by Peter Elkind
Carnes pressed his point. “You understand the experts have come in here and testified that if you are under the effects of succinylcholine, [you are] absolutely, totally limp like a rag doll. You understand that?”
“I understand that,” said Holland.
“You observed and reported in both instances tonic-clonic seizure movement. You administered [Dilantin], an anticonvulsant drug…Is that right?”
Holland acknowledged that it was.
“And you were the doctor there. You were the one observing whatever those movements were.”
“That is correct.”
“Now,” said Carnes, his voice dripping with disbelief, “you want to back off and say, ‘well, it could have been succinylcholine.’”
“That is correct,” said Holland.
Burt Carnes ended the day content with what he had accomplished. Holland had testified previously that the seizure-like movements Chelsea displayed during the clinic arrests might have been caused by a low dose of succinylcholine, or the child’s emergence from the effects of the drug. But Carnes thought he had delivered his message to the jury—that Holland was rewriting medical history to aid the prosecution.
Ron Sutton recognized that Carnes was scoring some points. Holland sounded much worse under attack; she was retreating into a defensive shell. Hoping to minimize the damage, the DA was doing everything he could to distract the jurors during cross-examination. He shuffled papers and fiddled with lawbooks. He took out his gold pocket watch, dismantled it on the prosecution table, and then put it back together. On another occasion, as the defense lawyers preached that Genene was innocent, Sutton pulled out a handful of syringes he’d brought as evidence and lined them up in front of him, where they remained in the jurors’ sight.
Midway through the trial’s third week, Judge Carter confronted his second pivotal decision. The issue was whether to treat the jury to testimony from a new realm of incriminating evidence: the “extraneous offenses”—the cases of other children who had experienced emergencies in Genene’s presence. The prosecutors were eager to open that door. The defense might raise questions about the case of Chelsea McClellan, but the wholesale pattern was overwhelming. It had the power to snuff jurors’ doubts like a bucket of sand on a burning match.
Genene’s lawyers were similarly determined to slam the door and turn the key. In a hearing where samples of the testimony were heard outside the jury, Laura Little called the extraneous offenses prejudicial and inflammatory. The issue was what happened to Chelsea McClellan, not the other children; their emergencies were irrelevant.
Nick Rothe countered that the extraneous incidents were “strikingly similar” to the case on trial. Genene Jones, noted Rothe, pointing his finger at the defendant, was “the common denominator at all times.” This made Chelsea’s death not an isolated event but part of an ongoing scheme. The jury had to hear about the cases; only when all of them were examined did the horrible pattern become apparent.
The judge had spent the previous night mulling over the law; he fell asleep on the couch in his chambers amid a pile of briefs and legal books. Now, after a break, Carter returned to announce his decision: He would allow the testimony on the other children. The judge had dealt Genene’s defense another powerful blow.
Wave after wave of damaging evidence now spilled out before the jury. The army paramedics who had treated Jimmy Pearson appeared, dressed in uniform and wearing medals, to describe their wild helicopter ride with Genene. The jury heard about Misty Reichenau, who had stopped breathing after showing up in Holland’s clinic for mouth ulcers. The civilian paramedics who had transported Brandy Benites recounted how the baby went limp after Genene started a second IV in her foot. Dr. Webb recalled that he had been summoned to Holland’s clinic when Jacob Evans had arrested while the pediatrician was away. Webb told the jury he had ordered no medication for the baby, even though Genene had reported on medical charts that he ordered her to give Dilantin. And there was the story of Rolinda Ruff, brought in for diarrhea, the last of the babies who mysteriously had stopped breathing.
The nightmarish testimony dragged on, even as the horrible events had gone on, one after the other, until Genene Jones left Kerrville. Sutton summoned five mothers to the stand. Each told a tearful story of how one encounter with the LVN had pushed her child to the brink of death. The DA illustrated the pattern by marking each of the arrests in red ink on giant calendars placed before the jury. Several witnesses described Genene Jones’s appearance following the emergencies—her sweating, heaving body, her white face, and the strange, terrible look of excitement in her eyes.
For the defense, fighting the prosecution onslaught had become like sticking fingers in a bursting dike. And Sutton and Rothe were shrewdly foreclosing almost every path of counterattack. One opening was Genene’s explanation that she knew nothing about succinylcholine. How could she employ the drug as a weapon if she had no knowledge of how to use it? Sutton summoned Dr. Sheila Schwartzman, an anesthesiologist at the UT medical school in San Antonio, to answer that question. Schwartzman testified that in November 1980, she had given the nurses in the pediatric ICU an hour-long lecture on pediatric anesthesia drugs. Schwartzman still had the outline from her talk, which included a discussion of succinylcholine. It had spelled out appropriate doses for children, and it had noted that the drug’s tendency to cause bradycardia could be avoided through the use of atropine. Schwartzman was certain that Jones was present; the LVN had asked her to give the talk.
The defense lawyers thought they could exploit an inconsistency with the timing of Chelsea’s death. Everyone agreed that the child, after the injections and arrest in Holland’s clinic, had recovered almost completely in the emergency room. By the time Chelsea was readied for transport to San Antonio, the effects of succinylcholine—if indeed she had received the drug in the first place—clearly had worn off. How, then, could the prosecution blame Jones for Chelsea’s fatal arrest in the ambulance, more than an hour after the injections in the clinic? Sutton called DeAnna Armour, a woman whose mother baby-sat for Chelsea. Armour said she had accompanied her mother to Sid Peterson on September 17 after hearing of Chelsea’s arrest. She had seen Chelsea just before she was loaded into the ambulance. Armour testified that she also spotted Genene Jones near the child—and that she saw her give Chelsea another injection in the upper thigh. Genene explained that the child was getting Valium, Armour said. But Sharon Keith, the ER nurse, had told the jurors previously that she had already administered Valium, on Holland’s orders. The defense lawyers thought the story nonsense—a blatant fabrication to cover a gaping hole in the prosecution case. But there was no way they could rebut it. Sutton had his explanation: Genene had stuck Chelsea before the ambulance trip, sending the child into terminal arrest on the interstate to San Antonio.
To tie his case together, Ron Sutton turned once again to Kathy Holland. Led carefully by the prosecutor, the pediatrician shaped the suffering of her patients into a coherent pattern. Holland testified that it was Genene who prepared the injections and IVs that preceded the office emergencies. In each of the cases, she said, Jones had done it out of her presence. Sutton asked the doctor to consider the patients she had treated on the days when Genene was present. He focused on the children who were two years old or younger—and thus unable to talk. Wasn’t it true, asked Sutton, that every time Genene prepared an IV for a nontalking patient, the child “went down”? Yes, said Holland. The only patient older than two who had suffered an emergency was seven-year-old Jimmy Pearson, who was unable to talk. Sutton displayed this trend for the jury on a giant chart in the courtroom. Carnes rose to object. “This is no statistical analysis,” he complained. “This is something the State has put together in a motel room!” But Carter ruled for the prosecution once again.
First the judge had admitted the drug test, then he allowed the extraneous offenses. Now Holland was painting the events in her clinic as an obvious example of a nurse run amok. If it was all so clear, why ha
dn’t Holland done something—stepped in before a kid was dead and a half-dozen others had suffered? Carnes was determined to show the jury that the pattern was far from certain.
He challenged the doctor’s account that she had left Genene alone with each of the children. As he pressed her for detail, Holland’s memory began to falter. She hedged many of her answers and on more than one hundred occasions responded that she couldn’t recall the answer to a defense question.
Growing testy at the doctor’s memory lapses, Carnes questioned her claim that Brandy Benites had gone limp. He pointed out that Holland’s emergency room note on the incident—and even her civil deposition in the McClellan lawsuit—made no mention of limpness.
“I don’t always use the term ‘limp,’ Mr. Carnes, because I don’t always describe every single sequence of what the children do,” responded Holland. “I generally characterize the event.”
Carnes opened a copy of Holland’s deposition, adding his own emphasis to the reading. “In discussing Brandy Benites, the question was, ‘Was it evidenced to you at any time any symptoms which you felt looked like withdrawal from the effects of succinylcholine?’ And your answer was, ‘no.’ Not ‘maybe,’ not ‘I don’t recall,’ not ‘perhaps.’ An unequivocal no.”
“And that would still be my answer,” responded Holland. “…My interpretation of that question was that he was asking me for what I was feeling and thinking at the time of the occurrence of the events.”
Carnes didn’t understand how the doctor could have interpreted the question that way, but he pressed on. “Doctor, you have testified that you are a highly trained medical doctor with seven years of training, trained to make clinical observations of people whenever they are having a problem. In every single one of these cases, there is no indication in any record made at or near the time of the event, or in the deposition you gave in May of 1983, that any one of those additional children went limp for any period of time, is there?”
That might be true, said Holland, “but that doesn’t necessarily eliminate the existence of that.”
“Now, Doctor, in retrospect, here today in the courtroom, all of a sudden in every single one of these cases you have come forward and said there is this period of limpness. But you can’t remember how long it lasted, you can’t remember when it started or when it stopped, and it was always followed by what you, in your clinical observations, referred to as some seizure activity.”
“Uh-huh.”
“What is that based on, Doctor?”
Holland said she was relying now on a “retrospective view” of events. She said she had never been asked specifically whether children went limp “at any time.”
“Come on, Doctor,” snapped Carnes. “You knew what they were looking for in this two-day deposition. They were trying to find out whether there was evidence of succinylcholine having been used. Right?”
“All I know is that they were trying to find out the facts, and that is what I was trying to give them.”
“And they asked you every way possible whether, in your clinical opinion, succinylcholine was involved on any of these other children. You said no.”
“I did not have the back-up information at that May deposition that I now have.” Holland said she had become convinced by Dr. Holmstedt’s succinylcholine test on Chelsea. “At the time of that deposition, I didn’t have that information and was not about to speculate on a suspicion.”
Holland remained on the stand for parts of eight days—more than eighteen grueling hours in all. By the third day, she looked tired. On the sixth day, she cried while again describing her confrontation with Genene about the bottle of succinylcholine; Ron Sutton was pleased. By the seventh day, Holland had come down with flu and had to interrupt her testimony several times to ask for water. After she’d been through five hours of cross-examination, Sutton persuaded the judge that the doctor was too sick to continue. She finished her testimony the next morning.
Burt Carnes believed he had totally discredited the prosecution’s star witness. She had been forced to resort to memory lapses and semantic excuses. Carnes felt certain the jurors would not trust their grandchildren to the pediatrician’s care. But would they transfer enough blame to Holland to get Genene off the hook?
On the morning of February 7, the trial’s nineteenth day, Ron Sutton rose, as usual, at 5 A.M., to prepare the last of his evidence. Through the testimony of forty-three witnesses, Sutton had chronicled the life and death of Chelsea McClellan, the drug test that showed succinylcholine was in her body, and the emergencies that had stricken other children under the care of Genene Jones. There was only one thing left. He had promised the jury a motive.
Throughout the prosecution case, the DA had sprinkled hints. Witnesses had mentioned the nurse’s complaints about the inadequacy of pediatric care at Sid Peterson Hospital. Holland had recalled the day when Genene, walking out of the hospital’s ICU, had spoken wistfully of her hope that it might someday be named in memory of Chelsea. And Jacob Evans’s grandmother had told the jurors of Genene’s insistence that children required an ICU just for them.
Sutton had teased reporters with the remark that the prosecution’s case wouldn’t be over “until the fat lady sings.” Now, as his forty-fourth and final witness, Sutton called Mary Virginia Morris, a heavyset LVN who worked at Sid Peterson Hospital. Morris told the jury that she and Genene had gone to nursing school together in San Antonio. She had lost contact with her classmate—until 2 A.M. on September 11, 1982, when Jones was admitted to Sid Peterson for a complaint of bleeding ulcers, while Morris was working the night shift.
Morris had dropped by Genene’s room for a friendly chat later that morning. The nurse said she asked what Genene was doing in Kerrville. “She said that she was up there to help Dr. Holland run her clinic,” Morris recalled, “and that she was up there to help start a pediatric intensive care unit.”
“Did she discuss how it would be staffed or anything?” asked Sutton.
“She said that it was going to be run by all LVNs, which struck me as odd.” Morris voiced her skepticism to Genene—registered nurses customarily supervised ICUs—but she said Jones was “very adamant.”
“Did you discuss a need with her for a pediatric intensive care unit?” asked Sutton.
“Well, that was the next thing we talked about. I said, ‘And the other thing is, I don’t—we have sick children, but I don’t think there is enough sick children [in Kerrville] to constitute a pediatric ICU.’”
“And when you told her that you didn’t think there were enough sick children there to justify a pediatric intensive care unit, did she respond to that?” asked Sutton.
“Yes, sir,” Morris told the jurors. “She said, ‘Oh, they are out there. All you have to do is go and find them.’”
The state rested its case.
Thirty
For the counselors to the accused baby-killer, there was only one significant decision to make: whether to put Genene Jones on the witness stand. Jim Brookshire, Burt Carnes, and Laura Little had been wrestling with that question since accepting the case. After the prosecution rested, Judge Carter adjourned the proceedings for a day. It offered Genene’s lawyers a chance to ponder their strategy.
Three considerations weighed in favor of placing the nurse before those who sat in her judgment. The first was that Genene could be magically persuasive; each of the lawyers had felt the tug of Genene’s perfect belief in her innocence. They also needed to consider the impact of Genene’s failure to testify. Juries were instructed to conclude nothing from a defendant’s refusal to take the stand, but it was human nature to believe that those following such a course had something to hide. Finally, there was the distinct possibility that the defense had nothing left to lose. Genene’s attorneys had tried to block admission of the succinylcholine test—and failed. They had fought to bar testimony about the extraneous offenses—and failed. They had chipped away at the credibility of the prosecution witnesses, particularly Kathy Hollan
d—but with uncertain results. The accumulated weight of prosecution evidence now stood revealed as overwhelming. Perhaps Genene Jones’s force would prove as beguiling to one or two jurors as it had to Kathy Holland.
There were also powerful reasons to shield the nurse from scrutiny. For Genene to help herself on the witness stand, she would need to project a transformation that far transcended new clothes and fingernail polish. Painted by prosecution witnesses as an egomaniacal, cold-blooded killer, Genene would have to come across as truthful, compassionate, and—most of all—benign. While her lawyers held the stage, they could try to build such an image. Through carefully rehearsed questioning, they would portray Genene as a dedicated mother, summon up her determination to fight for her “little angels,” and evoke her grief at Chelsea’s death. Genene would play the part of the humble nurse, just an LVN following orders, who enjoyed little power to affect the health of her patients, for better or for worse. If all went well, at the moment the performance was over, the jurors would doubt such a woman could ever harm the fragile children entrusted to her care.
But then Ron Sutton would rise, and Genene would stand exposed to a brutal cross-examination. A defendant who remained calm and steadfast in the face of such an onslaught might actually bolster her case further. But with this defendant, that seemed unlikely. Genene’s blood seemed to boil at the mere mention of Sutton’s name. And the district attorney would come to the interrogation with precisely the fuel to turn up the heat. The problem was that Genene had already talked far too much. She had told her story to a Texas Ranger, to two grand juries, in a civil deposition, and to reporters from television, radio, magazines, and newspapers. Already the prosecution testimony had revealed a score of conflicts with the single version of events that Genene had given her own lawyers. From the untold number of occasions when Genene had gabbed away to others, Sutton had surely uncovered dozens more inconsistencies. Worst of all, the defense attorneys didn’t have a clue what they were. Putting Genene on the stand would be like walking across a minefield; any move they made might blow up in their faces.
