement Cullen made a "confession." More like a "story" that isn't over yet. Because Charles Cullen cut a deal with prosecutors, who agreed to remove the death penalty if he cooperated in further investigations.

How does a man go from being "a patient advocate … organized, very giving of his time, so much to offer, very bright, witty & intelligent" (as one supervisor called Cullen) to being the probable cause in the mysterious deaths of so many?

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Good question and perhaps ultimately unanswerable. But Graeber (left) methodically mines Cullen's unstable life history and murderous career, including Cullen's first (of 20) failed suicide attempts beginning when he was 9 years old. (He mixed the contents of a chemistry set into a glass of milk and ended up only making himself sick.) His history of personal problems, including charges of stalking, hardly stopped there, however. And despite the initial glowing employment reviews he'd receive — "a gift from the scheduling gods, a hire almost too good to be true" — there was something plainly "off" about Cullen's work habits, which led to his being repeatedly issued disciplinary citations and dismissed from his every assignment in New Jersey and Pennsylvania. How Cullen was able to pass from one assignment to the next is itself a frightening record of hospital hiring practices. Equally frightening but not surprising: the lengths to which hospital administrators will go to avoid adverse publicity and lawsuits.

Graeber knows his way around a hospital, including its nursing stations. Growing up, he often accompanied his physician father on his rounds, and he's a former medical student himself. He can write of CernerPowerCharts (a mobile computer database nurses use to track patient care) and the pill-dispensing Pyxis machine — key sources for tracking Cullen's hidden nursing activity — without losing the reader in the process. When The Good Nurse turns to the work of New Jersey detectives Danny Baldwin and Tim Braun, the book doesn't bog down in police procedures. And when Amy Loughren, a nurse who befriended Cullen and acted as his confidante, leads to his undoing, this story takes on the ingredients of suspense thriller. But slow down and do not overlook the book's end notes. They contain vital information. And do admire Graeber's insights into one man's madness.

Why did Charles Cullen kill? As Graeber writes:

"His intervention on behalf of his patients was a compulsion that had little to do with the patients themselves; often, in fact, he failed to notice the patients at all, only their outcomes. Each spasm of control offered [Cullen] a period of relief and afterglow."

And:

"Access to the vulnerable allowed [Cullen] to manifest death without dying. He'd learned to kill himself by proxy." •

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