52
Amy laid out her new discoveries across the table for Tim and Danny the following afternoon. Charlie had been bartending, she told them, titrating a pharmacopeal mélange, from both drugs he’d pulled from the Pyxis machine’s cabinet and drugs he hadn’t.1 Each drug in the cocktail had a specific biochemical effect. Together, they were a biochemical symphony. In combination, it didn’t require nearly so much of any one drug to push a vulnerable patient over the edge. One drug pushed while the other pulled.
Only the patient’s reaction mattered. The gap of time between the serving of the cocktail and the patient’s reaction was suspenseful. There might be a crash or a code or a Lazarus-like recovery. The cocktail was the riddle and the lab reports were the answer.
She had imagination enough to make sense of the patterns, but she couldn’t begin to imagine the monster that amused itself with them. All she was certain of was that it wasn’t the same gentle soul who was her friend Charlie. The emotional disconnect bothered her as much as the murders themselves.
Amy considered herself to be a perceptive person—a spiritual traveler, a listener with well-tuned antennae for the frequency of vibes. Growing up as she did, she had always assumed that if she was near another monster she would feel it. And yet, standing next to Charlie, she had never felt anything like evil. Maybe she’d gotten him wrong, or maybe her antennae were broken. Or maybe, Amy thought, she was half blind, and could see only the good in people.
Charlie’s Cerner pages comprised all of the charting he had done at Somerset. Each page told her she had assumed wrong. Charlie was not, actually, the world’s greatest nurse, the greatest chart keeper Amy had ever seen. He had hardly typed a line.
It was, in fact, the worst charting Amy had ever seen. There were blotches of words here and there, blurts, spasms of hurried and misspelled observations. It couldn’t have taken him more than a minute to do that work. Whatever he was doing on the computer, it wasn’t input. That meant Charlie had been outputting something.
Amy had to wait until her next shift to print out the rest of the records. This time, she couldn’t wait until she got home. That morning she called ahead, then brought her paperwork to the second floor of the prosecutor’s office to share her discovery with the detectives.
The Cerner automatically kept track of everything a nurse did within the system, and provided a time and date stamp of every page a nurse had browsed. Charlie was browsing all night. That was what he was doing. Browsing.
The word dragged a fingernail up her arm.
In her dream that night, Charlie was standing by the Pyxis, laying out the IV bags. Helpful. He did this alone.
There were patients on the ward, listed on the whiteboard. Strenko, Simco, Strickland, each with a number. The room numbers were a kind of lottery; the nurses worked different numbers every day. Some nurses thought certain numbers were lucky and played them in the lottery. Some of the numbers reflected on themselves, front and back, like 212. Some were birthdays if you were born in February.
Now Charlie’s at the Cerner. On the screen is a patient, not his. Now another patient, another.
The nurses are in the rooms, tending the cells. Charlie is in his. He draws the shades and closes the door and pulls the horseshoe curtain around the patient. Why so secret? Is Charlie in the room? Which room? He has three patients in three rooms. All three blinds are closed. It could be any of the three. It’s like three-card monte. Where’s Charlie? But he’s not in the rooms. Charlie is at the nurse’s station, pulling drugs. Why so many? He’s alone at the Pyxis, but he’s not using the Pyxis. Why so often? Another nurse needs to pull a drug and Charlie offers to do it for her. Why so helpful?
On top of the Pyxis, Amy can see the IV bags, clear little udders in a row. Each has a sticker with numbers and letters, ten-point type, you’d need your glasses to see. Is he wearing his glasses? He is not. Charlie is vain. He’s handsome. He can’t see.
You’d have to slow down, stop, study the bags to figure which goes to which patient. Does he? He has the cocktail in his hands and he sticks one. Does he know the name or the number? Does he know where it goes?
He’s back behind the Cerner computer cart now, a new patient up on the screen. Then another. Then another. Why so many, Charlie? What are you looking for, hon?
Charlie, what are you looking for?
Charlie doesn’t know. That’s why he’s looking.
It’s a lottery.
Amy’s awake.
Crossed with the Pyxis reports, Cullen’s Cerner records were the most incriminating piece of evidence the SCPO had against him thus far. But in order for the detectives to understand it, Amy needed to provide a quick primer.
Cerner had been introduced to the medical profession only a few years before as a compact and efficient way to input notes on patients, to look up their allergies, code status,2 lab values, etc. But nurses were only supposed to do that for the patients they were caring for on shift.
What nurses never did, at least not any nurses Amy had ever known, was use Cerner to look up the status of other nurses’ patients. But that, it seemed, was exactly what Charlie Cullen had been doing.
Amy started with Charlie’s June forays into the chart of patient Florian Gall. The hospital records showed that Gall had gone into cardiac arrest at 9:32 a.m. on the morning of June 28 and died approximately forty-five minutes later.
Gall was not Cullen’s assigned patient on the night he died. Yet the Cerner records showed Charles Cullen snooping into Gall’s medical chart at 6:28 a.m., then again at 6:29 a.m. on June 28. He was checking in, only minutes apart, looking for something only a half hour after the dig spike had registered in Gall’s lab work, and three hours before the dig levels in Gall’s system would stop his heart.
“And that’s just Gall,” Amy said. The Cerner records contained lines and lines of Charlie Cullen’s log-ins at the computer, thousands of them, sometimes hundreds a night.
“He was studying them,” Danny said. “Why the fuck was he studying them?”
Amy thought she knew. The nurses had IV bags lined up for them. But what if Charlie had made a drug cocktail, and injected it into one or more of the IV bags sitting by the Pyxis? He wouldn’t need to bring them to the patient’s rooms, he wouldn’t need to be present at all. The other nurses—even Amy—would do that work for him. Charlie could simply retreat to his corner and use the Cerner to scan the lab reports and the patient’s progress. Cerner would tell him where his loaded IVs landed. He wouldn’t need to be present for the death to feel the impact; you could just scan back on the Cerner anytime and follow the action. It could be that same night or the next day, it didn’t matter; the event was always available on the screen to be relived again and again. Was that what he was doing? Amy felt her heart beginning to sicken. She had delivered his drug cocktails. And her friend Charlie had been following the action across the ward, like the box scores on a sports page.
53
November 29, 2003
The Gall toxicology report came in at 10:38 Saturday morning. Most of the paperwork was dedicated to what they didn’t find: some ninety-six different drugs, from acetaminophen to zolpidem. What the tests did find was digoxin, and plenty of it: 23.4 mcg/l in the vitreous fluid, 32.0 mcg/kg in the spleen, 40.8 mcg/kg in the heart, and 104 mcg/kg in the kidney. Now Mambo could amend his report. Cause of Death: Digoxin Toxicity. Manner of Death: Homicide. They had both a murder victim and the murder weapon. But they still didn’t have any sure way to convict the murderer.
The SCPO team was meeting twice a day now. The Pyxis reports and Cerner printouts were the single largest piece of evidence they had tying Cullen to the drugs that had killed Gall. But the Pyxis news merely demonstrated that it was possible for Charles Cullen to have gotten the drugs he needed to kill. Prosecutor Forrest knew that was a far cry from proof of murder.
Charles Cullen could easily claim the Tylenol orders were valid and real.1 Amy’s read of the Pyxis suggested Cullen had been pla
ying a code game with patients across the ward, a supposition that was perhaps too complex to ever prove. Nor could they prove that Cullen’s numerous Pyxis cancellations were anything other than mistakes, or that his Cerner stalking across the ward was anything other than a creepy but harmless obsession. And with Cullen out of work, it was obviously too late to catch him red-handed without risking another murder. There was only one sure way to put Cullen away: he’d have to confess his crimes, or at least one of them, to someone he trusted. If the Reverend Gall wasn’t going to end up a cold case like Ethel Duryea, Tim would need to ask Amy for another favor.
The detectives set Amy up with a phone in one of the old offices of the Narcotics Division, where outgoing calls came up on caller ID as private number. She caught Charlie at home at just before 11, giving him her sunniest “Hi Honey!”
As their conversation turned to the case, she said, “I think the thing that bothers me so much, Char, is that I really felt like you were one of the reasons that I was there. It’s just not the same without you. And you know, I mean, it sucks. It sucks without you there.”
Charlie was certain now that he had been fired because of his photo in the nursing advertisements. Somebody had seen it, they’d reported him, checked the dates on his application. Charlie liked this version of events; it was a reminder of his lasting effect on the world, his picture and its consequences. He was a victim, but a famous one. They’d mailed him out, his face, smiling, handsome, Charles. It appeared in two magazines, as well.
“You’re a star, Charlie!” Amy said. She told him she missed him terribly. Couldn’t he come back to her—back across the state line, to Somerville? “I want—I want to see you, okay?”
“Okay,” Charlie said.
“I mean, I don’t know,” Amy said, her voice charged and flirty. “I, I honestly don’t know how Cathy would feel about that, but—”
“She tells me that, you know, she would have no problem with me seeing someone else, and I shouldn’t have any problems with her seeing anybody,” Charlie said.
“Right,” Amy said quickly, pulling back. She’d felt safe playing on the edge, using charms she knew would appeal to him as a man but assuming he wouldn’t cross the line of platonic friendship. He never had before. But, seeing other people? “Well, maybe, you know even—maybe you, me and Donna, we can get together,” she said. Not a date, just a reunion with nurses from the unit.
“All right,” Charlie said. He didn’t sound quite as interested now. “So, yeah, ah… yeah. We can try and arrange something.”
“Do you have my phone number?”
“Ah, yeah, I still have it,” Charlie said. “You know, somewhere…”
“I know you won’t call,” Amy teased. She needed to reengage him without engaging his sex drive. “I know you’re a dumbass, you’re not gonna call, you’re not gonna get in touch with me, and you know this sucks. It just sucks.”
Charlie picked up on her pity, and pushed for more. “I just like, right now, I feel like totally worthless, is what I feel right now.”
“Well you’re not, okay? You’re not.”
“Because, I hate to say it, but you know, to me, my job is an important part of my, of my sense of identity. Who I am.”
“I know, Charlie.”
Charlie started to explain again about why he’d been fired, rambling unintelligibly on the subject for several minutes about the dates, why he’d gotten them wrong, the way they’d gotten him wrong…
“How about Zoloft?” Amy suggested. “How about some Prozac?”
Charlie stopped. “Well, I don’t know.”
“You know what, they have the new one,” Amy said. “Zoo-Pro, you know?”
“One of each.”
“Yeah, seriously, though, I mean—”
“Right.” Charlie wasn’t interested in that kind of help.
“This is a, a real shitty time for you.”
“I just got so depressed. I just didn’t care at all.”
“Charlie,” Amy said. “How can I help?”
He already had his résumé out there, on a couple job-search websites, Amy had heard they were good for hospital work, but with the holidays coming, and the prospect of child support again, he was having trouble staying positive. “I feel like I have like a month or so before I really start freaking out.”
“And that’s why you’re gonna need me as a support, you dumbass!”
“Yeah.”
“You know you’ve got to keep in touch,” Amy said. “And I will definitely keep in touch. And actually, I’m being—I’m being kind of rude, ’cause I’m using one of my friend’s phones, because my phone died, so I should probably get off ’cause it’s long distance.”
“Yeah, I guess so,” Charlie said.
“So I will e-mail you and you will definitely call me. Promise?”
“I will.”
“No, promise!”
“I—I promise.”
Tim waited till he heard both clicks before time-stamping the tape. Amy had been pitch-perfect on the phone, drawing him in, making plans for future contact, and providing critical information the detectives could get nowhere else. The problem was the information itself. Charlie Cullen was actively looking for work.
Tim honestly didn’t know what he was expected to do next. He’d had wanted to get the experts at the FBI involved, but Forrest had forbidden him from contacting Quantico. The SCPO would have to grind out this case alone; meanwhile, every day they worked was a day Cullen was out in the world, free to kill again. It might be days before he was back in an ICU. The reports from the surveillance team backed it up. Cullen was out there, interviewing, and who knew what else. The slow, case-building approach was taking too long. The only thing left was the direct approach.
54
The detectives watched Charlie Cullen out in front of the house, pulling out trash cans.
“This is going to work or it’s not,” Tim said.
“Can’t argue with that,” Danny said. “How you want to do this?”
“Let’s kill the little prick with kindness,” Tim said. “And if he resists, let’s just kill him.” He buttoned the automatic window and whistled.
Charlie looked up to see a car smoking in the December air. An official kind of car, big and new, New Jersey plates. The driver had his window down, his arm out like trying to catch a waiter. “Hey Charlie,” the guy yelled. “Come here.”
Charlie stopped, not sure what to do with the trash. He had the two barrels, trying to drag both to the curb at once, which wasn’t working except by dragging them backward.
The detectives stepped out of the car.
“You know who we are?” Braun asked. Smiling at him. Friendly.
Charlie stopped and blinked at the ground. Two of them, both with mustaches, the white guy in a leather jacket and a black guy in a suit. Charlie thought he saw another guy, waiting inside.1 “You’re policemen.”
“That’s right, Charlie, we’re policemen,” Braun said. “Actually, we’re detectives, Charlie. And do you know why we’re here?”
“I assume it’s something related to the Somerset Medical Center,” Charlie said.
“And you assume that because…”
“Well, from the New Jersey license plates.”
“Well, let me tell you, that’s very perceptive, because you’re right.”
“Am I under arrest?”
“You’re the target of our investigation, Charlie. We’re investigating the deaths at Somerset, and we need to ask you some questions.”
“Yeah, I was—they questioned me at the hospital, twice,” Charlie said. “About the unusual incidents. They did that recently, asking me about the incidents there.”
“Great. Okay. Now we want to talk to you, too.”
Tim opened the backseat, patting the frame as if he were calling a dog, hoping Charlie followed directions. “Come on. We’ll go for a ride. We can talk back at our office.”
“Um, I don’t—I don’t have my
coat,” Charlie said.
Charlie’s head was turned toward the ground but his eyes were glancing up now, stealing looks at the street, at the men, at the back of the car.
“You won’t need the coat,” Tim said. “It’s warm in here.” He patted the backseat again. “Let’s go.” Not telling him he had to, not saying it was a choice, either.
It was different from the other police cars Charlie had been in: roomier, more comfortable, and with no divider between the front and back seats. The detectives were all chitchatty during the drive, keeping it loose. They talked about work, sports, even the weather. Tim knew the pizza place near the intersection where Charlie grew up in West Orange, he remembered the mascot of Charlie’s high school team. They drove Cullen across the state line, and showed him, unofficially, the interrogation room of the Somerset County police station. And when Charlie seemed loose enough, they let it rip.
Back in Newark Tim used to have guys handcuffed to an eyebolt on his desk. He’d look up from typing their statement and there’s the guy, asleep in the chair. In for murder, going away for twenty years, snoring away. It took Tim a while to realize that for some guys, the stressful part was getting away with it, day by day. Getting caught was a relief. Getting caught meant at least there was nothing left to worry about, at least for some guys. But not, Tim realized, for guys like Charlie.
It was 2 a.m. when Braun’s unmarked Crown Vic pulled back in front of Cullen’s house. They had nothing. Cullen slid out across the backseat and headed silently toward his door. Braun rolled down his window.
“Yo, Charlie,” he said. “Look at me.”
Charlie squinted against the high beams.
“Next time you see me,” Braun said, “you’re wearing handcuffs.”
Then Tim Braun stuck an arm out the window, a fist balled at the end of his leather jacket. He knew it was ridiculous, but there it was, he couldn’t help it. He was so frustrated. His fist out a window was as close as he could get to a threat.
The Good Nurse: A True Story of Medicine, Madness, and Murder Page 22
