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

Day nurse Kim Wolfe goes to the drug closet and finds the sharps container filled with cardboard. She gets other nurses, who helps empty the sharps container and catalogue the drug containers. They struggle to understand why someone would steal these drugs, which don’t have any street value or addictive capabilities. One of the drugs is a strong paralytic that is very rarely prescribed, and the nurses worry about where it might have been injected. They resolve to watch the drug closet to see if the culprit appears. Kim watches Charlie arrive for his shift early and lock himself in the drug closet; he’s the only person to close the door all day. When he leaves, the sharps container is full, and Kim calls the floor manager. On the morning of June 3, a day nurse and the floor manager sort through the sharps container and then establish a new protocol to check its contents. The floor manager contacts risk management staff, who contact the hospital’s attorney, who calls a malpractice specialist named Paul Laughlin. When Charlie arrives at work and the sharps container fills shortly afterward, Paul comes to the hospital and pulls Charlie in for questioning.

Paul interviews Charlie, beginning with the basics of his work habits and gradually making his way to discuss the missing drugs. Charlie is vague in his responses, alleging that his lack of sleep makes it hard to remember things. When Paul points out that the drugs only go missing when Charlie is working, Charlie neither confirms nor denies his culpability. Security escorts him out of the hospital.

Three days after his interview with Paul, Charlie has already secured work at Sacred Heart Hospital. He quickly begins dating a coworker. Within two weeks, he’s let go because one of his fellow nurses also worked at Easton Hospital, where Charlie killed Ottomar Schramm. She and her peers petitioned against Charlie, resulting in his termination.

The administrators of St. Luke’s call other hospitals in their areas, warning them about Charlie. However, they don’t reach out to the public, news, or police, instead choosing to keep their concerns internal.

In September 2002, Charlie responds to a recruitment flier for the Somerset Medical Center of New Jersey, deciding that his recent failures in Pennsylvania mean that he must return to his home state to practice nursing. Somerset is an affluent county in New Jersey and has cutting-edge medical facilities that offer impressive signing bonuses. Charlie lies about his criminal history and his reasons for leaving his past employment. He receives neutral references from St. Luke’s and positive words from Warren Hospital, securing a job.

Charlie earns the respect of his colleagues by being fast and helpful. He makes friends with a fellow night nurse named Amy Loughren, and the two share stories about their past traumas. Amy is a beautiful woman who suffered abuse as a child that have caused her to have panic attacks as an adult. She’s drawn to Charlie because he seems like he needs protection, resonating with her maternal nature and past struggles. She observes his unusual habit of giving patients too much lotion and his obsession with studying charts at the nurse’s station. The strain of the job starts to wear on Amy, exacerbating her atrial fibrillation. To help Amy rest, Charlie starts to do more of her work, and he starts poisoning patients again. The author lists six victims and the methods that Charlie uses to kill them. Amy has a pacemaker put in and returns to work full-time.

The hospital establishes a sign-out policy for insulin, which Amy is resistant to because it requires nurses to estimate the amount of insulin in the fridge where it’s stored. She and her supervisor, Val, argue about the new protocol. Amy hasn’t noticed the increased number of codes and doesn’t know that Charlie is under suspicion. In June 2003, Charlie begins manipulating the drug delivery system, placing orders and canceling them. Because of a problem with the machine, it administers the medicine anyway, giving him access to drugs that aren’t on his patients’ charts. He injects Mrs. Jin Kyung Han with excessive digoxin, but she survives. Reverend Florian Gall arrives at the hospital with a bacterial infection, and his retired nurse sister waits in his room. Charlie dislikes her because she has professional opinions, so Charlie targets Gall. Over the course of the week, he starts to recover, but Charlie initiates a digoxin overdose.

The Somerset Medical Administration has noticed a pattern of digoxin overdoses. They note that Gall is “Patient 4” and have the assistant pharmacist Nancy Doherty reach out to poison control to assess his bloodwork.

In July 2003, Nancy calls New Jersey Poison Control for help understanding digoxin toxicity. Dr. Bruce Ruck, pharmacist for Poison Control, returns her call. Nancy tells Bruce about Mrs. Han and Reverend Gall, pointing out that Gall’s digoxin levels spiked after he stopped receiving injections. When Bruce presses her, she admits that Gall died, and Bruce reassesses his stance. Nancy confesses “off the record” that two more patients had similar chemical spikes. Bruce consults with other specialists and performs calculations before calling Nancy back.

Bruce outlines the digoxin dosage that would cause such high spikes and notes that human bodies don’t make digoxin. In addition, he discusses the hospital’s insulin overdoses before declaring that the concern is a “police matter” (99). He states this several times, emphasizing that even if it was an accident, the police must be notified. He tries to comfort Nancy before she ends the call to talk to her supervisors.

Bruce describes the discussion to his supervisor, Dr. Steven Marcus, who concludes that someone is killing patients. When they don’t receive a call back, Bruce calls the hospital the next day and speaks to Stuart Vigdor, the head of the pharmacy, who tells Bruce that the administration and attorneys have moved forward with the investigation. Bruce receives a phone number for Mary Lund, the hospital’s quality assurance manager. Vigdor assures Bruce that the hospital is investigating he situation but also sounds afraid. Bruce promises confidentiality but doesn’t mention that because his phone is a government line, their conversations are recorded.