Criminal - The Nurse

Episode Date: August 11, 2023

When Amy Loughren started working as a nurse at Somerset Medical Center, she did everything she could to hide the fact that she had a heart condition. And then, another nurse named Charles Cullen discovered Amy’s secret. He told her that he would keep it, but she didn’t know that he was keeping his own secret too. Say hello on Twitter, Facebook and Instagram. Sign up for our occasional newsletter, The Accomplice. Follow the show and review us on Apple Podcasts: iTunes.com/CriminalShow. Sign up for Criminal Plus to get behind-the-scenes bonus episodes of Criminal, ad-free listening of all of our shows, members-only merch, and more. Learn more and sign up here. Listen back through our archives at youtube.com/criminalpodcast. We also make This is Love and Phoebe Reads a Mystery. Artwork by Julienne Alexander. Check out our online shop. Episode transcripts are posted on our website. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Botox Cosmetic, Adabotulinum Toxin A, FDA approved for over 20 years. So, talk to your specialist to see if Botox Cosmetic is right for you. For full prescribing information, including boxed warning, visit BotoxCosmetic.com or call 877-351-0300. Remember to ask for Botox Cosmetic by name. To see for yourself and learn more, visit BotoxCosmetic.com. That's BotoxCosmetic.com. Support for Criminal comes from Apple Podcasts. Each month, Apple Podcasts highlights one series

worth your attention, and they call these series essentials. This month, they recommend Wondery's Ghost Story, a seven-part series that follows journalist Tristan Redman as he tries to get to the bottom of a ghostly presence in his childhood home. His investigation takes him on a journey involving homicide detectives, ghost hunters, and even psychic mediums, and leads him to a dark secret about his own family. Check out Ghost Story, a series essential pick, completely ad-free on Apple Podcasts.

Tell me a little bit about what an ICU nurse does. So as an ICU nurse, we are really taking care of the most sick patients in the hospital. They could be there because they had a heart attack. They could be there because they have problems with their lungs and breathing, and they need to be on special machines and special drips. They can have so many different IV bags hanging. They can have different apparatuses attached to them that only ICU nurses know how to manage. Amy Loughran had been working as a nurse for almost 15 years, when in 2001 she got a job at Somerset Medical Center in New Jersey, about four hours away from where she was living. And I made an arrangement with the hospital that I would come down, I would work only on weekends, and I would stay in the hospital.

For that, I was paid an exorbitant amount of money. And also, I needed that money because I was quite sick, and I needed a procedure that my insurance was not going to cover completely. Amy told us she'd had issues with her heart since getting into a car accident in 1993. She saw a lot of doctors, many of whom said her heart problems were stress-related. She worked night shifts. Finally, she got a diagnosis, electrical cardiomyopathy. At that point, they were talking about putting me on the transplant list. Did you tell the hospital that you had this condition?

No. The hospital had my contract through a travel nurse company, and they could end my contract at any time. If they found out that I was that ill, they easily could have said that I was not appropriate to be working 12 and 16 hour shifts in the ICU. So at this point, you're commuting a great distance. You're living in the hospital as you're working. I mean, what was life like for you? What was life like at home? I was pretty exhausted. And when I was home, I had my two daughters. They were

11 and 6. So they're five years apart. And I was also directing my oldest daughter's sixth grade play. So on Tuesdays and Wednesdays, I had play practice with her entire class. And the rest of the time when the girls were in school, most of the time I just slept and tried very hard to take care of myself. And then, about nine months after she'd started, a new nurse started working at the hospital. I met Charles Cullen when he was orienting to the intensive care unit. I saw him in the hallway. He was standing with the nurse that was orienting him. And I knew this nurse to be perhaps not the best person to give him direction. And so I gave him a look and went up to him and told him if he had any questions that I'd be happy to help. And we started talking from there and became fast friends. He was very shy and he was also

brilliant and very drawn to introverted people. He was also, it seemed like he may be depressed. And I really wanted to know who he was outside of what we were doing inside the ICU. And so we talked a lot. We talked a lot about his personal life, my personal life. And he really took care of me emotionally at that time. At that point, because everything seemed so hopeless for me, I was really frightened for my health. I was frightened to leave my daughters behind. I was frightened of being found out that I probably was not physically capable of doing my job and losing my contract. And then my, my, not just the fact that I would lose that contract. If I lost that contract, I would lose more than money. I would lose my health insurance, which meant that I could not be cared for. And also the way that the insurance worked at that time, I could have been denied insurance trying to get insurance after that if I had lost my contract.

And I really also was holding on to that secret. And when I was sick and when I was at the hospital and struggling physically, Charlie noticed those things. I was able to hide it from other people, but not from Charlie. Amy says that Charles Cullen first noticed she was sick on a night when she felt something going on with her heartbeat, an arrhythmia. I became very weak. I started to pass out, and I took myself into a room and hooked myself up to one of the monitors to try and discover which particular arrhythmia I was in. And he saw me go into the room and then the arrhythmia showed up on the monitor. He initially thought that it was a patient that was in that room,

but it was an empty room that I went into. He then came in, saw that I was in that dysrhythmia. I did not have my medication with me. And Charlie went to the medication dispensing machine and pulled out a medication for me and helped me by giving me that medication. And I assume that you're not really allowed to do that. No, it is quite frowned upon. And even at this time, it was definitely frowned upon. And both of us could have been in really big trouble. Amy says that after that night,

Charlie was always around to help her get through a shift when she wasn't feeling well. They both worked on the night shift, and when the hospital was quiet, they talked about their lives. Charlie was divorced and had two daughters, just like Amy. And we also had this unspoken language. We could look across the hallway at each other and just make a facial expression and be able to know what was on the mind of the other. We ended up working most of our shifts together so that we could support each other. We would do our care together. We would bathe our patients together. If one of us wanted to go on break,

we always helped each other by taking care of the other's patients. We definitely relied on each other every shift. Charles Cullen kept Amy's secret, but she didn't know that he was keeping his own secret too. I'm Phoebe Judge. This is Criminal. When did you notice that something odd was happening at the hospital? I noticed that our lab results were coming back skewed. In the mornings, we would draw labs on our patients, send them off, and then we would get the results, computerized results. If those results were completely in critical zones, then we would receive a phone call from the lab itself.

We were receiving a lot of those phone calls, mainly phone calls saying that our patients' blood sugars were extremely low and dangerously low, where our patients could seize or our patients could die. Amy thought there must be a lab error. It was, there was no possible way that our patients, all of our patients' labs would be off to the point that they were. Some of us were getting blood sugars of 3 or 12. Anything under 60 is something that we would treat. And these were patients that were not diabetics, were not on an insulin drip, and we're not receiving insulin from us. So we knew that there was something going on. The insulin then started to be locked up

and put in the narcotics drawers. And my direct manager had told us that we had to start signing for the insulin. And the way that they had it set up in the dispensing system, we needed to account for the amount of units that was left in the bottle once we drew out our own dosages for our patients. And to me, there was no possible way to know how many units were left in the bottle. And they were going to tell us that we had to sign saying that we knew exactly how many units were in that bottle. And I said this was completely illogical, and I was refusing to do that. And Charlie was very concerned that I was making such a big deal about it. He pulled me aside and said, just sign for it, just stop. And I wouldn't. Did you notice that any patients were having different outcomes than you might expect, you know, apart from the labs?

The lab numbers are skewed, but were you also seeing patients having major problems? We had so many codes. We had sometimes multiple codes a night. I saw that as we had quite a few very critical patients. What is a code? So a code is when someone's heart stops or when they stop breathing or their oxygen level is so low that we need to adjust something, usually what it means is that someone is in the process of dying, and we need to save their life. There were surprises in some of the outcomes, people that I did not expect to go downhill so quickly, although it's a critical care and it's never something that you can predict. I definitely did not feel that it was completely out of the ordinary.

I just remember we were going through many, many codes quite often. In the middle of all this, Amy found out that Charlie had been fired. Being fired was scary to me to think that the best nurse that I worked with had just been fired. And it sent shockwaves through the entire ICU because for us, it meant if Charlie could be fired, all of us could be fired. And it was a very, very dark time. I mean, did you immediately think about yourself hiding this medical condition, him giving you the drugs that one time to help? Did you think, oh gosh, what are they going to find out about me or they're trying to figure something out?

Absolutely, I thought about that. And I was scared for myself in the sense that I no longer had my partner to work with and wondering what that meant for me. I was also very scared for Charlie. He had so many bills and I was really scared for Charlie. He had so many bills, and I was really scared for him. At work, everyone was talking about Charlie. And everyone there was very curious to find out what had happened. And when I called, he explained to me he had been fired because he hadn't been honest on his application. This didn't really make sense to me. Charlie had been working at Somerset for more than a year, and he was respected by his colleagues. He'd been featured in a nurse recruitment pamphlet. It had his photograph and said,

Charles appreciates the technology. Amy wondered why the hospital would be looking back at his application now. Charlie said that someone he used to work with must have seen the recruitment pamphlet and called Somerset to talk about him. Amy asked Charlie about it. He explained to me that there were some medications that were not disposed of properly, and he was a scapegoat for those medications.

And I assume, you know, there are so many, rightfully so, regulations and safety checks within a hospital and ICU that someone could make a mistake like that and you could see how that could happen. It doesn't mean they're a terrible person or a bad medical practitioner. You know, there are ways in which we can screw up in this profession. Yes, there were ways that any of us could make a mistake at any time. And it is one of the reasons why specifically critical care nurses are so precise in delivering care, because it's so easy to overlook something. A few days later, Amy heard that detectives were asking to talk to some of the nurses. Rumors started going around that all of this had something to do with Charlie. The only reason in my mind detectives would be in the hospital investigating anything had to have been narcotics. That was the only thing that Charlie had been taking drugs. There had been no time in my interactions with him that I would have thought that he had been taking drugs. So I thought that it was a witch hunt. And then Amy heard that the detectives were especially interested in talking to her.

I was really scared. And knowing that Charlie had already been fired, and they were asking about him specifically, everyone knew that Charlie and I worked together and we were best friends. So I was really frightened. Amy avoided her interview with the detectives as long as she could. She even called in sick every time they made an appointment. But after a couple of weeks, her manager sent her in. She met with Detective Danny Baldwin from the Somerset County Prosecutor's Office. The hospital's risk manager was also in the room. When I first went in the room to speak with the lead detective, Danny Baldwin, I told him what I thought.

I said, this is absolute bullshit, and this is a witch hunt, and if he thought that I was going to be throwing Charlie under the bus, he was barking up the wrong tree. Then the risk manager got pulled out of the room for some reason, and we were in the room alone, me and Danny Baldwin. And he said he wanted me to look at something. He pushed some papers across the desk, and it was the Pixis printout, which is our medication dispensing records, and it was the history of Charlie's interactions with that machine. And when I saw some of the medications that he had been taking out, also not hiding that he was taking out some medications that were lethal. I also saw very quickly that there was a pattern of canceling medications and a pattern of taking out

a couple of things that seemed completely innocent, like toothpaste, mouthwash, A&D ointment. Those types of interactions with the Pyxis, no one would know unless they saw the drawer. But next to those very innocent items, there were deadly medications. Digoxin. There was potassium.

Phenylephrine. Nitroprusside. Things that could kill people. So, you know, in this system, you input what you're taking out from the bank of all of the supplies and drugs, but it's easy to open the door, say you're taking some toothpaste, but actually take potassium. That's correct. We'll be right back. Still you, but with fewer lines. Botox Cosmetic, Adabotulinum Toxin A,

is a prescription medicine used to temporarily make moderate to severe frown lines, crow's feet, and forehead lines look better in adults. Effects of Botox Cosmetic may spread hours to weeks after injection causing serious symptoms. Alert your doctor right away as difficulty swallowing, speaking, breathing, eye problems, or muscle weakness may be a sign of a life-threatening condition. Patients with these conditions before injection are at highest risk. Don't receive Botox cosmetic if you have a skin infection. Side effects may include allergic reactions, injection site pain, headache, eyebrow and

eyelid drooping, and eyelid swelling. Allergic reactions can include rash, welts, asthma symptoms, and dizziness. Tell your doctor about medical history, muscle or nerve conditions including ALS or Lou Gehrig's disease, myasthenia gravis, or Lambert-Eden syndrome in medications, including botulinum toxins, as these may increase the risk of serious side effects. For full safety information, visit BotoxCosmetic.com or call 877-351-0300. See for yourself at BotoxCosmetic.com. Support for Criminal comes from Apple Podcasts. Each month, Apple Podcasts highlights one series worth your attention, and they call these Series Essentials.

This month, they recommend Wondery's Ghost Story, a seven-part series that follows journalist Tristan Redman as he tries to get to the bottom of a ghostly presence in his childhood home. His investigation takes him on a journey involving homicide detectives, ghost hunters,

and even psychic mediums, and leads him to a dark secret about his own family. Check out Ghost Story, a series essential pick, completely ad-free on Apple Podcasts. Amy agreed to see Detective Danny Baldwin and his partner Tim Braun at her house the next day. They drove the three and a half, almost four hours up to my home in upstate New York. And they did not realize that I lived so far from the hospital. So when they asked if they could come to my home to talk to me, they did not know that it was going to be hours getting to my house in the middle of nowhere. And when they did arrive, they brought a lot of paperwork with them that they had received

from the hospital. And they decided to just put it all out there for me. And I started to point out things that I noticed in Charlie's Pixis printouts and some of the documentation that they brought with them. And there were definitely signs that were so obvious that he had been doing something sinister, that I couldn't speak. I just couldn't speak. Did you recognize any of the patients in the documents that they were sharing with you? I did. I recognized many of the patients that I had taken care of and the patients who died in my care and on my watch, yes.

Once you started to place people, patients with these dogs, did you start to go back in your mind thinking, well, that night I was there at 10.52 and Charlie, what did you start to remember? I started to really drive myself crazy trying to find a time when I had overlooked something or that maybe my intuition had been kicked in and there just wasn't. I had so much guilt that I could not think of a single moment where my intuition said something is wrong. There was one particular code that Charlie and I had walked in on him injecting a patient. And I do recall that that particular medication was not the medication that we should have been using to treat that particular dysrhythmia. And I eventually had covered up for him. I had said that it was me who ordered that particular medication. And later I found out that that patient had been allergic to that medication. And probably it was that medication that killed her and that I had walked in on him. Being the code leader, I was responsible for everything that happened in that

code. And I wondered in that code why he chose that particular medication. I assumed because of who he was and that he was making an executive decision or perhaps he didn't have the correct medication. And the medication that he gave really wasn't wrong. It was just a medication that we didn't necessarily use anymore. So I kept to thinking that perhaps I was just making this all up in my head and I was seeing something that I was being told to see. I could not reconcile that my friend Charlie, this gentle and kind person, could have done these terrible things. that my friend Charlie, this gentle and kind person, could have done these terrible things. During the detectives' visit, Amy's phone rang.

It was the hospital's risk manager calling. And essentially told me that I was not to be talking to the detectives without having some type of a hospital administrator or someone that was representing me because it could be dangerous for me. She also wanted me to talk to her if the detectives did reach out. Now, during that phone call, Tim was on one side of me and Danny was on the other side. And I was talking on one of those old school wall phones with the cord. And here these two huge detectives were sitting on either side. So they heard everything that she said. And when I hung up the phone, I simply said to the detectives, let's get him. Because I knew at that moment that the hospital was going to do everything that they could to support themselves

and not to take care of those patients. And I was angry. I was really angry. When the detectives asked Amy if she would agree to talk to Charlie on the phone while they listened in, she said yes. So what would you talk to Charlie about when you would speak with him? I would talk to him mostly about what was happening at home. I would talk to him about whether he was looking for a job. I wanted to know if he was okay emotionally, and I just made it very clear that I was still his friend and that we were still going to stay in touch and that I wasn't going to lose him as a friend.

Was it hard to act normal? It was hard, and yet it was also easy because I did miss him. I did want to hear his voice. I did want to know how he was doing. I wasn't afraid of him. I wasn't angry with him. I was sad for him. And all of those things, those were not emotions that I would be able to, let's say, fake or play. Those were real. And so it was easy to talk to him. What was he like on the phone? Quiet, funny, sad, very, very sad. He was scared. He was scared that he wouldn't find another job. Mostly, he was pretty darn depressed. And then Amy found out that Charlie had found another nursing job. When we found out that Charlie had gotten a job, we decided we couldn't wait. We needed to keep him

away from patients. And at that point, the only way that we felt that we could get him behind bars and make it stick was to get a confession. My understanding was that it was up to me to get this confession, or we could lose this entire case. The detectives asked Amy if she would meet up with Charlie in person, and they asked her if she would wear a wire.

Amy agreed, and called Charlie and asked if they could have lunch. That must have been terrifying to, I mean, doing, investigating on your own and looking at documents and helping behind the scenes, but to now put on a wire. Yeah. And yet to me, I was trained as a code nurse. I was trained as a trauma nurse. I was trained to be disassociated from my feelings during some of the worst times in anyone's life and to stay calm and to really have my head around what I needed to do in the moment. And that was the place that I went. When I agreed to wear the wire, when I agreed to meet with Charlie,

I knew the place to go within myself, that dissociative place. And I knew how to talk to Charlie. Would this be the first time you'd be face-to-face with him since he'd been fired? Yes, it would be the first time. We'll be right back. questions. What should you use it for? What tools are right for you? And what privacy issues should you ultimately watch out for? And to help us out, we are joined by Kylie Robeson, the senior AI

reporter for The Verge, to give you a primer on how to integrate AI into your life. So tune into AI Basics, How and When to Use AI, a special series from Pivot sponsored by AWS, wherever you get your podcasts. So what is enterprise software anyway? What is productivity software? How will AI affect both? And how are these tools changing the way we use our computers to make stuff, communicate, and plan for the future? In this three-part special series, Decoder is surveying the IT landscape presented by AWS. Check it out wherever you get your podcasts. Take me through that day. What, did you meet with the detectives early to put on the wire? Just take me through that day what did you meet with the detectives early to put on the wire just take me through that day so i met them at this technical facility where we had recorded conversations over the phone with Charlie before. And a tech was there to put the wire on me. And so

I had just like a little tank top on. And while he was wiring me up, he did notice that I had a fairly fresh scar on the left side of my chest. And he asked me what it was because he didn't want to put the wire over it. And I said it was my pacemaker. And it was really at that time, he talked to Tim and Danny, and they were adamant that we weren't going to do this. They did not know that I was sick. They did not know that I was struggling. They did not know that I had had a pacemaker placed during this time. And I didn't share that with them because I didn't want them to know. And I said, we're going in, we're doing this. So they wired me up. I had a wire microphone under this baggy shirt. And then went to this sports bar and Charlie drove there. And the very first thing that he did when he saw me was hug me. And I was just terrified that that little black box that was attached to the small of my back that he would notice. And luckily,

he didn't. And we sat down and we talked for hours. I mean, you must have been very conflicted to be sitting next to someone who you like so much, who was clearly in trouble, but also have this knowledge that you had seen a lot of documents which showed pretty clearly that he had been murdering people. I went in with this knowledge that I would be able to talk him into talking to me about it. And knowing what I knew, I would be able to at least talk to him on a medical level about what had happened. And I really wanted to make that connection with him so that it would feel to him like we were in it together. And eventually, that's what I said to him, is that I did know that he I was still there for him. I was still with him and that I wanted to go to the police station together. I would stay with him through everything.

And he definitely became a different person. His entire posture changed. His eyes changed. And he sat up straighter. He became more smug. His voice changed. And he said, I want to go down fighting. I want to go down fighting.

Detectives Tim Braun and Danny Baldwin were listening the whole time from the parking lot. Charlie left the restaurant first and drove away. He was arrested by police, waiting for him on the road, and taken in for questioning. When Amy came out, she went right to the detective's unmarked car. I collapsed into Danny Baldwin and just kept saying, did we get him? Did we get him? Did we get him? Unfortunately, the recording did not pick up when he said that he wanted to go down fighting. The recording malfunctioned. I did not know that it had malfunctioned. So they didn't have the confession? know that it had malfunctioned.

So they didn't have the confession? They did not have the confession. The police had centered their investigation on the death of a priest named Florian Gall, who had come into the hospital with a very high fever. He'd also had an irregular heartbeat. The cardiologist on call was treating him, and he was getting better. But then one morning, he suddenly went into cardiac arrest and died. Police believed he'd been injected with a lethal dose of a drug called digoxin. When

Amy had looked over the records, she noticed that Charlie had ordered more Dijoxin in one month than she had in her entire time at the hospital. The police asked Amy if she would talk to him again. They said that we needed the smoking gun. We needed him to say the words. We needed him to actually, and I met again with Charles Cullen. When I met with him, I knew this was my last chance. This was the only chance I was going to have to ever get a confession out of him. And I needed him to understand that if he did not talk about it and tell us about it, then he was going to drag his daughters through a trial and that it would traumatize them. And so eventually after another hour or so of talking to him, he finally decided to protect me.

He decided that I could easily be implicated in those murders. And he started to talk. And he told me specifically how he murdered Florian Gall in the hospital, and then he spoke and spoke and talked and talked for hours and hours and hours. And when I did finally find out everything that he had done, I can't explain the emotional guilt and shame that I had felt for caring for this human and how I had to reconcile that. I had to figure that out. In April 2004, Charles Cullen pled guilty to killing 13 patients and attempting to kill two others while he was employed at Somerset Medical Center in New Jersey. He eventually pled guilty to killing more patients at hospitals he'd worked at before he arrived at Somerset. Some of those hospitals had not reported suspicious deaths that might have been linked to Charles Cullen to oversight agencies, police, or other hospitals where he was applying to work.

In many cases, they weren't required to. As the New York Times put it, Mr. Cullen was able to continue mostly because of systemic failures, and his career reveals gaping holes in hospital and government systems. Investigators believe he could have killed as many as 400 people. Charles Cullen claimed he did it to prevent patients who were already dying from suffering anymore. But I had seen the evidence. I knew that Charlie had used medications to literally torture people. He did not choose medications to very carefully and happily and gently put people to sleep. He had access to those medications as well.

He never chose those. He chose medications that harmed people, that were physically painful and emotionally painful. That's not mercy killing. That's not euthanasia. That's not mercy killing. That's not euthanasia. That's torture. He's currently serving 18 life sentences. In 2005, the New Jersey legislature passed a law that requires hospitals to report information they have

about health care worker misconduct that endangers patients. It's referred to as the Cullen Law. At least 35 states have adopted similar requirements. Amy Loughran quit nursing. Today, she lives in Florida, near her daughters and grandchildren. Criminal is created by Lauren Spohr and me. Nadia Wilson is our senior producer.

Katie Bishop is our supervising producer. Our producers are Susanna Robertson, Jackie Sajico, Lily Clark, Lena Sillison, Sam Kim, and Megan Kinane. Our technical director is Rob Byers. This episode was mixed by Veronica Simonetti. Engineering by Russ Henry. Julian Alexander makes original illustrations for each episode of Criminal. You can see them at thisiscriminal.com and sign up for our newsletter at thisiscriminal.com slash newsletter

If you like the show, tell a friend or leave us a review It means a lot We hope you'll join our new membership program, Criminal Plus Once you sign up, you can listen to criminal episodes without any ads and get a bonus episode each month. To learn more, go to thisiscriminal.com slash plus. That's thisiscriminal.com slash plus. We're on Facebook and Twitter at Criminal Show

and Instagram at criminal underscore podcast. We're also on YouTube at youtube.com slash criminal podcast. Criminal is recorded in the studios of North Carolina Public Radio, WUNC. We're part of the Vox Media Podcast Network. Discover more great shows at podcast.voxmedia.com. I'm Phoebe Judge. This is Criminal. The number one selling product of its kind with over 20 years of research and innovation,

Botox Cosmetic, adipotulinum toxin A, is a prescription medicine used to temporarily make moderate to severe frown lines, crow's feet, and forehead lines look better in adults. Effects of Botox Cosmetic may spread hours to weeks after injection causing serious symptoms. Alert your doctor right away as difficulty swallowing, speaking, breathing, eye problems, or muscle weakness may be a sign of a life-threatening condition.

Patients with these conditions before injection are at highest risk. Don't receive Botox Cosmetic if you have a skin infection. Side effects may include allergic reactions, injection site pain, headache, eyebrow and eyelid drooping, and eyelid swelling. Allergic reactions can include rash, welts, asthma symptoms, and dizziness. Tell your doctor about medical history, muscle or nerve conditions including ALS or Lou Gehrig's disease, myasthenia gravis, or Lambert-Eaton syndrome in medications, including botulinum toxins, as these may increase the risk of serious side effects. See for yourself at BotoxCosmetic.com. are different. And according to Noom, there is no one size fits all approach. Noom wants to help you stay focused on what's important to you with their psychology and biology based approach. This

program helps you understand the science behind your eating choices and helps you build new habits for a healthier lifestyle. Stay focused on what's important to you with Noom's psychology and biology based approach. Sign up for your free trial today at Noom's psychology and biology-based approach. Sign up for your free trial today at Noom.com.