Latest / Murder Files Unsealed / The Angel of Death: The Crimes of Nurse Charles Cullen

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The Angel of Death: The Crimes of Nurse Charles Cullen · Murder Files Unsealed

• 0:00
  Speaker 1: Imagine for just a second the one place in the
• 0:03
  Speaker 1: world where you expect to be absolutely, you know, unconditionally safe.
• 0:08
  Speaker 2: Right, like a fortress.
• 0:09
  Speaker 1: Exactly. You're in a hospital intensive care unit. The ambient
• 0:14
  Speaker 1: noise is just the rhythmic, reassuring beep of heart monitors
• 0:18
  Speaker 1: and the low hum of ventilators.
• 0:21
  Speaker 2: You're surrounded by millions of dollars of life-saving technology.
• 0:24
  Speaker 1: Yeah, and more importantly... You are surrounded by highly trained
• 0:29
  Speaker 1: professionals who have dedicated their entire lives to healing. But
• 0:34
  Speaker 1: what if the person walking into your room, like the
• 0:36
  Speaker 1: person adjusting your IV bag with a comforting smile, isn't
• 0:40
  Speaker 1: actually trying to save you?
• 0:42
  Speaker 2: What if they are actively trying to kill you? Right.
• 0:46
  Speaker 1: It's just terrifying to even think about.
• 0:49
  Speaker 2: It's the ultimate subversion of the social contract, really. I mean,
• 0:51
  Speaker 2: we are wired to trust caregivers.
• 0:54
  Speaker 1: Yeah, from birth, basically.
• 0:56
  Speaker 2: Exactly. So when you strip that away and that trust
• 0:59
  Speaker 2: is weaponized against us, it's not just frightening. It dismantles
• 1:03
  Speaker 2: our entire understanding of societal safety nets.
• 1:07
  Speaker 1: OK, well, let's unpack this, because today's deep dive is
• 1:09
  Speaker 1: going into some incredibly dark, complex territory. We are looking
• 1:13
  Speaker 1: at the life and crimes of Charles Cullen.
• 1:16
  Speaker 2: A truly chilling figure.
• 1:19
  Speaker 1: Yeah, he really is. This is a man who exploited
• 1:21
  Speaker 1: that exact blind trust we place in medical professionals to
• 1:24
  Speaker 1: to become what is very likely the most prolific serial
• 1:27
  Speaker 1: killer in American history.
• 1:29
  Speaker 2: Which is saying something.
• 1:30
  Speaker 1: I mean, we're talking about an estimated and terrifying 400 victims.
• 1:35
  Speaker 2: It is a staggering number, just hard to wrap your
• 1:38
  Speaker 2: head around.
• 1:39
  Speaker 1: Totally. But what makes this analysis so critical is that
• 1:43
  Speaker 1: we aren't just looking at a timeline of murders.
• 1:45
  Speaker 2: No, we are dissecting a blueprint of catastrophic institutional failure.
• 1:50
  Speaker 1: Right, because this isn't merely the story of a single
• 1:53
  Speaker 1: bad actor, is it?
• 1:54
  Speaker 2: Not at all. It's an indictment of the entire bureaucracy
• 1:57
  Speaker 2: that shielded him.
• 1:58
  Speaker 1: Yeah. So the mission of this deep dive isn't just
• 2:00
  Speaker 1: a list off his crimes like some macabre encyclopedia. We
• 2:04
  Speaker 1: want to really understand how this happened.
• 2:07
  Speaker 2: We are definitely looking at the psychology of a killer.
• 2:10
  Speaker 1: Absolutely.
• 2:10
  Speaker 2: But we are equally focused on the systemic failures. Right.
• 2:14
  Speaker 1: The legal loopholes and the bureaucratic blind spots that allowed
• 2:17
  Speaker 1: this man to move freely through the health care system
• 2:20
  Speaker 1: for 16 years.
• 2:21
  Speaker 2: And we're drawing on a lot of solid sources for this.
• 2:24
  Speaker 2: Comprehensive toxicology reports, behavioral profiling, court transcripts.
• 2:29
  Speaker 1: Plus the direct accounts of the investigators and the nurses
• 2:31
  Speaker 1: who inadvertently worked alongside them.
• 2:34
  Speaker 2: Which are honestly some of the most harrowing parts of
• 2:37
  Speaker 2: the source material.
• 2:38
  Speaker 1: Absolutely. So to really understand how a predator hides in
• 2:42
  Speaker 1: plain sight for that long, we have to start at
• 2:44
  Speaker 1: the very beginning. We have to look at the making
• 2:47
  Speaker 1: of this supposed victim.
• 2:49
  Speaker 2: Right. So looking closely at the psychological evaluations from his
• 2:52
  Speaker 2: later trials, Charles Cullen was born in February 1960.
• 2:56
  Speaker 1: This was in West Orange, New Jersey, right?
• 2:58
  Speaker 2: Yes, exactly. And from day one, his baseline environment was
• 3:02
  Speaker 2: profoundly unstable.
• 3:04
  Speaker 1: How so?
• 3:05
  Speaker 2: Well, he was the youngest of nine children born into
• 3:07
  Speaker 2: extreme poverty, and he was actually described by his own
• 3:10
  Speaker 2: family as a late-life mistake.
• 3:13
  Speaker 1: Wow. That is brutal to hear as a kid. And
• 3:16
  Speaker 1: the instability just compounds almost immediately, doesn't it?
• 3:19
  Speaker 2: It does. His father dies when he is just seven
• 3:22
  Speaker 2: months old.
• 3:23
  Speaker 1: So they were essentially surviving on welfare checks and charity
• 3:26
  Speaker 1: in the 1960s.
• 3:28
  Speaker 2: Yeah. There's this immense crushing struggle just to keep the
• 3:31
  Speaker 2: lights on and food on the table for nine kids.
• 3:33
  Speaker 1: I can't even imagine.
• 3:35
  Speaker 2: That environment creates a baseline of absolute chaos. And when
• 3:37
  Speaker 2: you combine that with genetic or psychological predispositions for a
• 3:41
  Speaker 2: personality disorder, well, it's a bad mix.
• 3:45
  Speaker 1: Which psychiatrists later identified in Cullen, right?
• 3:47
  Speaker 2: Exactly. You mix that cluster of disorders with a highly unstable, impoverished,
• 3:53
  Speaker 2: and emotionally chaotic background, and the results are incredibly volatile.
• 3:57
  Speaker 1: And we actually see the first major manifestation of this
• 4:00
  Speaker 1: when he is just nine years old.
• 4:03
  Speaker 2: Yes. He attempts suicide by drinking chemicals from a children's
• 4:06
  Speaker 2: chemistry set.
• 4:08
  Speaker 1: A nine-year-old trying to end his life by intentionally ingesting
• 4:12
  Speaker 1: caustic chemicals. It's incredibly bleak.
• 4:15
  Speaker 2: It really is.
• 4:16
  Speaker 1: But it also signals a very specific relationship with chemistry
• 4:20
  Speaker 1: in the human body, doesn't it?
• 4:21
  Speaker 2: Absolutely. And this becomes even more pronounced a few years later.
• 4:25
  Speaker 1: Right. There's this incident with his sister's boyfriend.
• 4:28
  Speaker 2: Yeah. The boyfriend is horribly abusive, beating his sister to
• 4:31
  Speaker 2: the point of a miscarriage, actually.
• 4:33
  Speaker 1: Just awful. And Cullen decides to retaliate, but he doesn't
• 4:38
  Speaker 1: confront him.
• 4:40
  Speaker 2: No, he doesn't grab a baseball bat or call the police.
• 4:43
  Speaker 2: He tries to poison the boyfriend's drink with eyedrops.
• 4:46
  Speaker 1: Which sounds kind of mundane, but the toxicology of that
• 4:49
  Speaker 1: choice is fascinating, isn't it?
• 4:51
  Speaker 2: It's deeply revealing. He likely used a common over-the-counter eyedrop
• 4:55
  Speaker 2: containing tetrahydrozoline.
• 4:57
  Speaker 1: Okay, so what does that actually do?
• 4:59
  Speaker 2: Well, when ingested, it acts as an alpha-1 agonist.
• 5:02
  Speaker 1: Meaning what, exactly, for those of us who aren't doctors?
• 5:06
  Speaker 2: Basically, it means it rapidly crosses the blood-brain barrier and
• 5:09
  Speaker 2: tells the central nervous system to sharply drop blood pressure
• 5:13
  Speaker 2: and heart rate.
• 5:14
  Speaker 1: Oh, wow. So... It's not a joke.
• 5:17
  Speaker 2: No, it can cause a severe, sudden physiological crash.
• 5:21
  Speaker 1: So he isn't engaging in direct physical confrontation. He is
• 5:25
  Speaker 1: literally using chemical warfare.
• 5:27
  Speaker 2: Exactly. It allows him to inflict devastating physiological harm while
• 5:32
  Speaker 2: maintaining physical distance.
• 5:34
  Speaker 1: And crucially, plausible deniability. Right.
• 5:37
  Speaker 2: But I have to push back a little on this
• 5:39
  Speaker 2: whole troubled childhood framing, though. Go ahead. Because yes, the
• 5:42
  Speaker 2: poverty and the abuse are awful. But we see countless
• 5:46
  Speaker 2: tragic childhoods that don't result in serial killers.
• 5:49
  Speaker 1: That is very true. People survive horrific trauma every day
• 5:54
  Speaker 1: and become empathetic adults.
• 5:56
  Speaker 2: So is this eyedrop incident the exact moment we see
• 5:59
  Speaker 2: his eventual weapon.
• 6:00
  Speaker 1: Of choice crystallizing? It's almost like he realized very early
• 6:04
  Speaker 1: on that poison was, well, the coward's way to play God.
• 6:08
  Speaker 2: How do you mean?
• 6:08
  Speaker 1: Like, You don't have to be the biggest or the
• 6:11
  Speaker 1: strongest guy in the room if you control the molecular
• 6:14
  Speaker 1: chemistry of the people around you.
• 6:16
  Speaker 2: That's a good point, but I wouldn't call it a
• 6:18
  Speaker 2: crystallization of a weapon of choice so much as the
• 6:20
  Speaker 2: manifestation of a deep-seated pathology.
• 6:23
  Speaker 1: Okay, explain that a bit more.
• 6:24
  Speaker 2: I disagree that it's just about being a coward. While
• 6:27
  Speaker 2: the trauma was real, adolescent behavioral analysis shows that trauma
• 6:31
  Speaker 2: alone doesn't create a killer.
• 6:33
  Speaker 1: Right, it needs a catalyst.
• 6:34
  Speaker 2: Exactly. It's the interaction between that trauma and a profound
• 6:39
  Speaker 2: underlying cluster B personality structure, specifically vulnerable narcissism.
• 6:44
  Speaker 1: Vulnerable narcissism. So it's about ego fundamentally. Yes.
• 6:48
  Speaker 2: He didn't just want to hurt the boyfriend. He wanted
• 6:50
  Speaker 2: to feel intellectually superior to him.
• 6:52
  Speaker 1: Ah, I see. Poisoning someone flips the power dynamic completely.
• 6:56
  Speaker 2: Precisely. Suddenly, he holds the ultimate power over life and death,
• 7:00
  Speaker 2: but he doesn't have to look them in the eye
• 7:02
  Speaker 2: or risk them fighting back.
• 7:03
  Speaker 1: He becomes the invisible architect of their suffering.
• 7:06
  Speaker 2: Exactly.
• 7:07
  Speaker 1: That distinction between cowardice and a need for invisible superiority
• 7:12
  Speaker 1: makes perfect sense. He wants to be the smartest guy
• 7:15
  Speaker 1: in the room, pulling all the strings.
• 7:17
  Speaker 2: And that underlying pathology really collides violently with the defining
• 7:21
  Speaker 2: trauma of his teenage years. Right.
• 7:23
  Speaker 1: A moment that absolutely warps his relationship with the medical
• 7:26
  Speaker 1: system forever. It's December 1977. Cullen is 17 at this point.
• 7:31
  Speaker 1: And his mother, Florence, who is basically the only person
• 7:34
  Speaker 1: he has any real emotional connection with, is killed in
• 7:37
  Speaker 1: a horrible car crash.
• 7:39
  Speaker 2: Yes, his sister had a seizure while driving, leading to
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  Speaker 2: the crash.
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  Speaker 1: It's just tragedy after tragedy.
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  Speaker 2: And the psychological impact of this specific loss is catastrophic
• 7:48
  Speaker 2: for him.
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  Speaker 1: Because of how it went down at the hospital, right?
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  Speaker 2: Exactly. When he learns of the accident, he rushes to
• 7:54
  Speaker 2: Mountainside Hospital in Montclair, desperate to see his mother.
• 7:57
  Speaker 1: But by the time he arrives, the hospital bureaucracy has
• 8:00
  Speaker 1: already processed her and transferred her body away.
• 8:02
  Speaker 2: So he doesn't get to say goodbye.
• 8:04
  Speaker 1: And he blames the hospital for that. Entirely.
• 8:07
  Speaker 2: Completely. He feels the institution literally stole his mother from him.
• 8:13
  Speaker 1: He never forgives them for that administrative coldness.
• 8:16
  Speaker 2: No, he doesn't. This incident plants a seed of deep,
• 8:20
  Speaker 2: enduring grievance against hospitals and the health care system as
• 8:23
  Speaker 2: a whole.
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  Speaker 1: A grievance that he will nurture for decades.
• 8:27
  Speaker 2: Yes, it becomes a core part of his identity.
• 8:30
  Speaker 1: So he's devastated. attempts suicide again, drops out of high school,
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  Speaker 1: and essentially decides he needs to hit the reset button
• 8:37
  Speaker 1: on his entire life.
• 8:39
  Speaker 2: Which leads him to the military.
• 8:41
  Speaker 1: Right. In 1978, he joins the U.S. Navy. He's looking
• 8:45
  Speaker 1: for a family, a place to belong.
• 8:47
  Speaker 2: And he gets assigned to a submarine, the USS Woodrow Wilson.
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  Speaker 1: Which, if you understand his psychological profile, has to be
• 8:57
  Speaker 1: perhaps the worst possible environment for him.
• 8:59
  Speaker 2: Oh, absolutely.
• 9:00
  Speaker 1: Absolutely.
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  Speaker 2: The Navy, and submarine life in particular, requires intense teamwork,
• 9:05
  Speaker 2: extreme close quarters, and an incredibly thick skin.
• 9:10
  Speaker 1: It's a high-pressure, enclosed ecosystem.
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  Speaker 2: And Cullen carried a profound victim mentality.
• 9:17
  Speaker 1: So how did he handle the typical military culture? Terribly.
• 9:21
  Speaker 2: He perceived almost any kind of normal social friction, ribbing,
• 9:25
  Speaker 2: or rejection as intense, targeted bullying.
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  Speaker 1: It's a massive paradox, really. You sign up to be
• 9:32
  Speaker 1: trapped in a metal tube under the ocean for months
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  Speaker 1: at a time to escape your life, but you bring
• 9:37
  Speaker 1: your ultimate baggage right on board with you.
• 9:39
  Speaker 2: Right, this massive victim complex.
• 9:43
  Speaker 1: He wanted the romanticized Hollywood war movie life, but the
• 9:46
  Speaker 1: reality was just being stuck in a pressurized can with
• 9:50
  Speaker 1: the exact same type of guys who gave him a
• 9:51
  Speaker 1: hard time in high school.
• 9:53
  Speaker 2: And his reaction was to isolate himself. He felt constantly targeted,
• 9:57
  Speaker 2: and his behavior became increasingly erratic.
• 10:00
  Speaker 1: Like what kind of erratic?
• 10:02
  Speaker 2: Well, he would wear surgical masks on duty, claiming the
• 10:05
  Speaker 2: air was contaminated, things like that.
• 10:07
  Speaker 1: That's definitely going to single you out on a sub. Exactly.
• 10:11
  Speaker 2: The Navy quickly realized he was a liability in a
• 10:14
  Speaker 2: sensitive environment. So in March of 1984, they discharged him.
• 10:18
  Speaker 1: But here is a crucial bureaucratic detail that sets a
• 10:22
  Speaker 1: precedent for his entire life.
• 10:24
  Speaker 2: This is a huge theme in the sources.
• 10:26
  Speaker 1: Right. Despite his erratic behavior and multiple suicide attempts while enlisted,
• 10:31
  Speaker 1: the Navy gave him an honorable or essentially neutral discharge.
• 10:36
  Speaker 2: They didn't flag him as a psychological danger. They just
• 10:38
  Speaker 2: processed him out and made him someone else's problem.
• 10:41
  Speaker 1: They passed the buck. So he comes home, works at
• 10:44
  Speaker 1: a department store for a bit, feels totally aimless.
• 10:47
  Speaker 2: And then he makes a career choice that is just
• 10:49
  Speaker 2: chilling in its calculation.
• 10:51
  Speaker 1: He decides to go to nursing school. And he doesn't
• 10:54
  Speaker 1: just go anywhere.
• 10:55
  Speaker 2: No, he enrolls at Mountainside Hospital.
• 10:57
  Speaker 1: The exact same hospital where his mother's body was taken.
• 11:00
  Speaker 1: The place he blamed for his greatest trauma.
• 11:03
  Speaker 2: We really have to analyze why he chose nursing and
• 11:06
  Speaker 2: why he chose that specific location.
• 11:08
  Speaker 1: It can't be a coincidence.
• 11:10
  Speaker 2: In 1984, nursing was still overwhelmingly a female-dominated profession. Right.
• 11:15
  Speaker 2: Psychological profiling from the sources suggests Cullen believed that in
• 11:18
  Speaker 2: a female-dominated space, he would face less of the aggressive,
• 11:22
  Speaker 2: hyper-masculine bullying he experienced in the Navy.
• 11:25
  Speaker 1: He thought he would find a more compliant maternal environment.
• 11:30
  Speaker 2: Exactly. Somewhere he could actually wield some power and authority.
• 11:33
  Speaker 1: I have to challenge the idea that he was just
• 11:35
  Speaker 1: looking for a softer environment, though.
• 11:37
  Speaker 2: Okay, why is that?
• 11:39
  Speaker 1: Because deliberately going to work at the specific hospital you
• 11:42
  Speaker 1: blame for stealing your mother... That feels like he was
• 11:46
  Speaker 1: actively infiltrating enemy territory.
• 11:48
  Speaker 2: It does have that element to it.
• 11:50
  Speaker 1: It feels like a hostile takeover of his own trauma.
• 11:54
  Speaker 1: Like he wanted to control who lived and died in
• 11:56
  Speaker 1: the very system that he felt had wronged him so deeply.
• 12:00
  Speaker 2: I wouldn't necessarily call it a hostile takeover as much
• 12:03
  Speaker 2: as a desperate attempt to rewrite his own narrative.
• 12:06
  Speaker 1: Okay, explain that distinction.
• 12:08
  Speaker 2: You're right that it wasn't about finding a soft environment,
• 12:10
  Speaker 2: but it also wasn't pure vengeance against the institution itself.
• 12:14
  Speaker 2: He was seeking a captive audience.
• 12:16
  Speaker 1: A captive audience?
• 12:18
  Speaker 2: Yeah, by mastering the protocols of the hospital that he
• 12:21
  Speaker 2: felt victimized him, he was mastering his own trauma. He
• 12:24
  Speaker 2: didn't want to destroy the hospital. He wanted to become
• 12:27
  Speaker 2: its god.
• 12:28
  Speaker 1: Wow, that is a terrifying way to look at it,
• 12:31
  Speaker 1: but it makes so much sense. So he graduates in
• 12:35
  Speaker 1: June 1987, has a very quick whirlwind marriage, and starts
• 12:39
  Speaker 1: his first real nursing job.
• 12:41
  Speaker 2: At the St. Louis Barnabas Hospital burn unit.
• 12:44
  Speaker 1: And we really have to talk about what a burn
• 12:46
  Speaker 1: unit actually entails, because it's a brutal reality check.
• 12:51
  Speaker 2: It is arguably one of the most intense units in
• 12:53
  Speaker 2: any hospital.
• 12:55
  Speaker 1: His primary duty involves scrubbing dead and dying skin off
• 12:58
  Speaker 1: of severe burn victims. It's a process called debridement. Right.
• 13:02
  Speaker 2: It's necessary so they can grow new skin, but it
• 13:04
  Speaker 2: is agonizing for the patient.
• 13:06
  Speaker 1: It requires heavy narcotics, and it's incredibly taxing for the
• 13:10
  Speaker 1: nurse doing it day in and day out.
• 13:12
  Speaker 2: It is a horrific, high-stress environment, especially for someone fresh
• 13:16
  Speaker 2: out of training. The sensory overload is immense.
• 13:20
  Speaker 1: The smells, the screaming, the constant proximity to extreme suffering.
• 13:25
  Speaker 2: Exactly. It would break many stable people, but for Cullen,
• 13:29
  Speaker 2: it served as a crucible.
• 13:31
  Speaker 1: And it's within this high-stress environment that he crosses the
• 13:34
  Speaker 1: line from fantasy to active murder. Yes.
• 13:38
  Speaker 2: June 1988. Judge John Yango. A 72-year-old man is admitted
• 13:43
  Speaker 2: to St. Barnabas with severe sunburn.
• 13:45
  Speaker 1: Sunburn. So not even a life-threatening thermal burn initially.
• 13:49
  Speaker 2: Right. He is hooked up to a standard intravenous drip.
• 13:53
  Speaker 2: He's under Collins' care. And suddenly, he dies.
• 13:57
  Speaker 1: And this isn't an isolated incident.
• 13:59
  Speaker 2: No, this becomes a terrifying pattern over the next few years.
• 14:02
  Speaker 1: Yeah, this becomes a terrifying pattern over the next few years.
• 14:05
  Speaker 2: Yes, patients start mysteriously crashing.
• 14:07
  Speaker 1: What were the staff seeing exactly?
• 14:10
  Speaker 2: The medical staff started noticing this frequent, inexplicable deterioration in
• 14:14
  Speaker 2: patients who were otherwise completely stable.
• 14:17
  Speaker 1: Like they were fine one minute and crashing the next.
• 14:20
  Speaker 2: Yeah. A patient would be prepped for a routine procedure,
• 14:23
  Speaker 2: completely fine. An IV bag would be hung, and suddenly
• 14:28
  Speaker 2: the patient becomes incredibly sick.
• 14:30
  Speaker 1: What were the symptoms?
• 14:31
  Speaker 2: They were experiencing massive sudden drops in blood sugar, plunging
• 14:35
  Speaker 2: into hypoglycemic shock.
• 14:37
  Speaker 1: To understand how terrifying that is, You really have to
• 14:39
  Speaker 1: look at the mechanism of an insulin crash.
• 14:42
  Speaker 2: It's a very specific physiological response. Right.
• 14:45
  Speaker 1: If you inject a massive dose of insulin into someone
• 14:48
  Speaker 1: who isn't diabetic, it forces all the glucose in their
• 14:51
  Speaker 1: blood into their cells.
• 14:52
  Speaker 2: And the brain relies almost entirely on glucose to function.
• 14:56
  Speaker 1: So while the patient is breathing perfectly fine, their brain
• 15:00
  Speaker 1: is literally starving to death in a matter of minutes.
• 15:03
  Speaker 2: It's awful. They become confused, start seizing, and eventually slip
• 15:07
  Speaker 2: into a coma.
• 15:08
  Speaker 1: Exactly. And the nurses at St. Barnabas figured out a
• 15:11
  Speaker 1: chilling detail about these crashes, didn't they?
• 15:14
  Speaker 2: They did. When they disconnected these specific IV bags, the
• 15:18
  Speaker 2: patient's condition would stop deteriorating.
• 15:20
  Speaker 1: So the bags were the common denominator.
• 15:22
  Speaker 2: Right. So they inspect the bags, and they find tiny,
• 15:26
  Speaker 2: almost imperceptible pinpricks in the plastic of the saline bags.
• 15:29
  Speaker 1: Just tiny holes.
• 15:31
  Speaker 2: Yes. They tested the remaining fluid and found lethal doses
• 15:35
  Speaker 2: of insulin. Someone was deliberately injecting insulin into the bags.
• 15:40
  Speaker 1: We've gone from a kid trying to drop chemicals in
• 15:42
  Speaker 1: a drink to a nurse weaponizing the very tools of healing.
• 15:46
  Speaker 2: It's a massive escalation.
• 15:48
  Speaker 1: But the truly scary part isn't just that he did it.
• 15:51
  Speaker 1: It's how the hospital system reacted.
• 15:54
  Speaker 2: This is where the institutional failure begins.
• 15:56
  Speaker 1: Right. By January 1992, St. Barnabas knows someone is tampering
• 16:01
  Speaker 1: with IV bags. They launch an internal investigation.
• 16:05
  Speaker 2: And they call Cullinan for an interview.
• 16:07
  Speaker 1: How does he react?
• 16:08
  Speaker 2: He gets angry that he's being questioned, acts highly offended,
• 16:11
  Speaker 2: and simply quits on the spot.
• 16:13
  Speaker 1: He just walks out the door.
• 16:15
  Speaker 2: Just leaves.
• 16:16
  Speaker 1: And because of the way the medical bureaucracy functioned in 1992,
• 16:20
  Speaker 1: I mean, there were no digital statewide databases tracking nurse misconduct.
• 16:24
  Speaker 2: No, nothing like that existed.
• 16:25
  Speaker 1: So he practically vanishes from their liability radar. He's hired
• 16:30
  Speaker 1: almost immediately down the road at a hospital in Phillipsburg.
• 16:33
  Speaker 2: Yep.
• 16:34
  Speaker 1: Now, how does a guy fleeing an active internal investigation
• 16:37
  Speaker 1: regarding lethal IV bags get a new job in an ICU?
• 16:41
  Speaker 2: Well, because when the new hospital called St. Barnabas for
• 16:44
  Speaker 2: a reference, they received what's called a neutral reference.
• 16:48
  Speaker 1: We really need to dissect the concept of the neutral
• 16:50
  Speaker 1: reference because it is the linchpin of this entire tragedy.
• 16:54
  Speaker 2: It really is. In the late 80s and early 90s,
• 16:58
  Speaker 2: the legal landscape surrounding employment was undergoing a massive shift.
• 17:01
  Speaker 1: Everyone was suing everyone. Exactly.
• 17:04
  Speaker 2: Hospitals were terrified of defamation lawsuits.
• 17:07
  Speaker 1: So if St. Barnabas told Phillipsburg, we think Charles Cullen
• 17:11
  Speaker 1: is murdering patients, but they didn't have a criminal conviction
• 17:14
  Speaker 1: to prove it, what happens?
• 17:17
  Speaker 2: Cullen could sue them for slander and potentially win millions
• 17:20
  Speaker 2: of dollars.
• 17:21
  Speaker 1: It's less like hiding a bomb and more like a
• 17:23
  Speaker 1: financial shell game.
• 17:25
  Speaker 2: It's a great way to put it.
• 17:26
  Speaker 1: The hospital's risk management department treated a serial killer not
• 17:30
  Speaker 1: as a crime, but as a toxic asset.
• 17:33
  Speaker 2: They were just trying to pass the toxic asset off
• 17:35
  Speaker 2: their books and onto another hospital's balance sheet before the
• 17:38
  Speaker 2: state auditors came knocking.
• 17:40
  Speaker 1: It is a perfect, sickening analogy. It was institutional self-preservation
• 17:45
  Speaker 1: masquerading as standard human resources policy.
• 17:48
  Speaker 2: They confirm his dates of employment, his title, and nothing else.
• 17:52
  Speaker 2: They pass the toxic asset along.
• 17:54
  Speaker 1: And the consequences of passing that asset are immediate and fatal.
• 17:59
  Speaker 2: Unfortunately, yes.
• 18:01
  Speaker 1: It's August 1993. at the new hospital in Phillipsburg. A
• 18:05
  Speaker 1: 91-year-old woman named Helen Dean is admitted.
• 18:08
  Speaker 2: And she's not even Cullen's patient.
• 18:10
  Speaker 1: Right, but Cullen walks into her room and tells her
• 18:13
  Speaker 1: visiting adult son, Larry, that he needs to leave the
• 18:16
  Speaker 1: room for a procedure.
• 18:17
  Speaker 2: So Larry leaves, comes back a bit later, and his
• 18:20
  Speaker 2: mother is highly agitated.
• 18:22
  Speaker 1: She tells him, he stuck me.
• 18:24
  Speaker 2: And Larry is suspicious right away.
• 18:26
  Speaker 1: He actually takes out a small magnifying glass on his
• 18:29
  Speaker 1: Swiss Army knife, examines her leg, and sees a fresh pinprick.
• 18:33
  Speaker 2: It's incredible that he noticed that.
• 18:35
  Speaker 1: And shortly after, Helen Dean codes and dies.
• 18:39
  Speaker 2: Larry knows something is wrong. He raises hell. He forces
• 18:42
  Speaker 2: the hospital to investigate.
• 18:44
  Speaker 1: They test Helen's blood for dozens of drugs. They run
• 18:46
  Speaker 1: massive toxicology screens.
• 18:49
  Speaker 2: But they find absolutely nothing.
• 18:51
  Speaker 1: Because they were running standard screens. They didn't test for digoxin. Exactly.
• 18:57
  Speaker 1: Let's explain digoxin because this becomes his signature weapon and
• 19:00
  Speaker 1: it's a terrifying one.
• 19:02
  Speaker 2: Digoxin is a cardiac glycoside typically derived from the foxglove plant.
• 19:07
  Speaker 1: Okay. And what is it normally used for?
• 19:09
  Speaker 2: It's a medication used to treat heart failure. Its mechanism
• 19:12
  Speaker 2: of action is highly specific. It inhibits the sodium potassium
• 19:16
  Speaker 2: ATPase pump in the heart cells.
• 19:18
  Speaker 1: Okay. Bear with me here. What does that actually mean
• 19:20
  Speaker 1: for the heart?
• 19:22
  Speaker 2: When you block that pump, Sodium builds up inside the cell,
• 19:25
  Speaker 2: which in turn prevents calcium from leaving the cell.
• 19:27
  Speaker 1: Right, so there's a calcium buildup.
• 19:30
  Speaker 2: Yes, and that intracellular calcium buildup increases the force of
• 19:33
  Speaker 2: the heart's contractions while simultaneously slowing down the electrical conduction.
• 19:38
  Speaker 1: So in a normal microdose, it helps a failing heart
• 19:42
  Speaker 1: beat stronger and steadier.
• 19:43
  Speaker 2: Exactly. It's a very helpful drug when dosed correctly.
• 19:47
  Speaker 1: But what happens in a massive overdose?
• 19:50
  Speaker 2: In a massive overdose, that calcium buildup causes absolute electrical
• 19:54
  Speaker 2: chaos in the heart.
• 19:55
  Speaker 1: The heart just loses its rhythm entirely.
• 19:58
  Speaker 2: Right. The patient goes into severe arrhythmias, ventricular tachycardia, and
• 20:02
  Speaker 2: a ventricular cardiac arrest. It is highly toxic.
• 20:05
  Speaker 1: And the scary part is how hard it is to detect, right?
• 20:08
  Speaker 2: Very hard. It is incredibly difficult to detect post-mortem unless
• 20:13
  Speaker 2: a toxicologist specifically runs a radio immunoassay looking for it.
• 20:17
  Speaker 1: So if you don't suspect digoxin, you won't find it.
• 20:20
  Speaker 2: Right. It doesn't show up on a standard drug panel.
• 20:23
  Speaker 1: So Cullen slips through the cracks again. The hospital clears him.
• 20:28
  Speaker 1: He even passes a police lie detector test regarding Helen
• 20:31
  Speaker 1: Dean's death.
• 20:32
  Speaker 2: Which just emboldens him further.
• 20:34
  Speaker 1: But while he's successfully pulling off these incredibly sophisticated murders
• 20:38
  Speaker 1: at work, His personal life is completely imploding.
• 20:42
  Speaker 2: It's a rapid downward spiral. By 1993, his heavy drinking
• 20:47
  Speaker 2: and erratic paranoid behavior lead his wife to file for divorce.
• 20:50
  Speaker 1: And he loses custody of his two daughters.
• 20:53
  Speaker 2: Right. And then he is arrested for trespassing after breaking
• 20:57
  Speaker 2: into a female colleague's house while she and her son
• 20:59
  Speaker 2: were sleeping.
• 21:00
  Speaker 1: Which is a terrifying escalation of stalking behavior. Absolutely.
• 21:04
  Speaker 2: He has multiple suicide attempts and is in and out
• 21:06
  Speaker 2: of psychiatric institutions around this time too.
• 21:08
  Speaker 1: I mean, Well, think about your own workplace. Think about
• 21:11
  Speaker 1: how thorough a background check is just to get hired
• 21:14
  Speaker 1: at a mid-level corporate job.
• 21:16
  Speaker 2: They want your credit score, your past employers, a criminal
• 21:19
  Speaker 2: background check.
• 21:20
  Speaker 1: Exactly. Yet here is a guy who has a trespassing
• 21:23
  Speaker 1: arrest for stalking a co-worker, is fresh out of psychiatric care,
• 21:28
  Speaker 1: has a documented history of suicidal ideation, and leaves a
• 21:32
  Speaker 1: trail of unexplained patient deaths wherever he goes.
• 21:35
  Speaker 2: It defies logic.
• 21:37
  Speaker 1: And he's still being handed the keys to hospital pharmacies
• 21:40
  Speaker 1: across two states.
• 21:42
  Speaker 2: The neutral reference shield protected him every single time.
• 21:45
  Speaker 1: It's just unbelievable.
• 21:47
  Speaker 2: And you have to factor in the desperation for trained
• 21:50
  Speaker 2: ICU nurses during a nationwide nursing shortage at the time.
• 21:53
  Speaker 2: Hospitals were willing to overlook gaps in a resume.
• 21:56
  Speaker 1: So he just keeps moving. November 1998, he's at Easton
• 22:00
  Speaker 1: Hospital in Pennsylvania, where he kills a 78-year-old man named
• 22:04
  Speaker 1: Otto Schramm using the same method.
• 22:07
  Speaker 2: Asking the family to leave, injecting the patient.
• 22:09
  Speaker 1: And by June 2000, he lands a prestigious, well-paying job
• 22:13
  Speaker 1: at St. Luke's in Bethlehem, Pennsylvania.
• 22:16
  Speaker 2: And he almost gets caught there.
• 22:18
  Speaker 1: What happened at St. Luke's?
• 22:20
  Speaker 2: Fellow nurses see him going into the medicine closet, and
• 22:22
  Speaker 2: after he leaves, they find fully stocked shelves of medication
• 22:25
  Speaker 2: just thrown away in the trash.
• 22:28
  Speaker 1: Why was he throwing it away? Just creating chaos? Probably.
• 22:32
  Speaker 2: And another nurse finds a sharps box, you know, the
• 22:34
  Speaker 2: secure biohazard containers where you put used needles, stuffed full
• 22:38
  Speaker 2: of unused, full vials of heart and blood pressure medication.
• 22:42
  Speaker 1: So they report him to administration.
• 22:44
  Speaker 2: Yes. But rather than face the internal investigation and risk
• 22:47
  Speaker 2: his nursing license being officially suspended, he resigns.
• 22:50
  Speaker 1: He uses the exact same escape hatch.
• 22:52
  Speaker 2: And the hospital administration lets him go, presumably relieved they
• 22:55
  Speaker 2: don't have to deal with a public scandal or a
• 22:58
  Speaker 2: union fight over firing him.
• 23:00
  Speaker 1: It is maddening. The sheer bureaucratic inertia is almost as
• 23:04
  Speaker 1: sociopathic as the murders themselves.
• 23:07
  Speaker 2: It's a system designed to protect itself, not the patients.
• 23:10
  Speaker 1: So this cycle of killing and quitting brings us to
• 23:13
  Speaker 1: the most complex and terrifying chapter of this story. It's
• 23:17
  Speaker 1: September 2002.
• 23:19
  Speaker 2: Charles Cullen arrives at Somerset Medical Center in New Jersey.
• 23:22
  Speaker 1: And this is where he completely refines his disguise, isn't it?
• 23:26
  Speaker 2: Up until now, he had been somewhat of a transient loner,
• 23:30
  Speaker 2: the weird guy in the corner who eventually gets pushed out.
• 23:32
  Speaker 1: Right.
• 23:33
  Speaker 2: But at Somerset, he alters his strategy completely. He embeds himself.
• 23:37
  Speaker 1: He makes friends.
• 23:39
  Speaker 2: Very close friends. He becomes best friends with two veteran nurses,
• 23:42
  Speaker 2: Amy Lowren and Donna Hargreaves. They were so close, they
• 23:45
  Speaker 2: actually called themselves the Three Musketeers.
• 23:48
  Speaker 1: Amy describes him in interviews from the sources as brilliant, shy,
• 23:51
  Speaker 1: and friendly. She felt incredibly protective of him.
• 23:55
  Speaker 2: And as a co-worker, he was the guy everyone wanted
• 23:57
  Speaker 2: on their unit.
• 23:59
  Speaker 1: Because he was picking up the slack.
• 24:00
  Speaker 2: Exactly. He took the brutal night shifts. He worked weekends
• 24:04
  Speaker 2: so others could be with their families. He was always
• 24:06
  Speaker 2: volunteering to help turn heavy patients or start difficult IVs.
• 24:10
  Speaker 1: He was the quote-unquote ideal hire.
• 24:13
  Speaker 2: What's fascinating here is the evolution of his masking. He
• 24:16
  Speaker 2: didn't just hide in the shadows. He hid in plain
• 24:18
  Speaker 2: sight by becoming indispensable.
• 24:21
  Speaker 1: So he made them need him.
• 24:22
  Speaker 2: Yes. Behavioral experts analyzing this period note that he leaned
• 24:26
  Speaker 2: heavily into Amy's natural inclination to be a caregiver.
• 24:30
  Speaker 1: He cultivated a vulnerable relationship with her. Right.
• 24:33
  Speaker 2: He made her feel like he needed her protection and guidance.
• 24:36
  Speaker 1: Which is a brilliant manipulation tactic because it completely blinds
• 24:40
  Speaker 1: the protector to the reality of who they are protecting.
• 24:44
  Speaker 2: Exactly. You don't suspect the person you are mentoring of
• 24:47
  Speaker 2: being a mastermind.
• 24:49
  Speaker 1: And that psychological blindness is tested almost immediately. There's this
• 24:53
  Speaker 1: harrowing incident during a patient coding in the ICU.
• 24:57
  Speaker 2: Amy is the code leader managing the room. Cullen is
• 25:00
  Speaker 2: assisting her.
• 25:01
  Speaker 1: The patient's heart rhythm is chaotic, and Cullen administers a
• 25:04
  Speaker 1: drug called lidocaine.
• 25:06
  Speaker 2: Now, lidocaine is an antiarrhythmic drug. It works by blocking
• 25:10
  Speaker 2: sodium channels in the heart, which can help stabilize certain
• 25:13
  Speaker 2: types of ventricular arrhythmias.
• 25:15
  Speaker 1: But it was the wrong move here.
• 25:17
  Speaker 2: Very wrong. It is an older medication, and it was
• 25:20
  Speaker 2: not standard protocol for the specific cardiac event that was
• 25:23
  Speaker 2: happening in that room.
• 25:24
  Speaker 1: And more importantly, the patient was severely allergic to it.
• 25:27
  Speaker 2: Yes. The lidocaine throws the patient's system into deeper shock,
• 25:31
  Speaker 2: and they die.
• 25:32
  Speaker 1: So the attending doctor comes in, looks at the chart,
• 25:34
  Speaker 1: and demands to know who gave the contraindicated outdated drug.
• 25:39
  Speaker 2: And Amy steps up.
• 25:40
  Speaker 1: She takes the blame.
• 25:42
  Speaker 2: She is the code leader, so she takes the absolute blame.
• 25:44
  Speaker 2: She blindly trusts Cullen's brilliance so much that she assumes
• 25:48
  Speaker 2: he must have had a genius advanced medical reason for
• 25:51
  Speaker 2: giving a drug that just killed their patient.
• 25:53
  Speaker 1: And she protects him from the doctor's wrath.
• 25:55
  Speaker 2: It's a profound example of cognitive dissonance in a high-stress environment. Right.
• 25:59
  Speaker 1: When someone you trust deeply does something inexplicable, your brain
• 26:03
  Speaker 1: tries to fix it.
• 26:04
  Speaker 2: Exactly. The human brain will invent a rationalization, like, he
• 26:08
  Speaker 2: knows something I don't, or it was a calculated risk.
• 26:11
  Speaker 1: Rather than accept the horrifying truth that your friend is
• 26:14
  Speaker 1: doing something grossly negligent or worse, malicious. Exactly.
• 26:18
  Speaker 2: And the rationalizations just keep piling up on that unit.
• 26:21
  Speaker 1: Soon, the intensive care unit is seeing completely crazy lab results.
• 26:25
  Speaker 2: Patients with sky-high digoxin levels who aren't even prescribed the drug.
• 26:30
  Speaker 1: Patients whose blood sugar is dropping to zero for no
• 26:33
  Speaker 1: clinical reason.
• 26:34
  Speaker 2: Donna Hargreaves, the other nurse in their trio, was actually
• 26:37
  Speaker 2: pulled aside and questioned by management because one of her
• 26:40
  Speaker 2: patients had an insane digoxin level.
• 26:43
  Speaker 1: And she started doubting herself, right?
• 26:45
  Speaker 2: Yeah, she started obsessively double-checking all her doses, having other
• 26:48
  Speaker 2: nurses verify her math because she was terrified she was
• 26:51
  Speaker 2: losing her mind and making lethal mistakes.
• 26:54
  Speaker 1: This is the part that is so hard to wrap
• 26:57
  Speaker 1: your head around for anyone who hasn't worked in that environment.
• 27:00
  Speaker 2: How so?
• 27:01
  Speaker 1: He is the guy bringing you coffee at 3 a.m.
• 27:03
  Speaker 1: He's taking your terrible weekend shifts. How much cognitive dissonance
• 27:08
  Speaker 1: does it take for a team of highly trained, incredibly
• 27:11
  Speaker 1: smart ICU nurses to look at literally impossible lab results
• 27:15
  Speaker 1: and conclude, oh, the hospital computer system must be glitching,
• 27:19
  Speaker 1: rather than my shy best friend is a prolific serial killer.
• 27:24
  Speaker 2: It takes a lot, but you really have to put
• 27:26
  Speaker 2: yourself in that environment. An ICU is built on a
• 27:28
  Speaker 2: foundation of implicit, unwavering trust.
• 27:31
  Speaker 1: You have to trust everyone around you.
• 27:34
  Speaker 2: You trust the pharmacy to compound the right drugs. You
• 27:36
  Speaker 2: trust the lab machinery to report accurate numbers. And you
• 27:39
  Speaker 2: absolutely trust the nurse standing next to you when a
• 27:42
  Speaker 2: patient is bleeding out.
• 27:43
  Speaker 1: Because if you don't, the whole system collapses.
• 27:46
  Speaker 2: Exactly. To suspect a colleague of intentional murder is to
• 27:50
  Speaker 2: pull the thread that unravels your entire professional reality. You
• 27:53
  Speaker 2: would rather believe the million-dollar lab equipment is broken than
• 27:57
  Speaker 2: believe the nurse helping you turn a patient is a monster.
• 28:00
  Speaker 1: But the data was real. The lab wasn't broken. And
• 28:03
  Speaker 1: while the nurses on the floor were blinded by friendship
• 28:05
  Speaker 1: and operational stress, outside experts looking purely at the data weren't.
• 28:10
  Speaker 2: Right. In June 2003, a nurse from Somerset Medical Center,
• 28:14
  Speaker 2: who is deeply unsettled by these lab results, calls the
• 28:18
  Speaker 2: New Jersey Poison Control Center.
• 28:20
  Speaker 1: And she gets an expert named Bruce Ruck on the line.
• 28:23
  Speaker 2: Now, the nurse is just looking for a clinical consultation.
• 28:26
  Speaker 2: She asks about abnormally high digoxin levels in a patient
• 28:29
  Speaker 2: who had recently been taken off the drug.
• 28:31
  Speaker 1: What does Ruck think at first?
• 28:33
  Speaker 2: Initially, Ruck and his toxicology team assume it's just a
• 28:36
  Speaker 2: tragic medication error, an accident.
• 28:39
  Speaker 1: Like misread handwriting on a chart or something.
• 28:41
  Speaker 2: Exactly. But two weeks later, a pharmacist from the exact
• 28:44
  Speaker 2: same hospital calls Bruce Ruck with the exact same concern
• 28:48
  Speaker 2: about a different patient.
• 28:50
  Speaker 1: And this is the turning point, right here.
• 28:53
  Speaker 2: Ruck is a toxicologist. He sees patterns. He asks a
• 28:56
  Speaker 2: very specific diagnostic question.
• 28:58
  Speaker 1: What does he ask?
• 28:59
  Speaker 2: He says, Do you also have patients with unexplained low
• 29:03
  Speaker 2: blood sugar and high potassium?
• 29:05
  Speaker 1: And on the other end of the line, there is
• 29:07
  Speaker 1: just dead silence. Then the pharmacist says, yes.
• 29:12
  Speaker 2: That combination of anomalies, digoxin overdoses and massive insulin overdoses
• 29:18
  Speaker 2: happening in the same unit within days of each other,
• 29:21
  Speaker 2: is statistically impossible by accident.
• 29:24
  Speaker 1: Right, because you do not accidentally mix up insulin and digoxin.
• 29:28
  Speaker 2: They are used for completely different things, stored differently, and
• 29:31
  Speaker 2: dosed differently.
• 29:32
  Speaker 1: So Ruck tells them immediately, you have a police matter
• 29:35
  Speaker 1: on your hands. Someone is doing this on purpose.
• 29:38
  Speaker 2: You would think this is the moment the hospital locks down,
• 29:41
  Speaker 2: calls the police and secures the unit.
• 29:42
  Speaker 1: Like any rational person would think. Instead, what does the
• 29:46
  Speaker 1: hospital administration do?
• 29:48
  Speaker 2: They call poison control back and the executive bosses at
• 29:52
  Speaker 2: Somerset Medical Center literally yell and scream at Bruce Ruck's team,
• 29:56
  Speaker 2: telling them to mind your business.
• 29:59
  Speaker 1: It is a breathtaking display of institutional cowardice. It's like
• 30:03
  Speaker 1: an airline finding a bomb on a plane and telling
• 30:06
  Speaker 1: the bomb squad to mind their business because it might
• 30:08
  Speaker 1: hurt ticket sales.
• 30:10
  Speaker 2: The institutional cowardice here is staggering.
• 30:13
  Speaker 1: The hospital's immediate reflex was self-preservation.
• 30:17
  Speaker 2: Because acknowledging a serial killer on staff means massive civil lawsuits. Right.
• 30:22
  Speaker 1: Potential loss of Medicare and Medicaid accreditation and a total
• 30:26
  Speaker 1: public relations nightmare that could bankrupt the facility.
• 30:29
  Speaker 2: So rather than call the authorities, they opted to conduct
• 30:32
  Speaker 2: an internal investigation.
• 30:34
  Speaker 1: Which lasted four months.
• 30:37
  Speaker 2: Four months while Colin was still working in the ICU.
• 30:40
  Speaker 1: Like he said earlier, they treated him like a toxic asset.
• 30:44
  Speaker 1: They were trying to figure out a way to quietly
• 30:46
  Speaker 1: offload him without triggering an audit.
• 30:48
  Speaker 2: And the internal investigation predictably concludes it's inconclusive, which further
• 30:53
  Speaker 2: delays any police involvement.
• 30:55
  Speaker 1: That delay costs lives.
• 30:57
  Speaker 2: Finally, under immense pressure from internal whistleblowers and poison control,
• 31:01
  Speaker 2: the hospital goes to the state police.
• 31:03
  Speaker 1: But they still downplay the severity, framing it as a
• 31:07
  Speaker 1: potential record-keeping issue.
• 31:09
  Speaker 2: However, the police start poking around, requesting records, and the
• 31:12
  Speaker 2: heat gets too high for administration.
• 31:15
  Speaker 1: So on October 31, 2003, Somerset suddenly fires Charles Cullen.
• 31:21
  Speaker 2: And they don't fire him for murder.
• 31:24
  Speaker 1: No, they fire him on a technicality. claiming he was
• 31:27
  Speaker 1: responsible for some unopened medication vials that were improperly disposed of.
• 31:32
  Speaker 2: And Cullen plays the victim perfectly.
• 31:35
  Speaker 1: He tells his best friends, Amy and Donna, that he's
• 31:38
  Speaker 1: being framed by management because he's a whistleblower.
• 31:41
  Speaker 2: And they believe him.
• 31:42
  Speaker 1: They are absolutely devastated for him. They think he is
• 31:45
  Speaker 1: the victim of a vindictive corporate administration.
• 31:48
  Speaker 2: Amy even offers to give him a glowing personal reference
• 31:51
  Speaker 2: for his next job.
• 31:52
  Speaker 1: Which sets the stage for one of the most intense
• 31:55
  Speaker 1: psychological pivots in criminal history.
• 31:57
  Speaker 2: It really is a movie-level pivot.
• 32:00
  Speaker 1: The detectives are now physically in the hospital, interviewing the
• 32:03
  Speaker 1: nursing staff one by one. But they are being shadowed.
• 32:07
  Speaker 2: Right. The hospital's risk managers, the corporate lawyers, are sitting
• 32:10
  Speaker 2: in on every single interview, breathing down the detectives' necks.
• 32:15
  Speaker 1: Interrupting questions, making sure nobody says anything that could open
• 32:18
  Speaker 1: the hospital to civil liability.
• 32:20
  Speaker 2: The detectives realize they are being stonewalled by the institution itself.
• 32:25
  Speaker 1: But then, during Amy's interview, the risk manager gets called
• 32:28
  Speaker 1: out of the room for a moment.
• 32:30
  Speaker 2: And the lead detective takes his one shot. He slides
• 32:33
  Speaker 2: a thick stack of paper across the table to Amy.
• 32:35
  Speaker 1: It's the printouts from the Pyxis machine. Let's explain what
• 32:39
  Speaker 1: the Pyxis machine is. Because the back-end mechanics of this
• 32:42
  Speaker 1: system are what ultimately caught him. Right.
• 32:45
  Speaker 2: The Pyxis machine is an automated, highly secure medication dispensing
• 32:48
  Speaker 2: cabinet used in modern hospitals.
• 32:50
  Speaker 1: It replaced the old system of open medication carts.
• 32:53
  Speaker 2: Yes. To get a drug, a nurse has to log
• 32:56
  Speaker 2: in with a unique ID, select the patient, and select
• 32:58
  Speaker 2: the drug. The drawer containing only that specific drug pops open.
• 33:02
  Speaker 1: And the back-end database records who took it, what they took,
• 33:06
  Speaker 1: and exactly what time they took it.
• 33:08
  Speaker 2: It's essentially a digital fingerprint designed to prevent theft and
• 33:11
  Speaker 2: track inventory.
• 33:12
  Speaker 1: But Cullen knew how to manipulate the back-end, didn't he?
• 33:15
  Speaker 2: He did. He would use the cancel function.
• 33:19
  Speaker 1: How did that work?
• 33:20
  Speaker 2: He'd request a drug, the drawer would open, he'd pocket
• 33:23
  Speaker 2: the vial, and then he'd hit cancel order on the screen.
• 33:27
  Speaker 1: So the machine logged that the drawer opened, but it
• 33:30
  Speaker 1: didn't record the drug as being dispensed to a patient.
• 33:33
  Speaker 2: Exactly. But it still left a digital breadcrumb trail of
• 33:36
  Speaker 2: his excessive access to those specific drawers.
• 33:39
  Speaker 1: So Amy is looking at Charles Cullen's digital fingerprint on
• 33:42
  Speaker 1: these back-end printouts, and what she sees shatters her entire world.
• 33:48
  Speaker 2: What did the printout show her?
• 33:50
  Speaker 1: She sees that on one particular night, Cullen logged in
• 33:53
  Speaker 1: and withdrew 12 vials of digoxin, a medication that in
• 33:57
  Speaker 1: a normal ICU you might use one or two vials
• 34:00
  Speaker 1: of in an entire month.
• 34:02
  Speaker 2: He took out 12 in a single shift.
• 34:05
  Speaker 1: In that instant, all the cognitive dissonance evaporates.
• 34:09
  Speaker 2: She knows exactly what that means.
• 34:10
  Speaker 1: Right. Amy is a veteran ICU nurse. She knows exactly
• 34:14
  Speaker 1: what those drugs do, and she knows there is no
• 34:17
  Speaker 1: legitimate medical reason to possess that quantity.
• 34:20
  Speaker 2: She realizes immediately that her best friend is killing people.
• 34:24
  Speaker 1: And the realization goes from heartbreaking to absolute pure horror.
• 34:29
  Speaker 1: Because as she analyzes the timestamps and the patient charts,
• 34:33
  Speaker 1: she understands how he was doing it.
• 34:35
  Speaker 2: And it is infinitely worse than just walking into a
• 34:38
  Speaker 2: room and injecting a patient.
• 34:40
  Speaker 1: Much worse. The data showed he wasn't just injecting patients directly.
• 34:45
  Speaker 1: He was going into the clean supply closets. and using
• 34:48
  Speaker 1: a needle to spike random, unopened bags of IV saline
• 34:51
  Speaker 1: with lethal doses of digoxin and insulin.
• 34:55
  Speaker 2: And then he would just put them back on the shelf,
• 34:57
  Speaker 2: mixed in with the safe bags.
• 34:59
  Speaker 1: This is the most sadistic element of his methodology. By
• 35:03
  Speaker 1: spiking random bags, he completely relinquished control over who died.
• 35:09
  Speaker 2: It was medical Russian roulette.
• 35:11
  Speaker 1: Unsuspecting, innocent nurses, including his best friends... Amy and Donna
• 35:15
  Speaker 1: were rushing into supply closets during emergencies, grabbing these spiked
• 35:19
  Speaker 1: bags and hanging them on their own patients.
• 35:21
  Speaker 2: He weaponized his own friends. He made them his unwitting accomplices.
• 35:27
  Speaker 1: I really want to emphasize this point for anyone listening,
• 35:29
  Speaker 1: because later on in interviews and court filings, Cullen tried
• 35:34
  Speaker 1: to claim that these were mercy killings.
• 35:36
  Speaker 2: He tried to paint himself as a dark angel, ending
• 35:39
  Speaker 2: the suffering of terminal patients.
• 35:41
  Speaker 1: But how in the world can you claim mercy? when
• 35:44
  Speaker 1: you were poisoning a random pile of IV bags in
• 35:47
  Speaker 1: a supply closet.
• 35:48
  Speaker 2: You can't.
• 35:49
  Speaker 1: You have absolutely no idea if that bag is going
• 35:51
  Speaker 1: to be used on an 80-year-old terminal cancer patient or
• 35:54
  Speaker 1: a 20-year-old who is just recovering from a routine appendectomy.
• 35:58
  Speaker 2: The randomized spiking completely dismantles his defense. It proves beyond
• 36:03
  Speaker 2: a shadow of a doubt that it was never about empathy, mercy,
• 36:06
  Speaker 2: or relieving suffering.
• 36:08
  Speaker 1: It was purely about playing God.
• 36:10
  Speaker 2: It was about the thrill of knowing a lethal trap
• 36:12
  Speaker 2: was set, going about a shift, and waiting to see
• 36:15
  Speaker 2: who would fall into it. He was a predator, not
• 36:18
  Speaker 2: a savior.
• 36:18
  Speaker 1: The sheer betrayal Amy must have felt is unimaginable. She
• 36:22
  Speaker 1: knows he's a killer. The detectives know he's a killer.
• 36:26
  Speaker 1: But the detectives hit another wall.
• 36:28
  Speaker 2: Right. The Pyxis records prove he stole drugs, which is
• 36:31
  Speaker 2: just theft.
• 36:32
  Speaker 1: But to arrest him for murder, they need to prove
• 36:35
  Speaker 1: intent to kill.
• 36:36
  Speaker 2: And in a circumstantial medical case, proving intent is incredibly difficult.
• 36:41
  Speaker 1: A defense attorney could argue he was stealing the drugs
• 36:44
  Speaker 1: to sell them, or that he was just incompetent and
• 36:47
  Speaker 1: made massive medication errors.
• 36:49
  Speaker 2: The only way to guarantee a murder conviction and ensure
• 36:52
  Speaker 2: he never works in a hospital again is to get
• 36:54
  Speaker 2: a direct, undeniable confession.
• 36:57
  Speaker 1: Meanwhile, the clock is ticking. The police exhumed the body
• 37:00
  Speaker 1: of Reverend Florian Gall, a patient who had recently died
• 37:03
  Speaker 1: of a massive heart attack at Somerset.
• 37:05
  Speaker 2: And the toxicology from the autopsy confirms his tissue was
• 37:08
  Speaker 2: absolutely saturated with digoxin.
• 37:11
  Speaker 1: And then Amy gets a phone call. It's Cullen. He
• 37:15
  Speaker 1: sounds happy. He tells her he just passed his background
• 37:18
  Speaker 1: check and got hired at a new hospital.
• 37:21
  Speaker 2: That is the trigger point. The neutral reference system was
• 37:25
  Speaker 2: about to let him kill again.
• 37:27
  Speaker 1: If he starts a new job, more people will die.
• 37:30
  Speaker 2: The detectives realize they have to make a move, and
• 37:32
  Speaker 2: they ask Amy to do something incredibly dangerous.
• 37:36
  Speaker 1: They ask her to wear a wire, meet Cullen in public,
• 37:39
  Speaker 1: and try to extract a confession.
• 37:42
  Speaker 2: Put yourself in Amy's shoes. You are going to a
• 37:45
  Speaker 2: local restaurant to sit across a small table from a
• 37:48
  Speaker 2: man you now know for a fact is a prolific
• 37:51
  Speaker 2: serial killer.
• 37:52
  Speaker 1: You have to smile, pretend to be his sympathetic, loyal friend,
• 37:56
  Speaker 1: all while wearing a hidden microphone taped to your chest.
• 37:59
  Speaker 2: Knowing that if he finds out, you are completely defenseless.
• 38:04
  Speaker 1: The psychological toll that must have taken is staggering.
• 38:08
  Speaker 2: It is an act of immense bravery. and neurological control.
• 38:15
  Speaker 2: December 12, 2003, she meets him at a restaurant.
• 38:19
  Speaker 1: When he first sees her, he hugs her, and she freezes,
• 38:23
  Speaker 1: absolutely terrified he is going to feel the wire harness
• 38:26
  Speaker 1: under her clothes.
• 38:27
  Speaker 2: They sit down, there's silverware on the table, knives, forks.
• 38:32
  Speaker 2: She makes small talk for over two hours, building his trust,
• 38:35
  Speaker 2: playing the role of the sympathetic ear.
• 38:38
  Speaker 1: Before she finally drops the hammer. She says, Charlie, all
• 38:43
  Speaker 1: these hospitals are accusing you of harming patients. And I
• 38:47
  Speaker 1: know you did it.
• 38:48
  Speaker 2: The physical transformation in Cullen in that moment is terrifying.
• 38:53
  Speaker 1: Amy noted that his vocal tone dropped, his posture rigidified,
• 38:57
  Speaker 1: and his facial microexpressions completely shifted.
• 39:00
  Speaker 2: The shy, friendly nurse mask dissolved instantly. She said she
• 39:04
  Speaker 2: felt like the murderer was finally sitting in front of her.
• 39:07
  Speaker 1: He tells her he wants to go down fighting. He
• 39:09
  Speaker 1: absolutely refuses to confess on tape.
• 39:12
  Speaker 2: Amy tries to convince him to walk into the police
• 39:14
  Speaker 2: station with her to end it peacefully, but he refuses.
• 39:17
  Speaker 1: He says he doesn't want his two daughters to know
• 39:19
  Speaker 1: he is a monster.
• 39:21
  Speaker 2: But even without the direct confession on tape, his evasive
• 39:24
  Speaker 2: answers and the corroborating evidence give the police enough to act.
• 39:27
  Speaker 1: When he leaves the restaurant, they arrest him. in the
• 39:30
  Speaker 1: parking lot.
• 39:31
  Speaker 2: But the nightmare isn't over for Amy.
• 39:33
  Speaker 1: Because he's sitting in an interrogation room and he is
• 39:37
  Speaker 1: stonewalling the detectives.
• 39:39
  Speaker 2: The prosecutors are terrified he might beat the charges on
• 39:41
  Speaker 2: reasonable doubt or at least get out on bail.
• 39:44
  Speaker 1: So two days later, on December 14th, Amy Loughran walks
• 39:48
  Speaker 1: into the Somerset County Jail. She's wearing a wire again.
• 39:52
  Speaker 2: This is where we see an incredible display of practical
• 39:55
  Speaker 2: psychology and interrogation strategy by Amy.
• 39:59
  Speaker 1: She doesn't go in aggressive, does she?
• 40:01
  Speaker 2: No, she doesn't accuse him. She uses the exact same
• 40:04
  Speaker 2: emotional leverage that Cullen used to manipulate people. She appeals
• 40:08
  Speaker 2: directly to his vulnerable narcissism.
• 40:10
  Speaker 1: She tells him to be the hero. She tells him
• 40:13
  Speaker 1: that if this goes to a massive public trial, she
• 40:16
  Speaker 1: will be dragged through the mud and, more importantly... His
• 40:19
  Speaker 1: daughters will be destroyed by the media circus.
• 40:22
  Speaker 2: She uses his desire to be perceived as a good
• 40:25
  Speaker 2: father as leverage. She essentially says, if you really care
• 40:28
  Speaker 2: about us, you'll stop this right now.
• 40:30
  Speaker 1: And it works. The facade cracks because she offered him
• 40:33
  Speaker 1: a narrative where he could still feel like he was
• 40:35
  Speaker 1: in control, making the noble choice.
• 40:38
  Speaker 2: He finally breaks down and confesses to injecting Reverend Florian
• 40:41
  Speaker 2: Gall with a lethal dose of digoxin.
• 40:44
  Speaker 1: He admits the Reverend was actually recovering and on his
• 40:47
  Speaker 1: way out of the ICU before he killed him, which
• 40:50
  Speaker 1: further destroys the mercy killer narrative.
• 40:53
  Speaker 2: The dam breaks.
• 40:54
  Speaker 1: That one confession is all they needed to hold him.
• 40:57
  Speaker 2: But it was just the beginning.
• 40:59
  Speaker 1: The next day, December 15, 2003, Charles Cullen is officially
• 41:02
  Speaker 1: charged with murder.
• 41:04
  Speaker 2: When the news hits the hospital, Donna Hargroves, the third musketeer,
• 41:08
  Speaker 2: collapses on her kitchen floor sobbing.
• 41:10
  Speaker 1: She literally couldn't comprehend that her friend, The guy who
• 41:14
  Speaker 1: covered her shifts was a monster.
• 41:16
  Speaker 2: The emotional devastation left in his wake among his colleagues
• 41:19
  Speaker 2: is profound. They had to reconcile the fact that they
• 41:22
  Speaker 2: had unwittingly administered his lethal doses.
• 41:25
  Speaker 1: But legally, the prosecutors now face a logistical nightmare.
• 41:29
  Speaker 2: Cullen has worked at nearly a dozen hospitals across two
• 41:32
  Speaker 2: states over 16 years.
• 41:34
  Speaker 1: Gathering physical evidence for every suspected death is impossible.
• 41:38
  Speaker 2: Enter District Attorney John Morganelli in Pennsylvania. He coordinates an
• 41:42
  Speaker 2: unprecedented task force across all these jurisdictions.
• 41:46
  Speaker 1: They cross-reference Cullen's shift schedules with unexpected ICU deaths over
• 41:50
  Speaker 1: a decade and a half.
• 41:52
  Speaker 2: The pattern is undeniable.
• 41:53
  Speaker 1: But to get the full scope of the horror, they
• 41:56
  Speaker 1: need Cullen to talk. So they offer him a plea deal.
• 41:59
  Speaker 2: They take the death penalty off the table. In exchange,
• 42:02
  Speaker 2: Cullen agrees to cooperate and identify as many of his
• 42:05
  Speaker 2: victims as he can remember by reviewing medical records.
• 42:07
  Speaker 1: And he starts talking.
• 42:09
  Speaker 2: He pleads guilty to 29 murders, 22 in New Jersey,
• 42:12
  Speaker 2: 7 in Pennsylvania, and 6 attempted murders.
• 42:15
  Speaker 1: This includes his first victim, Judge Yango, the 91-year-old Helen Dean,
• 42:20
  Speaker 1: and Otto Schramm.
• 42:21
  Speaker 2: When it comes time for sentencing, the mask of the
• 42:23
  Speaker 2: good nurse completely disintegrates in the courtroom.
• 42:27
  Speaker 1: March 2006 in New Jersey. He is sentenced to 11
• 42:31
  Speaker 1: consecutive life sentences.
• 42:33
  Speaker 2: And throughout the victim impact statements, as families are pouring
• 42:36
  Speaker 2: their hearts out, he refuses to even look at them.
• 42:39
  Speaker 2: He just stares blankly at the floor.
• 42:41
  Speaker 1: But the Pennsylvania sentencing a week later is pure chaos.
• 42:45
  Speaker 2: He decides he doesn't want to be there.
• 42:47
  Speaker 1: For 30 straight minutes, he just loudly chants, Your Honor,
• 42:51
  Speaker 1: you must recuse yourself. Your Honor, you must recuse yourself.
• 42:55
  Speaker 1: Over and over, drowning out the judge and the victim's
• 42:58
  Speaker 1: families who are trying to speak.
• 43:00
  Speaker 2: Some might look at that and think he had completely
• 43:02
  Speaker 2: lost his mind, that it was a psychotic break.
• 43:06
  Speaker 1: But behavioral experts view it differently, don't they?
• 43:08
  Speaker 2: Yes. It was a final, desperate exertion of control. He
• 43:13
  Speaker 2: couldn't control who lived or died anymore, but he could
• 43:16
  Speaker 2: control the narrative and the audio in that courtroom.
• 43:19
  Speaker 1: He forced the judge to act.
• 43:21
  Speaker 2: The judge had him gagged and physically bound to his chair.
• 43:24
  Speaker 1: The author, Charles Graber, who wrote an incredible book on
• 43:27
  Speaker 1: this and was in the courtroom, said they wheeled him
• 43:29
  Speaker 1: out like Hannibal Lecter, tied up and still screaming through
• 43:32
  Speaker 1: the gag.
• 43:33
  Speaker 2: He received eight more life sentences in Pennsylvania, bringing the
• 43:37
  Speaker 2: total to 19.
• 43:38
  Speaker 1: He is currently in Trenton Maximum Security Prison, completely isolated
• 43:42
  Speaker 1: in solitary confinement for 23 hours a day. Because a
• 43:46
  Speaker 1: man who murders vulnerable people is a prime target for
• 43:49
  Speaker 1: other inmates.
• 43:50
  Speaker 2: He isn't eligible for parole until the year 2388.
• 43:54
  Speaker 1: And while the legal number is 29 murders, the true
• 43:57
  Speaker 1: scale of his evil is almost unfathomable.
• 44:00
  Speaker 2: Based on his own partial confessions regarding his early years
• 44:03
  Speaker 2: at St. Barnabas, where he casually admitted to killing three
• 44:06
  Speaker 2: to four people a week for five years, experts estimate
• 44:10
  Speaker 2: his actual victim count is likely over 400.
• 44:13
  Speaker 1: If that estimate of 400 is even close to accurate,
• 44:17
  Speaker 1: it means he murdered roughly one person a week for
• 44:19
  Speaker 1: his entire 16-year career.
• 44:21
  Speaker 2: Which leads us to a deeply disturbing realization.
• 44:24
  Speaker 1: How do we reconcile the fact that a serial killer
• 44:28
  Speaker 1: of this unprecedented magnitude wasn't stopped by the billion-dollar, highly
• 44:33
  Speaker 1: regulated American health care system?
• 44:35
  Speaker 2: He was stopped by one brave nurse with a wire
• 44:38
  Speaker 2: taped to her chest.
• 44:39
  Speaker 1: It is a damning indictment of the system.
• 44:42
  Speaker 2: The fail-safes did not fail. They were actively bypassed by
• 44:46
  Speaker 2: administrators who prioritized institutional reputation and financial liability over patient safety.
• 44:52
  Speaker 1: The system performed exactly as it was designed to. It
• 44:55
  Speaker 1: protected itself.
• 44:57
  Speaker 2: We've gone on quite a journey today, unpacking the dark,
• 45:00
  Speaker 2: calculated mind of Charles Cullen, the absolute betrayal of his
• 45:04
  Speaker 2: closest friends, and the sheer, terrifying bravery of Amy Lofgren,
• 45:08
  Speaker 2: the woman who finally brought him down.
• 45:10
  Speaker 1: It's a story that forces us to look critically the
• 45:13
  Speaker 1: institutions we rely on in our most vulnerable moments. And
• 45:17
  Speaker 1: to question the blind faith we place in bureaucratic systems. Exactly.
• 45:22
  Speaker 1: And that is what I want to leave you with today.
• 45:25
  Speaker 1: I want you to think about the invisible infrastructure of
• 45:28
  Speaker 1: trust that holds our modern world together.
• 45:31
  Speaker 2: It's something we take for granted every day.
• 45:33
  Speaker 1: When we walk through the sliding glass doors of a hospital,
• 45:36
  Speaker 1: we essentially surrender our bodily autonomy. We allow total strangers
• 45:40
  Speaker 1: to inject us with chemicals, to cut us open, to
• 45:44
  Speaker 1: monitor our breathing while we sleep.
• 45:47
  Speaker 2: And we do it based almost entirely on the authority
• 45:50
  Speaker 2: of a uniform and a plastic ID badge.
• 45:53
  Speaker 1: Cullen's story isn't just a biography of a monster. It
• 45:56
  Speaker 1: is a glaring, siren-blaring warning about what happens when massive
• 46:00
  Speaker 1: institutions prioritize their own survival and reputation over the safety
• 46:05
  Speaker 1: of the people they are sworn to protect.
• 46:07
  Speaker 2: It really is.
• 46:08
  Speaker 1: It leaves us with a question we all need to ask.
• 46:11
  Speaker 1: How do we demand real, transparent accountability in a system
• 46:14
  Speaker 1: where the truth is so easily swept into a sharps box?
• 46:18
  Speaker 1: Something to think about the next time someone offers you
• 46:20
  Speaker 1: a neutral reference. We'll catch you on the next deep dive.