With Rix running around counting ampoules of epinephrine and Walsh looking under every nook and cranny of the ward for anything she could find, they feared Gilbert was going to catch on to what was they were up to soon enough, anyway.
And then what?
Walsh had an inkling that Rix was up to something. She had known Rix for quite a while, and was convinced by the second week of February that she wasn’t herself since she had returned from vacation. For the past few days, Walsh had wanted to approach her with her own concerns, but she was having trouble finding the right words and place to do it.
But on February 13, the opportunity presented itself.
Staying late because they were shorthanded, Walsh entered the break room and saw Kathy Rix just sitting there alone, staring blankly into the muddy whirl of cream and sugar swirling around in her coffee cup. When Walsh thought about the events of the past few weeks hard enough, it seemed almost ridiculous that no one else had come forward, or at least said something. Since February 2, just eleven days ago, four patients had died on Ward C: Kenny Cutting, Leslie Smith, Jack Knightlinger and Henry Cormier.
How many more would it take?
Kathy Rix didn’t say anything as Walsh entered the room and walked toward the counter to make a cup of coffee.
After ripping open a small pouch of sugar, Walsh turned and looked at Rix, who just stared back at her with an exhausted look on her face.
“You know how it’s always kinda been a joke about Kristen being the angel of death . . . how we’re always joking about it?”
“Yes,” Rix said, nodding her head slowly.
“Do you ever think that maybe it’s not a joke? That maybe things are really going on?”
The silence in the room was deafening.
“I think about it all the time, Renee . . . all the time,” Rix said, dropping her head down on top of the table.
“Maybe we should talk.”
For the next few minutes, the two nurses swapped stories about what they had seen, heard, thought and felt. They left nothing out. It was like uncorking a bottle of demons that had built up for months. Yet, when everything set in and they realized what was going to have to happen next, that enormous weight had been replaced with a terrible sense of responsibility and confusion.
Where do we go from here?
No sooner had Rix and Walsh begun to vent their concerns, than John Wall walked in as though the meeting had been preplanned.
But Walsh abruptly stopped talking. Even though Rix and Wall had been discussing what to do for some time, Walsh, who didn’t know about it, was scared.
Rix then turned to Walsh and whispered, “I think we can trust John, Renee. He has his suspicions too. We’ve been talking about this for quite a while now.”
“Oh?” Walsh said, surprised.
“He has some of his own stories to tell.”
Worried that someone might walk in at any moment, the three nurses swapped a few stories and began discussing a plan.
“Should we go to Melodie?” Walsh asked. “The FBI? The Northampton Police Department? Who? Where?”
“No,” Wall said. “Who knows what she’ll do with the information.”
The nurses had every reason to believe that Melodie Turner, being management, and, remarkably, oblivious to what had been going on, would somehow try to cover it up. They were scared. Confused. This was serious now. The entire thing was about to explode, and they were going to be at the center of it. It had to be done right. If security found out, James Perrault would know. And they couldn’t chance that.
So they agreed to sleep on it for a few days and think about what needed to be done next.
CHAPTER 27
Northampton High School graduate Melodie Turner began working at the VAMC in 1979, after spending eight years at Northampton State Hospital, a psychiatric facility. Beginning her VA career as a staff nurse in psychiatry, in 1981, she was transferred to the acute medical ward. In 1983, armed with a bachelor’s degree in public health, Turner landed a position as nursing manager of psychiatry. Five years after that, the VA made her nursing manager of Ward C.
“But I don’t have any medical nursing experience,” a coworker later recalled Turner telling her bosses when they approached her with the idea. “I have never worked in an ICU in my life!”
“We don’t need a medical nurse; we need a manager. And you are a good manager . . . that’s what we want.”
This was, perhaps, one of upper management’s biggest mistakes: hiring a person who knew very little about what everyday life was supposed to be like on an acute medical ward to run the show.
So Melodie Turner, equipped with some rather impressive academic credentials, entered Ward C as nursing manager, according to some, knowing little about the medical side of nursing. She wasn’t qualified in ACLS. She didn’t know how to read a monitor or EKG. And she had no idea how to start an IV.
Now, however, she would be the person to decide if her staff was doing these basic nursing procedures accurately.
What was more, Turner had very little experience in codes and medical emergencies. Medical emergencies and codes rarely ever occurred on a hospital’s psychiatric ward. And if they did, nurses would call in the medical personnel.
Ignorance, however, ran all the way up the VAMC management chain. Turner’s bosses, others claimed, were no more knowledgeable in these areas of medicine than she was. The VAMC, for the most part, was a psychiatric hospital. In terms of beds, the psychiatric side of the hospital dwarfed the medical side by about three to one. Most of the people in management had been working at the VAMC—in the same office, in the same position—for their entire careers. As one nurse later put it, “They wouldn’t know what death statistics were if you hit them over the head with [them].”
Turner usually worked the 7:00 A.M. to 5:00 P.M. shift, so her hours dovetailed with each of the three shifts she was now responsible for. She was married with two kids, and her husband also worked at the VAMC. In her late forties, tall and skinny, with bleached-blond hair that was turning gray as the years piled up, Turner was extremely high-strung and, from day one, relished the role of being head nurse.
“Drama queen,” is how one of her former underlings described her.
As the staff got to know her, they learned quickly that her preoccupation with her looks fell in line with her controlling managerial style. She was never, for instance, shy about letting her minions know who the boss was. She put high standards on most of the nurses she had seen promise in—particularly Kathy Rix, John Wall and Renee Walsh—and always kept an eye on how they conducted their business. For this, some of the staff applauded her. Yet others considered her one of the toughest bosses they had ever worked for and complained that she had often abused her power and took her responsibilities to an impossible level—especially where discipline was concerned.
“She loved chaos and things being stirred up,” recalled an old colleague of Turner’s. “This way she could fix them—which she was really good at.”
“She could be intimidating,” another nurse later said. “Very, very controlling.”
At times, her managerial practices even bordered on harassment, and Turner often went out of her way to be overly insensitive while lecturing certain members of the staff.
“She would bring you to the point of tears, belittling you and your work, and then, when you started to cry, she’d tell you it was okay,” Rachel Webber later recalled.
Funny and witty, Turner enjoyed the larger-than-life persona she so desperately tried to project. Being estranged from her “mentally ill” mother for more than thirty years, some claimed, probably gave rise to her demanding absolute perfection from her staff.
One time, during the winter of 1993, personal phone calls became an issue on Ward C.
Earlier that day, Turner had been given a copy of all the long-distance phone calls that had been made on the evening shift for the past several weeks. After learning that some of the calls were as long as t
hirty minutes, she became “infuriated” and demanded to know who had been making the calls.
Rumor had it that one of the nurses, who had friends and family across country, had been calling home.
To find out who was responsible, Turner called each nurse into her office one by one. The nurses speculated that Turner knew who was making the calls, but couldn’t, in all fairness, make accusations without any solid proof.
Living up the same code of silence many cops adhere to, the nurses got together beforehand and agreed they would play the “I have no idea” game and leave Turner guessing. It would likely enrage her to the point where she would leave them alone and forget about the incident. In turn, the guilty nurse would stop making the calls, and life would go on.
After getting nowhere with her interrogation, Turner came out of her office and called everyone to the nurse’s station. She had something she wanted the staff to hear.
Pausing for a moment before speaking, Turner said, “What am I going to do with you guys?” Then, with a flip of her head, stormed off.
After that, whenever there was a problem and one nurse covered for the other, Turner would gather the staff together and, jokingly, say, “This evening shift is so close . . . [you guys] would probably cover up a murder.”
Not everyone agreed that Turner was so bad, however. One of her former colleagues recalled that although she didn’t see Turner as the best boss she’d ever had in her decade and a half as a nurse, she certainly didn’t agree with the sentiments of some of the others. The nurses who had problems with Turner were the same people who managed to piss her off in some way. Turner was, the nurse insisted, one hundred percent behind the nurses on Ward C—providing, that is, they stayed on her good side.
“She hated slackers and liars. If Melodie was behind you and respected your work, she would . . . stick up for you right down the line.”
By the beginning of 1996, Turner had had it with Gilbert. Although she saw her as an excellent code nurse, more knowledgeable in medicines than most, she had caught Gilbert in so many lies throughout the years that she’d lost any bit of professional respect she had left for her. She felt Gilbert could have been more “self-directed” and wanted her to seek out more work, responsibility, and uphold the “policies and frameworks” they had worked under to a greater degree.
Gilbert, of course, always let her down.
But besides noting it on Gilbert’s performance evaluations, Turner never took it any further.
As far as Gilbert’s name being on approximately seventy-five percent of the codes and fifty percent of the deaths since 1989, one might ask why Turner hadn’t been compelled by the numbers at least to speak to Gilbert.
It seemed odd that she hadn’t.
But what was even more peculiar was that for the past year Turner had sat on what was called the Medical Emergency Committee, along with representatives from the pharmacy, security, and supply and distribution departments. Headed by a physician, the group met once a month to review the previous month’s medical emergencies “for needs that might have come up in carrying out the medical emergencies [and] the whole deportment of the medical emergency.” They would discuss how the codes and emergencies were played out. They would make sure there was enough medication on hand during the episode, make a judgment as to how the code team responded, and rate how the overall code had been carried out.
One would have to assume the increasing amount of codes would have raised a red flag during one of these meetings.
But it never did.
“The Medical Emergency Committee,” a member of law enforcement later said, “including Melodie Turner, didn’t think that a serial killer was wandering through the halls of Ward C—so they certainly weren’t looking at these codes with a suspicious eye.”
Nevertheless, the roof was about to cave in on Melodie Turner.
CHAPTER 28
Late in the day on February 13, Renee Walsh and Kathy Rix got together to talk about their next move.
As they spoke, it became obvious that talking at work about such sensitive issues was probably not a good idea. The last thing Walsh and Rix wanted was for a rumor to start floating around that they were getting ready to turn Gilbert in.
So after a few moments, they decided to table the discussion for a later time. Walsh, however, had been treading water now for weeks, losing sleep, not eating. She suggested that whatever they decided to do had to be done quickly.
“Okay,” Rix said. “Don’t worry. I’ll call you at home later.”
The following day, Rix once again counted the epinephrine ampoules in the ICU and satellite pharmacy. In the ICU there were three; the satellite pharmacy still had twenty-two. Since she’d returned from vacation a week ago, there had not been a drop in the count. But that made little difference to her and John Wall. Because during the past week, while the epinephrine count in the ICU and satellite pharmacy stayed the same, there had been only one medical emergency, on February 11, and Gilbert was nowhere in sight when it occurred.
That, however, was all about to change.
Ed Skwira was born in Holyoke, Massachusetts, on May 25, 1927. Eighteen years later, he entered the U.S. Army, became a truck driver, and, after being discharged from the Army in early 1947, joined the local chapter of the Teamsters Union.
Not long after that, Skwira married a local gal, Stacia, and started a family, having three kids right off the bat.
Pushing six feet, two hundred and fifty pounds, with his greased back, jet-black hair, “Big Ed,” as the family called him, became known around the house years later as “The King.”
For whatever reason, ever since he had been discharged from the Army, Skwira had developed a hearty taste for hard liquor. And by February 1996, at sixty-eight years old, when he was admitted to AdCare Hospital in Worcester, Massachusetts, for alcohol abuse, Skwira admitted that he had been drinking scotch on a daily basis for fifty years.
His chief complaint when he arrived at AdCare on February 6, 1996, was alcohol dependence. But he was also suffering from diabetes, along with several other problems either directly or indirectly related to his years of abusing alcohol. Overindulging in hard liquor for five decades doesn’t come without a price, both physically and socially. Yet despite the health problems he had, Skwira’s alcohol abuse, remarkably, had little effect on his home life. At the time he was admitted to AdCare, he and Stacia had been married for forty-eight years, having celebrated their twenty-fifth and fortieth wedding anniversaries with extravagant parties.
Skwira had detoxed himself once before, two years earlier, and managed to stay sober for about six months, but then began drinking again.
After a quick assessment at AdCare, save for his drunkenness, Skwira checked out pretty well. He showed no signs of jaundice. His vision was good. He had no hearing problems. No chest pain. No shortness of breath. No palpations. No wheezing. And no diarrhea or constipation. He had no memory loss and, answering questions at will, could concentrate suitably. His vitals checked out incredibly well: his blood pressure was 150 over 90; temperature 96.8; pulse 100; and his heart had a regular rhythm and rate, with no rubs or murmurs. He wasn’t experiencing hallucinations, nor had he any thoughts of killing himself.
If he could beat his addiction to alcohol, everything else might just fall into place.
Within a few hours, however, Skwira would learn just how severe an alcoholic he was, and, because of that, his doctors planned on detoxing him “in a safe environment to prevent [any] medical or psychiatric complications.”
There was no getting around it: The next few days in Ed Skwira’s life would be hell.
For the next week, doctors kept him heavily medicated, trying to ward off the multitude of complications associated with withdrawal. But it being a seven-day program, by the end of the week, Skwira’s time had run out at AdCare, and the hospital couldn’t keep him any longer.
As a veteran of the U.S. military, however, Skwira was entitled to long-term care for his a
lcohol abuse, and on February 15, 1996, was transferred to the Leeds VAMC to begin what everyone had told him would be the fight of his life.
CHAPTER 29
A quaint little Southern belle, Renee Walsh believed things in life happened for a reason. Being a devout Episcopalian, she had always turned to God for comfort and guidance during times of uncertainty. The Lord gave a person only what they could handle—no more, no less. Lent was right around the corner. Perhaps more than any other year, it was time for Walsh to cleanse herself of the demons that had been haunting her now for weeks.
Something had to be done. It couldn’t wait any longer.
She was scheduled to leave work early on Thursday, February 15. Before gathering her things and signing out, Walsh pulled Kathy Rix into the locker room, took a quick look to see if anyone else was around and laid it on the line.
“It can’t go on any longer,” Walsh urged. “The longer we sit on this, the more it’s going to happen. I’ve made up my mind, Kathy. I think the best thing we can do, in order to be safe, since we’re government employees, is to go to see Melodie.”
For the past few days, the entire ordeal had caused Walsh a considerable amount of anxiety. She was still second-guessing what they were about to do. “What if I’m wrong?” she would ask herself while staring at the ceiling trying to fall asleep. “What if I’m so far off base . . . what if there’s some other explanation?”
Part of it was not wanting to believe it was possible. Northampton was akin to Mayberry, the fictional town where television’s The Andy Griffith Show was set in. Almost everyone knew one another. People stopped you at the gas station and asked how your kids were. Locals hung around the coffee shops and talked about taxes, Little League and upcoming elections. Who wanted to believe they had been living in the same community—or, worse, working side by side—with a serial killer?
What was more, what if they were wrong? Walsh worried the entire incident would end up in the newspapers if they went to the police. Anyway, the VA had always insisted that if a nurse had suspected some type of negligence, or had a complaint about another employee, the right thing to do was to go to one’s immediate supervisor and report it. If one didn’t get any satisfaction there, keep going up the chain of command.
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