Fatal

by Harold Schechter

  For twenty-two years, Jane had lived with people who—however well-meaning—had never let her forget that she was not one of them. Now, pushing thirty, she was out in the world on her own. She had no inherited money, no social position, no family to fall back on. Nor, aside from her domestic skills, did she have any definite occupation.

  At a time when females were taught that their “proper sphere” was in the home, career opportunities for respectable young women were severely restricted in America. Aside from teaching—either as school-marms or as private governesses—they might become seamstresses, servants, or workers in a textile mill. None of those occupations appealed to Jane. She wanted what most people do: a job that would bring in a living wage, while offering opportunities for personal fulfillment. For many years, her deepest appetites had gone largely unsatisfied. Now, she was tired of acting out her desires entirely in fantasy. At twenty-nine years old, she hungered to taste the exquisite pleasures she had spent so much time imagining.

  And so, in 1887, Jane Toppan—a classic psychopathic personality who longed to do harm—settled on the profession most congenial to her needs. She decided to become a nurse.

  5

  I solemnly pledge myself before God, and in the presence of this assembly: to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug.

  —“THE FLORENCE NIGHTINGALE PLEDGE”

  FOR MUCH OF THE NINETEENTH CENTURY, HOSPITAL nursing was typically handled by a bunch of remarkably unqualified women. In New York City, for example, the wards of Bellevue were staffed by former inmates of the Blackwell’s Island workhouse—women, generally arrested for drunkenness or prostitution, who were paroled on the condition that they serve a stint as nurses. Needless to say, the quality of care they offered the patients left a lot to be desired, particularly since many of them were illiterate and unable to read the directions on medicine bottles—a circumstance that often produced disastrous results.

  The situation was no less bleak in Boston. As early as 1850, a sanitary commission appointed by the Massachusetts State Legislature recommended “that institutions be formed to educate and qualify females to be nurses of the sick.” It would be another twenty-three years, however, before the first nursing school was established in Boston. It was to one of these training facilities—the school attached to Cambridge Hospital—that Jane Toppan applied for admission in 1887.

  For the two years of their training, student nurses were subjected to a brutal regimen. They worked seven days a week, fifty weeks a year, with no Christmas, Easter, or Thanksgiving holidays. They slept in cramped, dimly lit, unheated cubicles, three women to a cubicle. Typically, they were roused from their cots at 5:30 A.M. by the clanging of a wake-up bell. After making their beds, dressing, and consuming a hurried breakfast (which they were required to fix for themselves), they repaired to a parlor for morning prayers. By 7:00 A.M., they were on the job. Between their shifts on the various wards and their professional instruction, they typically worked twelve- to fourteen-hour days, with about seventy-five minutes off for lunch and supper. Their meals tended to be so sparse and unpalatable that many of the women spent all their meager wages on extra food.

  For her first month, the trainee was a probationer, consigned to the most menial drudge-work—scrubbing floors, emptying chamber pots, laundering soiled bedclothes, etc. By her second week on the job, she was also given charge of a handful of patients. Under the watchful gaze of the head nurse, the trainee learned how to give baths, dress bedsores, treat wounds, administer enemas, dispense medications. The head nurses—generally, stern, if not authoritarian, personalities—enforced discipline with a military rigor. The smallest infraction (grumbling about the quality of the food, for example) could get a trainee branded as a troublemaker. The rule book for one training school specified severe punishment for “any nurse who smokes, uses liquor in any form, gets her hair done at a beauty shop, or frequents dance halls.”

  If she successfully made it through her probation-ary period, the aspiring nurse was required to sign an agreement “to remain for two years in the Training School for Nurses as a pupil nurse and to obey the rules of the school and the hospital.” In return, she was promised board, lodging, a white bib-apron and a cap made of lace-trimmed organdy, plus a monthly stipend of seven dollars, out of which she was expected to pay for her clothes, textbooks, and incidental expenses.

  Typically, the trainee had charge of about fifty patients. Besides her medical duties—which involved everything from catheterizing patients to draining their suppurating wounds—she was responsible for keeping her ward in proper shape. Among her daily housekeeping tasks, she was expected to sweep and mop the floors, dust the furniture and windowsills, keep the furnace fed with coal, make sure the lamps were filled with kerosene. She was also required to prepare and serve the patients’ meals, change their beds, launder their clothes, roll bandages, and keep her writing quills sharply whittled so that her records would be legible to the head nurse and attending physicians.

  Once a week, generally between 8:00 and 9:00 in the evening, she was required to attend a lecture in medical theory presented by one of the hospital physicians. Subjects typically included: physiology, hygiene, dietetics, obstetrics, surgical emergencies, eye and ear diseases, pediatrics, and nervous disorders.

  At the end of her second year, she was given a final examination by a board of physicians. If she passed, she received a handsome diploma, signed by both the examining doctors and the nursing-school board of directors. The questions covered a wide range of topics, from anatomy to sickroom care. Since administering medicine was such a major part of a nurse’s duties, particular attention was paid to the subject of “materia medica.” The questions included in the final examination of one school in the 1880s—the period in which Jane Toppan received her training—reveal a great deal, not only about the knowledge expected of Victorian-era nurses, but about the kinds of medication commonly dispensed in those days:

  What is the correct dose of sulfate of atropia? Of sulfate of strychnia?

  How much morphia would you give to a child two years old? Four years old? Seven years old?

  What would you do for a patient who has taken an overdose of opium or morphine?

  What are poisons generally?

  There is no doubt that, in many respects, Jane Toppan had all the makings of a first-rate nurse. Having spent twenty-two years of her life as a full-time house servant, she could easily handle the grueling drudge-work required of her. She also had a winning bedside manner that charmed many of her patients. With her increasingly roly-poly looks and bubbly personality, she became known by a nickname that would stick with her throughout the rest of her life: “Jolly Jane.”

  Not everyone, however, was quite so taken with her. In fact, just as in high school, there were those who detested Jane throughout her student-nursing years, and for the same reasons. Besides toadying up to her superiors—the head nurses and hospital physicians—she enjoyed spreading nasty gossip about people she disliked. She was exceptionally devious, with an uncanny flair for escaping the consequences of her own wrongdoing while implicating others as the culprits. In at least two instances, she spread slanderous rumors about fellow trainees that ultimately led to their dismissal. And she exulted in the trouble she caused. Even Jane’s friends were somewhat taken aback by the unconcealed glee she displayed when the two disgraced (and wholly innocent) young women were expelled from the school.

  In terms of sheer mendacity, the malicious lies she told about others were matched by the outlandish fabrications she invented about herself. As had been true since childhood, Jane was absolutely shameless about making up wildly boastful stories and insisting on their truth, even in the face of the most unassailable evidence to the contrary. On one occasion, for example, she let it be known that she was thinking of moving to Russia. According to her story, the Czar had
heard of the wonderful strides being made by American nurses and—wanting only the best for himself and his family—had offered Jane an enormous salary to join his personal medical staff.

  Lies weren’t her only transgressions. Throughout her time at nursing school, she was suspected of stealing various items, from hospital supplies to small sums of money. Nothing could ever be proven against her, however. In all of her crimes, large and small, she was an expert at concealment. Despite the growing distrust and hostility she provoked among her peers, Jane’s vibrant personality—the sunniness she could radiate when it suited her purposes—blinded most people to the dark realities of her nature. She continued to be a favorite among many of the patients, who brightened up visibly whenever “Jolly Jane” showed up on the ward.

  In her own perverse way, Jane reciprocated their affection. She was particularly fond of certain patients, and felt so sorry to see them discharged that she would take steps to prolong their stay. Sometimes, she would falsify their records, inventing symptoms that they didn’t really have or adding a few degrees of temperature to their fever charts. When that wasn’t sufficient, she would administer small doses of medication that would make them feel worse—not seriously ill, just sick enough to remain in the hospital for an extra week or so.

  And those were the patients she liked.

  There were some that she actively despised. She was especially contemptuous of the elderly, and on more than one occasion was heard to remark that “there was no use in keeping old people alive.” She said it with a smile, and her listeners assumed she was joking. But she wasn’t. She was deadly serious.

  Exactly how many patients died at Jane Toppan’s hands during her time at nursing school is unclear. Even she couldn’t say with any certainty, though, according to her estimate, she was responsible for at least a dozen murders during those years. In both their commission and concealment, her crimes were carried out with a methodical cunning. There was nothing haphazard about Jane’s approach. On the contrary, she brought a terrifying rationality to the outrages she perpetrated. She set about studying the tools of her trade with a scholar’s diligence, frequently asking her teachers questions about the properties of various poisons. She knew that her curiosity on the subject wouldn’t arouse suspicion—not at a time when substances from arsenic to strychnine were routinely prescribed for a range of ailments.

  She also pursued her researches in private. In later years, when investigators went through her belongings, they discovered a well-worn medical textbook from her student-nursing days. When they picked it up, the book fell open to a section that Jane had obviously pored over many times. It was the chapter on opium.

  Throughout the nineteenth century, opium was a cheap, legal, over-the-counter drug—as easy to buy as aspirin is today. As a common ingredient in the countless patent medicines that flooded the marketplace in the 1800s, opium was used to relieve teething pains in infants, menstrual cramps in women, and diarrhea in dysentery patients. Insomniacs took it to promote sleep and consumptives to suppress coughing. Morphine, the principal derivative of opium, came into particularly wide use during the Civil War, when it was employed as a surgical anesthesia and painkiller. Some doctors also recommended it as a substitute for whiskey, believing that, of the two evils, morphine addiction was preferable to alcoholism, since (as a physician named J. R. Black wrote in 1889) morphine “calms in place of exciting the baser passions, and hence is less productive of acts of violence and crime.”

  Dr. Black, of course, had no knowledge of his deranged contemporary, Nurse Toppan, when he published those remarks. In her hands, morphine became everything he claimed it was not—productive of the most appalling acts “of violence and crime.”

  It is impossible to say exactly when Jane began conducting what she called her “scientific experiments.” By the time she was caught, she had perpetrated so many of them that she could no longer remember all the details. She herself had become a kind of addict, profoundly dependent on the ecstasy—the intoxication—of murder. Poisoning, as she put it, had became “a habit of her life.”

  At first she appears to have relied exclusively on morphine, injecting it into her victims, then standing at the bedside to observe the effects. She liked to see their pupils contract—listen to their breathing grow loud and stertorous—watch as a clammy sweat covered their faces. With a large enough dose, they would sink into a coma almost immediately and die within a few hours. Sometimes, they simply stopped breathing. She found it far more satisfying, however, when—as occasionally happened—their deaths were accompanied by violent convulsions.

  Her serious experimentation really began when she started combining the morphine with another drug: atropine. Derived from both the belladonna and datura plants, atropine has been employed throughout history—particularly in India—as a particularly deadly poison. In Victorian America it was used, like morphine, both as a painkiller and as a treatment for dozens of ailments: asthma, earache, night sweats, rheumatism, seasickness, tetanus, whooping cough, and many more.

  Its symptoms, however, are very different from—and in some cases diametrically opposite to—those produced by morphine. The mouth and throat grow parched, and the pupils widely dilated. Victims lose control of their muscular coordination and reel around like drunks. They are possessed by a strange sense of giddiness that soon passes into a wild delirium. They may babble incoherently, burst into maniacal laughter, or emit constant, anguished groans. Perhaps the most grotesque symptom of all is their incessant picking at real or imaginary objects. They pluck at their clothing—pull at their fingers and toes—snatch at invisible objects in the air. Even when they lapse into their final stupor, they continue to mutter feverishly and make constant spasmodic motions, clutching at the bedclothes or grasping at phantoms floating over their heads.

  In experimenting on her victims, Jane began dispensing morphine and atropine in varying combinations. Often she would inject the morphine first, then—just before the patient lost consciousness—force him to drink a glass of water in which she had dissolved an atropia tablet. Or she might wait until the victim had lapsed into a coma, then roll him over and administer an enema laced with atropine, letting the poison flow directly into his bowels.

  There was a twofold motivation to her method. First, it allowed her to mask her crimes. By varying the dosages and timing of the drugs, she produced a set of symptoms so perplexing that the doctors couldn’t ascertain the true nature of the patient’s condition, often ascribing it to diabetes or heart failure. Second, she did it for fun. She derived a keen, sadistic pleasure from playing with her victims—from doing terrible things to their bodies and watching the results—before deciding it was time for them to die.

  Not that she killed every patient she poisoned. Sometimes, she waited until her victim was near death, then did everything in her power to save him. When she succeeded, she seems to have felt genuinely proud of herself, taking a deep sense of satisfaction in her professional skill. (In this respect, Jane Toppan was similar to other homicidal health care workers who have followed in her wake—Richard Angelo, for example, the Long Island “Angel of Death,” who, in the 1980s, administered lethal injections to an indeterminate number of hospital patients so that he could rush to their aid and feel like a hero.)

  The gratification she derived from being a savior, however—from rescuing one of her own victims from the brink of death—was nothing compared to the feelings she experienced when they succumbed. In describing that sensation, Jane tended to rely on Victorian locutions—“delirious enjoyment,” “voluptuous delight,” “greatest conceivable pleasure.” In the end, however—and much to the horror of her contemporaries—she was extremely direct in her admission.

  Killing, she would ultimately confess, gave her a sexual thrill.

  6

  The art of the poisoner is habit-forming; once the secret dose has been successful, the poisoner is urged on by a desire to repeat his triumph.

  —HENRY MORTON ROBINS
ON,

  Science Catches the Criminal

  AT THE SAME TIME THAT JANE TOPPAN WAS ATTENDING nursing school, her great contemporary, Herman Melville, was at work on his final masterpiece, Billy Budd. Once a celebrated author, Melville had long since dropped from public sight. In 1887—the year Jane began her training at Cambridge Hospital—he was residing in utter obscurity in lower Manhattan, having retired from his job as a deputy inspector at the New York City Customs House, where he had worked for nineteen years. When he died in 1891, his passing would go virtually unnoticed. In a perfunctory, three-sentence obituary, the New York Times would describe him as a once-popular writer of “sea-faring stories” and give his first name as “Henry.”

  In the few years between his retirement and death, Melville’s creative energies were devoted to the composition of Billy Budd. The work—which would not be published until 1924, and even then in a seriously flawed transcription—deals with one of Melville’s obsessive themes: the eternal struggle between good and evil, as embodied in its title character, the “handsome sailor,” Billy Budd, and his nemesis, John Claggart, the diabolical master-at-arms who sets out to destroy the innocent hero for no other reason than his hatred of Billy’s beauty and goodness.

  At one point in the novella, the author pauses to contemplate the source of Claggart’s villainy. Living in a pre-Freudian age, Melville does not use the clinical language of modern-day psychology in accounting for the character’s behavior, relying instead on such old-fashioned phrases as “natural depravity” and “the mania of an evil nature.” But his description of the master-at-arm’s malevolent personality makes it clear that Claggart is a classic instance of what we now call a criminal psychopath: