Doctors Who Kill

by Davis, Carol Anne; Davis, Carol Anne

  There, doctors discovered that she was swallowing her own faeces – though, as she still wasn’t eating, they were surprised that she could produce so much excrement. She was moved to Rampton, the high security hospital for mentally ill prisoners, where she continued to self-harm.

  Trial

  Her trial began at Nottingham on 15th February 1993. The prosecution had wanted to tell the jury about a possible motive, Munchausen’s syndrome by proxy. They could produce two psychiatric reports testifying that Bev was suffering from this, but the judge ruled that these would suggest that Bev was crazy and might encourage the jury to convict her regardless of the other evidence.

  There was no shortage of witnesses at the trial, as nurses and bereaved parents took the stand, each testifying to the fact that Bev had always been present when the children developed life-threatening symptoms and illnesses.

  Back in her room at Rampton one night, Bev collapsed through lack of food and was taken to the nearest hospital, where she was fed via a tube.

  The court case continued without her, the prosecution producing witnesses for eleven weeks. In contrast, the defence could only fill three days with paid-for testimony from scientists.

  On 11th May, the jury retired. Twelve days later, on the 23rd, they returned and, over the next four days, declared her guilty of murdering Liam Taylor, Tim Hardwick, Becky Phillips and Claire Peck. She was also found guilty of nine counts of grievous bodily harm.

  When she was told about the outcome of the trial by her lawyer, Bev Allitt wept briefly in her hospital bed, then demanded that doctors remove the tube that was keeping her alive. She said that she wanted to die, but soon began to eat again. She was subsequently sentenced to thirteen concurrent life sentences, with the judge recommending that she serve a minimum of 40 years.

  An inquiry into the deaths led to the Treasury providing £500,000 to give compensation to the parents of children who were killed or injured.

  A bid for freedom

  Bev Allitt is still serving her life sentence at Rampton, which, being a hospital, is less austere than a prison. Several years ago, she appeared briefly in a televised documentary, looking slightly stocky but healthy. She answered the reporter’s questions about her daily routine but left the room as soon as she was asked about her crimes. She had previously announced that she had become engaged to a male patient at the hospital and hoped to marry him.

  In 2006, Allitt caused controversy when she launched an appeal for a reduced sentence. Crime writers pointed out that, if she were released, she would be young enough to have children and could essentially grow her own victims. Also, one of her surviving patients, Michael Davidson, gave an interview to a women’s magazine about his ordeal and said that life should definitely mean life.

  In December 2007, the High Court ruled that she would have to serve at least 30 years in prison, so she will be 54 (and statistically postmenopausal) before she can apply for parole.

  A psychological assessment

  Intrigued by the many different opinions held by both crime writers and the public about Allitt’s mental health and motivation, I contacted forensic psychologist Dr David A Holmes, author of Abnormal, Clinical and Forensic Psychology and The Essence of Abnormal Psychology. Dr Holmes, whose specialist areas include Munchausen’s syndrome by proxy, also featured in an ITV documentary about Beverly Allitt and her crimes. The interview took place in September 2009 and Dr Holmes’s replies are italicised.

  CAD: Beverly Allitt’s childhood, as far as we know, was unexceptional, yet she became a remorseless killer. Was she born with a personality disorder? What, in your opinion, informed her callous acts?

  Dr H: I think she was born with a personality distortion – this usually entails the development of more than one disorder from formative traits in childhood. She clearly had the ability to lie almost pathologically, easily convincing others of various stories that gained her attention. This is a warning sign of fledgling psychopathy. She also set fires and was reported to have killed a flatmate’s pet, which are two of the predictive signs of a serial killer. Psychopaths, sadists and killers often report harsh, inconsistent punishment in childhood. This may brutalise and teach violence as a means to an end. However, it is equally as often a reaction to the antisocial, uncaring and provocative behaviour of the developing deviant by parents, who will share the same unempathic, reactive genetic traits. In Allitt’s case, her feigning illness probably acted to avert punishment or harsh treatment as she would retreat into her ‘sick’ role. She was also poor academically and barely qualified to nurse but compensated by being very focused on patients and manipulating relatives, which is another sign of how psychopaths may ‘charm and disarm’ others.

  Allitt’s repeatedly feigned illness from an early age is a sign of factitious or Munchausen’s disorder, which is often a precursor to, and accompanies, MBP. This continued throughout her development and adulthood. Allitt had 100 days off during her nursing training, probably feigned illness.

  CAD: I’ve always believed her to be a classic case of Munchausen’s syndrome by proxy but some true crime writers reject this classification for her. Any thoughts?

  Dr H: Allitt had all the signs of MBP with Munchausen’s syndrome from childhood: pathological lying, psychopathic lack of empathy or consequences for others. Even when caught and held she still feigned illness, portrayed herself as a victim and showed no remorse or feelings as she distanced herself from the acts whilst focusing on her own plight. She competed with doctors and portrayed herself as an emergency angel of mercy rather than the Pied Piper of childcare.

  MBP is not a popular disorder and a substantial movement exists in most countries who deny a mother or female carer could hurt children, despite unambiguous video footage of them doing just that. Those who report cases are often attacked publicly and privately. This becomes more of an issue with a nurse employed in the health system. Allitt’s case had to be vetted by the Home Secretary because of the political implications of a health service employing potential killers (such as her and Colin Norris). She was the first UK nurse to face child-harm charges.

  CAD: At Rampton, she starved herself and also ingested faeces. Do you see this as a form of self-hatred or was it an attempt to prove to the public that she was mad, therefore ensuring that she wouldn’t be moved from a hospital environment?

  Dr H: These acts of starvation and eating faeces are extensions of her Munchausen behaviour and manipulation of the situation she was in. This serves the purpose of getting her attention, sympathy and special privileges. It also helped her towards pleading insanity as mitigation, and feigning insanity placed her in the relative comfort of a special hospital not prison. She was clearly forensically aware of such issues in the fearless, dispassionate way she reacted to arrest and simply slept in the holding cell without agitation or concern.

  CAD: Do you view her as mad, bad, sad or a combination of these?

  Dr H: I think she is personality-disordered and this lies between mad and bad. Her ‘condition’, having psychopathic and MBP traits should not reduce the ‘bad’ or punishment aspect of her crimes but should only be an issue in the length of sentence, which should be indefinite until she poses no risk. Her traits are aggravating, not mitigating. The fact she has no empathy simply makes her dangerous, not mad or sad.

  17 Charles Cullen

  If this nurse’s confession is true, he got away with killing patients for a remarkably long period, spanning from 1988 to 2003. Unusually, he admitted his crimes to detectives in detail, giving information which subsequently appeared in numerous newspaper and magazine features, television documentaries and books.

  An impoverished childhood

  Charles was born on the 22nd February 1960 to Florence and Edmond Cullen in New Jersey. They were staunch Catholics and he was their eighth child.

  The family were already poor but their finances took a turn for the worst when Edmond, a bus driver, died that summer. His widow still had seven children living at hom
e and she struggled to cope. Charles was bullied for wearing hand-me-down clothes and was so unhappy that, at nine, he swallowed the chemicals from a chemistry set in the hope of committing suicide. It spoke of his level of desperation, as children of this age group rarely try to kill themselves. When he was seventeen, his mother died in a car crash, leaving him orphaned. Charles had been her youngest child and they were very close.

  Devastated, Charles dropped out of school and, in April 1978, enlisted in the navy. After a year’s training he was assigned to work on a submarine but was so thin and pale that he was bullied mercilessly by the other sailors. Too timid to defend himself, he often took refuge in the ship’s sick bay, where he became friends with the naval doctor and admitted that he liked helping people and that he wanted to become a nurse. One day he took his fantasy too far, sneaking into the medical bay and dressing in the doctor’s green scrubs, mask and gloves. He was formally disciplined for this.

  Charles was discharged from the navy on 30th March 1984 – rumours would later circulate that he’d made another suicide attempt and had been let go because of psychiatric problems, but the navy refused to comment on this. Returning to his home town in New Jersey, he registered as a student at nursing school.

  The new nurse

  Charles applied himself rigorously to his studies, achieved mostly As and Bs, and graduated after three years with a nursing degree. Two months before he graduated, one of his brothers committed suicide.

  In May 1987, Charles became a registered nurse and, the following month, he married his girlfriend, Adrienne, who worked in a computer lab. He secured a job at St Barnabas Medical Center in Livingston, New Jersey, working in the burns unit. His colleagues found that he was a man of few words and that he lacked the easy manner of most of the female nurses, but he was efficient and always accepted overtime.

  Murder

  In the summer of 1988, a 72-year-old patient, John Yengo, was admitted to the unit suffering from a severe allergic skin reaction. Two weeks after his admittance, Charles Cullen injected his intravenous tube with a fatal dose of the heart drug lidocaine. Afterwards, he portrayed himself as the hero who had battled tirelessly – albeit fruitlessly – to restart the patient’s heart.

  Shortly afterwards he became employed by a different health service and, though he still worked at St Barnabas, he was no longer permanently attached to the burns unit. Instead, he spent time in whichever department needed him – everything from cardiac to intensive care.

  Whenever possible, Charles elected to work the graveyard shift, beloved of nurses who are serial killers. With no visitors and few medics around, he was free to do as he wanted, and that suited the secretive nurse just fine.

  His first daughter was born that year but he proved to be a remote father, preferring to be at work or slumped in front of the television, drinking heavily. The couple had a second daughter in 1992, after which the marriage deteriorated further; by now, Charles rarely spoke to his wife. He had wild mood swings, was often angry and so antisocial that he would barely say hello to their neighbours. Adrienne became increasingly afraid of him and began to consider divorce.

  Dangerous behaviour

  Charles’s spouse wasn’t the only person who had had enough of him – the administrators at St Barnabas had begun to suspect that someone was tampering with the patients IV bags. They believed that Charles had contaminated one of these bags of fluid with insulin and responded by refusing to give him any further shifts. However, they didn’t make their findings official and Charles moved on to a new nursing post at Warren Hospital, also in New Jersey, this time working in the coronary care unit.

  During this time, Adrienne reported her husband twice for domestic violence and, in January 1993, she filed for divorce, citing his extreme cruelty – he had beaten and even killed several of their family pets and would do bizarre things such as refusing to let her heat the house in winter. Now, Charles feared being alone, so again attempted suicide and spent several days in a psychiatric facility.

  Further deaths

  Charles’s heavy drinking had descended into alcoholism and the courts would only give him limited access to his two daughters for fear that he would harm them. He was prescribed antidepressants but sometimes neglected to take them, whereupon his already morose mood would darken further. It’s possible that he committed most of his murders during this ‘down’ time, creating excitement in an otherwise dull and flat day or night.

  Charles slipped into ninety-year-old Lucy Mugavero’s room on 9th March 1993 and injected her IV bag with an overdose of digoxin, a heart stimulant. She was only in hospital for a minor lung problem and was from a family who lived long lives – one of her brothers would reach the age of a hundred. But ninety is still considered to be a ripe old age so there was no autopsy.

  Charles also continued to cause havoc in his private life, virtually stalking a nurse who refused to go out with him. He even broke into her home and moved some of her belongings around. She contacted the police, who put a tap on her phone and Charles was trapped when he phoned her the following day and confessed to the incident. He was arrested and charged and told he’d be given a court date in due course. The following day he again attempted suicide.

  In April, his estranged wife, Adrienne, filed a restraining order against him, which was later granted. Charles spent some time in a psychiatric facility before returning to work.

  In June, he represented himself in court, trying to get access to his children, and in July, he used digoxin to kill one of his patients, 85-year-old Mary Natoli; when Charles’s life was in chaos, he got his revenge on society by killing its most vulnerable citizens.

  In August, the nurse pleaded guilty to breaking into his colleague’s home. Afterwards, he tried to take his own life for the umpteenth time, but he was always ambivalent as, though he hated his current situation and wanted to end it, he was afraid of death.

  Accused of murder

  In the autumn of 1993, Charles was accused of murder by the son of a deceased patient, Helen Dean. She had been operated on for cancer and had recovered so was about to be moved to a nursing home, but Charles came in and gave her an injection, after which her condition deteriorated. She complained to her son about the nurse who had stuck a needle in her leg and he took his concerns to her oncologist, who confirmed that she wasn’t due for an injection and that the registered nurse was not empowered to administer them. Helen appeared to have survived the jab but died later that day. At her son’s insistence, the hospital conducted an internal inquiry and Helen Dean was autopsied, but they didn’t test for digoxin and the autopsy was inconclusive.

  Charles was given a lie detector test by police but this, too, was inconclusive and no charges were filed; he continued to work at the hospital. However, his increasingly suspicious colleagues cold-shouldered him and, on 1st December, he resigned.

  The death toll mounts

  The following April, Charles started work at Hunterdon Medical Center, New Jersey in the intensive care unit.

  In June 1994, he received a nursing licence to work in Pennsylvania and, at the end of that year, his acrimonious divorce was finalised. There followed a couple of years in which he dated a married woman and was working hard to persuade her to leave her husband for him. He also continued his fight through the court system to have overnight access visits with his daughters.

  By the start of 1996, however, the affair was going downhill and Charles resumed his killing spree. On 21st January, he gave 71-year-old Leroy Sinn a fatal dose of digoxin. The father of four had been active up until his admission to hospital, working full-time and also taking on the role of elder in his local church.

  On 31st May, Earl Young also died of a digoxin overdose. The 75-year-old navy veteran had been enjoying his time in a retirement home and wasn’t expected to die in hospital. Nine days later, Charles gave 49-year-old Catherine Dext an unprescribed injection of the heart drug. The respected prison officer promptly expired.

  Twe
nty-four days later, the nurse murdered 65-year-old former teacher Frank Mazzacco. Again, Charles’s trademark digoxin was responsible.

  On 10th July, eighty-year-old Jesse Eichlin collapsed at his local church, was given CPR by a fellow churchgoer and taken to hospital. Shortly after being attended to by the serial-killing nurse, he died.

  It was apparent that Charles enjoyed the part of hospital life that most medics hate, namely witnessing the grief of the dead person’s relatives. Charles Cullen rarely approached the bereaved directly, but he hung around outside the door of many of the death rooms or pretended to nurse other patients who were in the next bed to someone who had just died. Lonely and embittered, he was in constant emotional pain and seemed to enjoy witnessing others in similar distress.

  In October, his girlfriend ended their liaison and Charles resigned from the hospital where they worked together, then had second thoughts and asked for his job back. Perhaps tellingly, they refused to reinstate him and he began to look for other work.

  The following month, Charles started a new nursing job at Morrisontown Memorial Hospital but he was soon being written up for various infringements, including ignoring a doctor’s order to stop giving sedatives to a patient. More alarmingly, he was seen to tamper with the oxygen setting on a ventilator. On another occasion, he was supposed to give an anti-coagulant drug to a patient but failed to do so, putting them at risk of a thrombosis clot. In August 1997, the hospital had had enough and fired him for poor performance.

  Unemployed, Charles spent hours tending his garden, attacking any cat that happened to stray over his seed beds. He bought himself a dog for company but the poor animal was removed by animal welfare officers after neighbours reported that he was ill-treating it. In early autumn, he was again treated for clinical depression as an inpatient at a psychiatric facility.