Mind of a Serial Killer - SERIAL KILLER: The Killer Nurse Pt. 1

Episode Date: November 3, 2025

He was trusted to save lives — but used his nursing uniform to hide pure evil. When Charles Cullen entered the medical field, he wasn’t looking to heal patients. He was looking for revenge. Over ...the course of 16 years, he quietly poisoned hospital patients across New Jersey and Pennsylvania, becoming one of the most prolific serial killers in American history.In this first episode, Killer Minds hosts Vanessa Richardson and Dr. Tristin Engels trace how Cullen’s childhood trauma, obsession with control, and thirst for vengeance led him to play God — one lethal injection at a time. Killer Minds is a Crime House Original Podcast, powered by PAVE Studios. Listen wherever you get your podcasts. For ad-free listening and early access to episodes, subscribe to Crime House+ on Apple Podcasts. Don’t miss out on all things Killer Minds! Instagram: @Crimehouse TikTok: @Crimehouse Facebook: @crimehousestudios X: @crimehousemedia YouTube: @crimehousestudios To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices

Transcript
Discussion (0)
Starting point is 00:00:00 Hi, Crime House community. It's Vanessa Richardson. And if you love digging into the most gripping true crime stories, then you need to listen to another Crime House original, Crimes of, with Sabrina Deanna Roga and Corinne Vienne. Crimes of is a weekly series that explores a new theme each season from crimes of paranormal, unsolved murders, mysterious disappearances, and more. Sabrina and Corinne have been covering the true stories behind Hollywood's most iconic horror. villains, and this month, they'll be diving into the paranormal. Listen to Crimes of every Tuesday on Apple Podcasts, Spotify, Amazon Music, or wherever you listen to podcasts. This is Crime House. They say revenge is a dish best-served cold, meaning if you've been a dish best-served cold, meaning if you've wronged, you shouldn't react immediately. Instead, you should patiently wait until the perfect
Starting point is 00:01:06 moment to seek your vengeance. That's exactly what Charles Cullen did. After experiencing a sudden tragedy as a teenager, Charles became extremely distrustful of hospitals and health care workers. He tried to find ways to cope with the hardship he'd been dealt in life. But when nothing made him feel better, Charles decided to wreak havoc on the institution he felt that wronged him, and give them a taste of their own medicine. The human mind is powerful. The human mind is powerful. It shapes how we think, feel, love, and hate.
Starting point is 00:01:56 But sometimes it drives people to commit the unthinkable. This is Killer Minds, a crimehouse original. I'm Vanessa Richardson. And I'm Dr. Tristan Engels. Every Monday and Thursday, we uncover the darkest minds in history, analyzing what makes a killer. Crime House is made possible by you. Please rate, review, and follow Killer Minds.
Starting point is 00:02:18 To enhance your listening experience with ad-free, early access to each two-part series and bonus content, subscribe to Crimehouse Plus on Apple Podcasts. Before we get started, Be advised, this episode contains discussion of abuse, depression, suicide, and murder. Please listen with care. Today we begin our deep dive on Charles Cullen, a killer nurse who believed he had the right to choose which patients lived and which ones died.
Starting point is 00:02:49 Despite his evil deeds, Charles slipped through cracks in the system for years. Eventually, he'd go on to make history as one of America's most prolific serial killers. As Vanessa goes to the story, I'll be talking about things like Charles Collins' childhood fascination with poison, criminals who use mental health struggles to manipulate people, and why someone might think that they have the right to take others' lives. And as always, we'll be asking the question, what makes a killer? You know what's better than the one big thing? Two big things.
Starting point is 00:03:27 Exactly. The new iPhone 17 Pro on Tellis' five-year rate plan price lock. Yep, it's the most powerful iPhone ever, plus more peace of mind with your bill over five years. This is big. Get the new iPhone 17 Pro at tellus.com slash iPhone 17 Pro on select plans. Conditions and exclusions apply. Now streaming on Paramount Plus. It's the epic return of Mayor of Kingstown.
Starting point is 00:03:54 Warden? You know who I am. Starring Academy Award nominee Jeremy Renner. I swear in these walls. Emmy Award winner E.D. Falco. You're an ex-con who ran this place for years. And now, now you can't do that. And BAFTA award winner Lenny James. You're about to have a plague of outsiders descend on your town.
Starting point is 00:04:12 Let me tell you this. It's going to be consequences. Mayor of Kingstown. New season now streaming on Paramount Plus. Before he was known as one of America's most prolific serial killers, Charles Cullen was defined by the kind of lost you live through, but never really get over. He was born on February 22, 1960, in West Orange, New Jersey to working class Irish Catholic parents, Edmund and Florence. Charles was
Starting point is 00:04:42 the youngest of eight children, and he was a surprise baby, born after his parents thought they were done having children. As the youngest child by several years, Charles felt disconnected from his older siblings. He didn't get much attention from his parents. either. Edmund worked long hours as a bus driver, and Florence was stretched thin with eight children at home. Things got even harder for the Cullins when Charles was just seven months old and his father suddenly died. Now Florence had to provide for everyone. She took various odd jobs to make ends meet, which meant she had even less time to spend with Charles. There are several elements of circumstantial neglect here. As the youngest with a big age gap, Charles was simply
Starting point is 00:05:27 less visible as it is, and losing his father and having an overwhelmed single parent amplified that invisibility. Without reliable attention or basic caregiving, a child is at high risk for an insecure attachment style. Clinically, that undermines emotion regulation, stress tolerance, and impulse control, and it increases social withdrawal or extreme attention seeking. It also increases the likelihood of permissive parenting. If the household also has no consistent rules, structure, or limits, then those risks can turn into enduring behavioral patterns. A child may adapt the mindset of, if I don't have rules at home, then why follow societal rules? Without his parents around, Charles had to learn about life from his siblings, and he picked up on some
Starting point is 00:06:15 unsettling behavior. By the time Charles was in elementary school, many of his siblings were young adults left to their own devices. Some of them started using drugs or disappearing for while before returning home unannounced. At times it was like a rotating door of down-and-out family members. Sometimes his sister's boyfriends moved in too. Charles never liked these men because they were always angry and abusive. One of them was so bad Charles's sister ran away from home to get away from him. But the boyfriend stayed and he turned his anger on Charles. We don't know the details of what this person did, but Charles was a small, sensitive kid. He didn't know how to stick up for himself.
Starting point is 00:07:00 Eventually, Charles couldn't take the abuse anymore. Since no one was looking out for him, he took matters into his own hands. Charles tried to poison his sister's boyfriend with lighter fluid. It doesn't seem like the man was gravely harmed, but he didn't stop tormenting Charles either. At some point, all Charles could do was try to think of a way to escape. So he mixed substances from a school chemistry set into a glass of milk and drank it, hoping it would kill him.
Starting point is 00:07:31 But it only made him sick. Okay, so this is deeply troubling, giving that he's only in elementary school. Let's start with the method of poisoning. We don't know how he learned about poisoning, and perhaps his interest in chemistry may have sparked that. But what we do know is that children who attempt to poison often do so because of neglectful invioling. mental health issues like depression or antisocial behavior. The reason they choose poisoning is often for practical reasons. Firstly, it's accessible. They can attempt with everyday household items, items that they themselves had been cautioned about from their own caregivers or even teachers, or they have read the labels directly on those items and learned on their own. It's non-confrontational, meaning it doesn't require physical overpowering, and it's otherwise concealed, which is practical for for a small child. Charles is young and cognitively immature, and black and white thinking can make lethal outcomes feel like a simple solution. But then he tried it on himself. And this is an indication
Starting point is 00:08:34 that his environment truly felt unbearable to him, and he had severely impaired coping. This combination is significant for early moral disengagement, which is a pattern that can be predictive of high psychiatric need and behavioral escalation if it remains untreated. So bluntly speaking, this is a crisis situation for danger to others and danger to self. Charles was so young at this time, as you mentioned, he was in elementary school. So when someone considers dying by suicide at such a young age, what kinds of other mental health risks or life challenges are they likely to encounter down the line? Early suicidal behavior raises the risk for recurrent attempts, chronic depression,
Starting point is 00:09:17 and post-traumatic stress reactions. It often co-occurs with emotional regulation problems, explosive anger or shutting down, as well as substance abuse as a maladaptive coping strategy. Attachment wounds and trust deficits also make relationships difficult, increasing isolation and risk of re-victimization or aggressive behavior. And over time, this pattern can produce functional impairment like unstable employment, legal trouble, and health problems. And clinically, early suicidal ideation also predicts higher lethality later if it goes untreated. Well, it's not clear how Charles first got the idea to poison someone else, let alone himself.
Starting point is 00:09:57 But it was clear that any chance of a happy childhood was out of his reach. Throughout his teenage years, Charles suffered from deep depression. As you said, Dr. Ingalls, he often skipped school because of it and stayed in bed all day. On those darker days, the only silver lining was that he got to spend a little more time with his mom. But when Charles was 17 years old, that small joy was ripped from his hand. too. On December 6th, 1977, Charles stayed home from school. His mother and one of his sisters had gone out to run errands. At some point, the phone rang, and Charles picked up. It was a staff member from Mountainside Hospital, calling to inform him that his mother and sister were in a bad
Starting point is 00:10:41 accident. They said he needed to get to the hospital right away. Charles rushed over. When he got to Mountainside, he learned that his sister had survived, but his mother did not. Charles was devastated. He asked if he could see her body so that he could say goodbye. And that's when hospital staff informed Charles that they had already sent Florence away to be cremated. Charles's grief quickly turned into outrage. He couldn't believe that the hospital would make such an important decision without talking to him first. He felt like they had robbed him of the chance to have closure. Charles had a hard time coping with his mother's death, as well as the rage he still felt toward the hospital. He didn't think he would ever overcome these awful feelings.
Starting point is 00:11:30 Shortly after his mother died, Charles tried to take his own life again. This time, the attempt landed him in a psychiatric ward. The entire time he was there, he refused to talk to doctors or receive any counseling. Eventually, Charles was sent home to deal with his grief on his own. Charles displaced anger toward the hospital makes sense when we zoom out and consider the bigger picture. His father passed unexpectedly as an infant, and although he was too young to remember that, a loss like that can still be developmentally difficult because it affects attachment, trust, and a sense of security. He was too young, so as he grew older, he had to trust secondhand information about his father, which likely came from existing caregivers, ones that he also
Starting point is 00:12:17 didn't trust, like his older siblings, for example. These developmental deficits are showing already at this stage, since he seems largely withdrawn from others and, as far as we know, doesn't have a strong social support system. His mistrust in others only deepened as a result of the experiences he had in his home, particularly with his sister's abusive boyfriend and the lack of intervention. He's incredibly depressed and spends most of his time at home, and his only protective factor, the quote silver lining that you mentioned, was the additional time he had with his mother. And now she's passed unexpectedly, and he cannot even verify that himself for closure. Charles needed concrete proof to grieve because he didn't trust people to be truthful.
Starting point is 00:12:59 Psychologically, it's likely that his refusal to participate in treatment following his second attempt is an extension of that mistrust. He lost trust in adult institutions, medical, and psychiatric, and their systems after this experience. Even though Charles refused psychiatric care, he did make an epiphany on his own. Due to his Irish Catholic upbringing, he believed suicide was a mortal sin that would cause him to spend eternity in purgatory. So he realized the reason his attempts never worked was because he didn't actually want to die. Now that Charles decided he wanted to live, he had to figure out how to spend the rest of his life. One thing he knew was that he wanted to get out of his childhood home as soon as possible,
Starting point is 00:13:45 and he wanted to get as far away as possible. So Charles dropped out of school, earned his GED, and joined the Navy. He was hoping for a fresh start, but the reality was much different. Charles began working on submarines, and it was grueling work. Not only that, but he had a hard time making friends. His fellow sailors teased him for being pale and weak. The longer the bullying went on, the more Charles started to feel trapped. He didn't think he could spend another minute crammed inside a steel tube with people he despised.
Starting point is 00:14:21 The only problem was he had signed a six-year contract. As a way to get through the long days, Charles started drinking heavily. And if he couldn't find liquor, he settled for ever. anything he could get his hands on, like mouthwash and even cleaning solution. Drinking mouthwash or cleaning solution when alcohol is unavailable, even in environments like this where access to alcohol may be limited, is a clinical red flag for possible dependency. At some point, it occurred to Charles that abusing alcohol could get him kicked out of the Navy,
Starting point is 00:14:54 which he wanted. So he started drinking even more. When that didn't work, he'd tried something more drastic. On January 13, 1984, 24-year-old Charles drank some cleaning solution, then told a medic what he'd done. He framed it as a suicide attempt, but in reality, Charles felt certain he wasn't going to die. He had only drunk enough to make himself sick. It was an extremely risky thing to do, and Charles lucked out.
Starting point is 00:15:25 He was removed from the submarine. However, he wasn't released from his contract. He was sent to a Navy psych ward. Just like before, Charles refused treatment. He wanted to get out of the military as soon as possible. He remained in the psych ward for a short while, but his idea didn't work quite as planned, because eventually the doctors there deemed him fit to serve.
Starting point is 00:15:50 Charles was enraged. He couldn't believe that doctors would send him right back into duty. He had poisoned himself for no reason. In his mind, they clearly didn't. didn't have his best interest at heart. The doctors may have made this decision because Charles' contract was ending soon anyway. In March of 1984, three months after he first went to the psych ward, Charles left and never looked back.
Starting point is 00:16:17 He had to figure out his next step in life, and while military service hadn't taught Charles much, there was one skill he felt confident in, playing with poison. However, he couldn't shake his anger at the doctors for dismissing his mental health issues. This resentment festered on top of the disdain he already felt towards health care workers. Soon, these feelings helped Charles realize what he wanted to do next. He was going to poison the entire medical field from the inside. Movember. You're not just fundraising, you're showing up for the men you love. Your dad, your brother, your partner, your friends. It isn't just a men's issue. It's a human one. That's why Movember
Starting point is 00:17:10 exists to change the face of men's health. From mental health and suicide prevention to prostate and testicular cancer research and early detection, Movember is tackling the biggest health issues facing men today. Join the movement and donate now at Movember.com. Get no frills, delivered. Shop the same in-store prices online and enjoy unlimited delivery with PC Express Pass. Get your first year for $2.50 a month. Learn more at pceexpress.ca.
Starting point is 00:17:43 In the spring of 1984, 24-year-old Charles Cullen left the Navy and returned home to New Jersey. Once there, he began working toward a new career. Charles hated hospitals and medical workers, which was why he was why he, he decided to wreak havoc on the hospital system from within. In May of that year, Charles enrolled in the nursing program at Mountainside Hospital,
Starting point is 00:18:08 the very same hospital where his mother had died seven years earlier. Charles becoming vengeful toward hospital workers and then choosing to study where his mother died is clearly no coincidence. It's the source of where his displaced anger and projection began and clinically a continuation of that. By choosing that location, he is gaining psychological control over the people he blamed, as well as proximity to the loss he had. And that proximity also created opportunity. He gained procedural knowledge and access to medications as well as access to vulnerable people.
Starting point is 00:18:42 And clinically, this pattern reads as unresolved grief plus chronic rage and justified retaliation, at least in his mind. What does it say about Charles that he would play such a long game for revenge? That's a long time to wait. Well, if you think about it, this is a continuation of his first attempt in murder when he was a child. His first attempted murder and even his first attempted suicide included using chemicals that were available, accessible, and silent. That is what he is priming to do now, only it's escalated because he is more sophisticated and deliberate. He's seeking to exploit clinical knowledge and have clinical access to more effective materials. This is methodical rehearsal that is motivated now by anger and revenge.
Starting point is 00:19:25 And this pattern also indicates he has a high level of manipulation. He's refining his tactics and has to simulate normalcy and to blend in while simultaneously hiding homicidal intent. Clinically, these are features you see with pronounced callousness, instrumental aggression, and skilled deception. He's also grooming an entire system, not just individual people or victims, and that's highly manipulative. Well, Charles had a plan. He knew that in order to convince people he was serious about nursing, he would have to study hard. And it worked. By 1987, 27-year-old Charles was excelling in the program and was even elected president of his nursing school class. Charles didn't just convince his colleagues that he was a good person. His false persona also helped out his
Starting point is 00:20:16 dating life. The 27-year-old was working part-time at a fast food restaurant to pay for his tuition. There, he met a young woman named Adrian Baum. Adrian worked at the restaurant, too, and they quickly hit it off, mostly because Charles was a full-on love bomber. He showered Adrian with flowers, candy, and other gifts. Charles also confessed to Adrian about his past struggles with depression and alcoholism. However, he assured her that that was all behind him. Adrian believed Charles was a changed man, with a bright future, and just six months after they began dating, they got engaged. Shortly after that, they were married, and they bought a home in Phillipsburg, New Jersey. Once they were settled in, Charles accepted a nursing position at the nearby St. Barnabas Medical
Starting point is 00:21:06 Center. Now his real plan could begin. Charles was assigned to night shifts on the burn unit. He tended to extreme burn injuries, which were often so bad, patients screamed in excruciating pain. Adult patients usually had an easier time coping because they could take morphine, but children weren't allowed to have anything stronger than Tylenol, and in Charles's eyes, it was cruel for the hospital to allow them to suffer. The children's pain reminded him of his own childhood trauma,
Starting point is 00:21:41 And just like when he was a kid, trying to find ways to put a stop to his torment, Charles wanted to do the same for them. He thought about all the drugs he had access to that could make them feel better. And at some point, he stopped caring about the rules and decided to take control. Back then, hospitals didn't regulate medication the way they do now. It was standard for nurses to get whatever they needed from a supply closet. All Charles had to do to get his hands on strong painkillers was walk in and take them. No one even tracked inventory, which meant no one noticed when drugs went missing.
Starting point is 00:22:19 Charles began stealing morphine from the supply closet and administering it to children. It didn't matter that it was against protocol. Charles truly thought he knew better than those above him. Well, Vanessa, you're definitely on to something there. Because when Charles was a child, he was in real psychological pain. not physical pain, but psychological pain, and no one came to rescue him. He never got reliable care or comfort, so to him, he learned to expect that help wouldn't come. And then he tried to take his own life himself by ingesting chemicals. Now, decades later, he sees vulnerable children
Starting point is 00:22:54 in a hospital and seemingly is reading them through that same lens. It's as if he's projecting his own pain onto these children. In his mind, they're like him. They're suffering, helpless, deserving of, quote, relief the way he once sought it. That lets him frame killing as mercy. He's showing up for them the way he felt no one showed up for him. And what he did when he was a child is he resorted to attempting suicide to end his pain. So clinically what we're seeing here is projection plus identification with the aggressor. He's displacing self-directed rage outward, and he's using this distorted compassion narrative to justify instrumental killing. It's not mercy. It's a way to regain agency and control, but masking revenge as care. I feel like Charles has some authority issues,
Starting point is 00:23:47 and is it common for people like this to see their defiance as maybe compassion or noble somehow, even when it's clearly not? Yes, it's actually very common. People who resent authority often recast their defiance as compassion in order to preserve a decent self-image and avoid responsibility. They often rationalize and morally disengage, meaning they reframe their harmful acts as justified or they downplay the victim's suffering or claim some kind of higher purpose. And framing behavior this way protects their identity and it reduces guilt or accountability and also preserves image and ego. Charles was playing God. it doesn't seem like he ever gave children enough morphine to cause any serious medical issues,
Starting point is 00:24:35 but that only bolstered his own ego when it came to portioning out drugs. Charles's concerning behavior didn't stop there. It carried into fatherhood when he and Adrian's first daughter, Shauna, was born in 1988. At first, Charles embraced being a dad, but soon he got tired of all the responsibility. One day Adrian came home to find Shauna asleep in her crib while Charles was out for a walk. When Adrian confronted him, Charles said it was fine because he knew Shauna wouldn't wake up. Adrian suspected that he had used cough medicine to put her to sleep, but he wouldn't admit to it. Adrian could tell something was changing in Charles for the worse.
Starting point is 00:25:19 She just couldn't figure out exactly what was going on. To make matters worse, she was the only one. with concerns. Because at work, Charles feigned a positive attitude. He was extremely knowledgeable and always lent his coworkers a helping hand. He seemed like a model employee and a dedicated nurse. But in reality, Charles was looking for an opportunity to take his clandestine methods to the next level. He'd become extremely resentful towards St. Barnabas Hospital. He believed they weren't doing enough to help patients who were in pain. Charles thought they should be punished for this.
Starting point is 00:25:58 And the best way to do that was to show them just how incompetent they were by wreaking havoc on patients. In June of 1988, a man named John Yango was admitted to St. Barnabas. John was 72 years old and suffering from Stevens-Johnson syndrome, a rare allergic reaction that causes excruciating pain and left him badly disfigured. The condition could be fatal, but not always. many patients recovered with time and care. Shortly after John arrived, his vitals started to improve.
Starting point is 00:26:33 The doctors and other nurses felt optimistic about his recovery, but Charles thought they were too confident. He'd been watching John suffer under their care, and he wanted the rest of the staff to see what he did, that they weren't as good at their jobs as they thought they were. So on the night of June 11th, Charles stole lytocaine from the supply closet and injected a lethal dose into John's IV line.
Starting point is 00:26:58 Shortly after, John died. Charles's rationalization here follows a predictable clinical logic. He framed the staff's hope as incompetence and his own actions as corrective. He saw this as an attempt to expose a perceived failure from the very institution he mistrusted. That lets him shift blame outward. But also, in this particular instance,
Starting point is 00:27:22 there are two other plausible explanation seconds. come to mind. Charles has been suffering from severe depression and hopelessness since he was young. Severe depression narrows cognition and biases someone toward hopeless meanings. If he's chronically miserable and never feeling improvement, but then sees a patient improving, it can create cognitive dissonance. And for someone like Charles, killing a recovering patient can be a way to resolve that. It allows him to make others share his misery or to deny them the hope he can't have, at least in his mind. However, if he is intent on proving other staff wrong with regard to their medical judgment or even their hope, then his need for control may be the primary
Starting point is 00:28:05 driving force here. This would give him a sense of control over decisions, control over life and death, control over suffering or hope, control over institutional narrative, relational dynamics, and control over his own emotional state. But of course, both can be true, and it's rarely ever just one factor. I'm curious, what's your take on the fact that he targeted patients as a way to get revenge on the hospital? Patients to Charles are symbolic of staff competence, so harming them punishes the institution without him having to confront the staff directly, which makes sense for Charles given his history and his pattern of behavior. But ultimately, what this does is it wrecks hospital functioning. It destroys patient trust and family confidence. It weakens staff morale, and it
Starting point is 00:28:53 creates fear and suspicion, which is exactly what he wants and exactly how he feels about institutions. So in a sense, this is a projection of his own beliefs, his own grief onto the institution. It's his way of saying, they took my closure, so I'll take theirs. But motive is rarely singular. So with that in mind, I think there are quite a few things that are driving Charles. Charles was clearly misguided, but despite how shocking his behavior was, he didn't get caught. To the other nurses, it seemed like John had simply taken a sudden turn for the worse. After all, he was an elderly patient in a critical care unit. After John's death, Charles continued working at St. Barnabas.
Starting point is 00:29:39 Over the next couple of years, he maintained his spotless reputation. No one knew he was hiding a deadly secret. But at home, things continued to unravel. Charles had started drinking heavily again. He hid bottles of alcohol in the basement where Adrian couldn't find them, and things only got worse in 1991. When Adrian gave birth to their second daughter, Saskia, Charles was under more pressure at home than ever.
Starting point is 00:30:07 Soon, Charles began channeling his emotions into his work. Now that he knew he could literally get away with murder, he started tampering with more IVs, and while we don't know for sure whether any other patients at St. Barnabas died as a result, hospital staff finally started to suspect he was up to no good. On February 11, 1991, one of Charles's co-workers, a nurse named Pam Allen, was prepping a patient's IV bag when she noticed it was leaking. When Pam looked closer, she realized the bag was overfilled. This was highly unusual, so Pam alerted the hospital's risk manager and sent the bag for testing. When the results came back, they showed something alarming. The bag was only
Starting point is 00:30:55 supposed to contain saline and heparin, a standard mix for IVs, but it also contained insulin. For people with diabetes, insulin is a life-saving drug. It lowers blood sugar when the body can't do it on its own. But for someone who doesn't need insulin, it can't. It can be a life-saving drug. It cause their blood sugar to drop dangerously low. Insulin poisoning can cause confusion, seizures, and even death. Pam had stumbled upon a clue for Charles Cullen's scheme. He was going into supply closets, stealing insulin, and injecting it into IV bags. We don't know how many times he did this, but by February of 1991, he was on a rampage, and even with Pam's discovery, he wasn't caught. Sure, it raised eyebrows, but the hospital still never imagined one of their own staff members
Starting point is 00:31:48 had spiked the bag on purpose. Instead, they chucked it up to a mishap until the issue became impossible to ignore. On February 14th, a patient named Anna Byers was placed on an IV drip after undergoing cardiac surgery. Within 30 minutes, Anna became violently ill. Doctors sent a sample of Anna's blood to the lab to try and figure it. out what was wrong, and the results showed alarmingly high levels of insulin. Staff in the cardiac unit didn't seem to be aware of the suspicious IV bag that Pam Allen found days earlier, so throughout the night Anna continued to crash. The medical staff stabilized her each time, but they couldn't figure out what was wrong. Finally, someone unplugged her IV, and Anna remained
Starting point is 00:32:38 stable for a while. However, at some point, she crashed again. This time it was nearly fatal. Not only that, but responding staff noticed that Anna's IV had been mysteriously plugged in again. Charles' predatory behavior is actually textbook, only it's being done in a professional setting. He's selected vulnerable targets, in this case patients. He used his clinical knowledge as his method and exploited routine workflows to move unseen. Expanding to other units is typical and also tactical. He's testing one word, learning detection risks, and then replicating. Offenders in the community will also test their limits. They also refine their tactics and they escalate in similar ways. It also does sound like he was more likely than not actively monitoring Anna by how you describe this. And this was
Starting point is 00:33:30 partly so that he could learn the routine of staff, but also partly so he could ensure he was successful. And it also makes me wonder if he was getting some kind of psychological gratification from this as well. Watching a patient gives him immediate feedback and a sense of mastery. It's also a reinforcing feedback loop because every successful outcome like the patient deteriorates, staff scramble, he stays hidden in secret. It strengthens the behavior. Charles seems to attack patients when he's feeling more stressed in his personal life. What does that say about him? Stress is a common trigger for many people.
Starting point is 00:34:06 Under severe stress, the prefrontal cortex, the part that plans, weighs consequences, and inhibits drives, becomes less effective. Most people become more irritable, impulsive, or dysregulated in everyday ways. Like, some people might shout, some people might drink more, or stress eat, or snap at loved ones, or make rash decisions. A serial offender, however, has the same stress physiology but a different baseline. They have rage, they have empathy deficits, antisocial patterns, violent fantasies, and practiced methods. Killing can, paradoxically, relieve stress for some offenders because it temporarily solves the exact internal problems that drove them, which are typically loss of control, unbearable shame, or intolerable rage. Charles was becoming more confident in his ability to poison people,
Starting point is 00:34:56 especially as he watched other nurses and doctors lose their confidence. Soon, Anna's nurses learned that another patient just down the hall was going through the same thing as her. Fortunately, both Anna and the other patient survived, but cardiac staff were unnerved. These clearly weren't random incidents. Neither patient had a history of diabetes or related issues. there was no reason for them to experience blood sugar crashes. Suspitions only grew over the next few months when these kinds of crashes began happening repeatedly.
Starting point is 00:35:30 Not just in the cardiac unit, but in all of the critical care units. Multiple patients suffered from inexplicable, near-fatal blood sugar crashes, and each time their lab results showed high insulin. The lab also discovered another crucial finding. Each patient had a form of insulin in their blood that wasn't made naturally in the body. In other words, it had been introduced from the outside. Once they learned this, hospital administrators finally connected the dots between all the crashes and the tampered IV bag that Pam Allen had found months earlier.
Starting point is 00:36:07 Now they realized someone in the hospital might be doing this to patients on purpose. As more patients went through this, hospital staff sent their IV bags for testing, and the results confirmed the hospital's suspicions. Someone was adding insulin. So in the summer of 1991, hospital administrators at St. Barnabas launched an internal investigation. But when they zeroed in on their main suspect, he found a way to slip through the cracks. Soon, Charles Cullen would go on to commit murders in other hospitals, and no one could stop him a new true crime podcast from tenderfoot tv in the city of maus in belgium women began to go
Starting point is 00:36:57 missing it was only after their dismembered remains began turning up in various places that residents realized a sadistic serial killer was lurking among them the murders have never been solved three decades later we've unearthed new evidence le maestro season two is a very Now. Listen for free on the IHeart Radio app, Apple Podcasts, or wherever you get your podcasts. In the summer of 1991, St. Barnabas Hospital launched an internal investigation into a series of insulin poisonings across their critical care units. Hospital administrators interviewed nurses to try and figure out who would do something so dangerous and cruel. And when 31-year-old Charles Cullen sat down for questioning, his behavior immediately raised red flags.
Starting point is 00:37:49 All of the other nurses had seemed scared and confused during their interviews, but Charles, who was a well-regarded nurse in the burn unit, was agitated and impatient. The head of hospital security seemed to have a gut feeling about Charles, and at some point he asked him point-blank if he was the one poisoning people. In response, Charles said, quote, You can't prove anything. After that, he got up and left the room.
Starting point is 00:38:17 Now, administrators felt certain he was behind things, but at the same time, Charles was right. They didn't have any proof that he was at fault. Even when they went to the local police with their suspicions, there was nothing authorities could do without hard evidence. So hospital administrators set out to find some. They installed hidden cameras in every supply closet, hoping to catch Charles stealing medication
Starting point is 00:38:42 and tampering with IV bags. But by this point, he knew they were onto him, so he hit pause on his poisoning schemes. At the same time, Charles thought if they really wanted to catch him, they could lift his fingerprints off the IV bags they had tested. But they didn't do that, which only reinforced Charles' lifelong belief that hospitals didn't really care about saving patients' lives.
Starting point is 00:39:08 Since they couldn't catch him in the act, the hospital decided to stop putting Charles' on the schedule. Technically, it wasn't a firing, more like a gentle push out the door. Other than that, Charles didn't face any consequences. So this likely emboldened him even more, even if he was being silently pushed out. Feeling successful and harming others reinforces the behavior for Charles and it inadvertently confirms to him that his methods are working and he is in control. Those feelings can reduce inhibition and make escalation. more likely. It makes him feel more capable, competent, and entitled. And this can also result
Starting point is 00:39:49 in more refined methods. But now he's also identifying with the aggressor, which I mentioned previously. That's a defense mechanism where a person adopts the behaviors, attitudes, or characteristics of an abuser or a powerful threatening figure to cope with trauma, fear, or helplessness. In this case, it's medical workers or the system. He despised medical workers and caregivers in general, again, goes back to his childhood with his siblings and his home life. He felt caregivers and medical workers were incompetent or untrustworthy. And the irony is he's become the very thing he despised. He is now the incompetent and untrustworthy medical provider that families should fear. Charles felt no shame about being quietly let go. At the same time, he couldn't
Starting point is 00:40:37 outsmart everyone. To explain the situation to his wife, Adrian, Charles claimed the hospital used him as a fall guy. But when he told her what happened with the IV bags, the story made Adrian think of her old suspicions that Charles had drugged their infant daughter with cough syrup. However, Adrian didn't want to be paranoid, so she kept her concerns to herself. A few months after Charles was let go, in January of 1992, he landed a new job at nearby Warren hospital. It seems like some of his old coworkers from St. Barnabas felt he was wrongfully punished. because they provided glowing recommendations, which Charles quickly lived up to. At Warren, he impressed people with his vast knowledge of different medications and made friends easily.
Starting point is 00:41:25 It was like he got a high out of being popular at work. Meanwhile, his home life dragged him down. Charles continued sneaking out to the basement to drink, and eventually Adrian caught on. Between her suspicions and his substance abuse, she finally had enough. had enough. Adrian told Charles she wanted a divorce. Charles seemed to accept the news at first, especially since Adrian told him he could keep living in their house while he looked for a new place, which proved to be a mistake. One night, Adrian called the police on Charles and said he had drunkenly attacked her. Charles denied it, and since Adrian couldn't provide hard evidence,
Starting point is 00:42:06 the officers didn't arrest Charles. But it does seem like they convinced him to stay somewhere else for the night. Because a little while later, when Charles was alone, he turned to his old, dire coping mechanisms. He mixed pills and alcohol, then drove himself to the emergency room at Warren Hospital, where he was currently employed, and said he tried to take his own life. But like before, Charles knew he wasn't going to die. In my experience working in forensic settings like corrections. Whenever someone makes a suicide attempt or gesture that is timed when they know someone will intervene, or they use a non-lethal method, or they take themselves directly to get medical care, it's generally a sign of manipulation for secondary game. In correctional settings, they have something
Starting point is 00:42:58 to gain by being placed in a crisis bed and taken off of the yard, and generally it's safety-related or a transfer to another institution. In the community, it can also be manipulative, but it can also be a cry for help or ambivalence between wanting to die and wanting to be rescued. In Charles' case, I think it is more likely than not a mixture of these,
Starting point is 00:43:22 and this is largely because he took himself to the hospital that quietly removed him and suspected him of criminal acts. He was taken off the schedule, and although he felt they couldn't prove he did anything wrong, being removed from the hospital meant removing his control. He wasn't able to continue monitoring them and therefore he had no idea what evidence they might have gathered in his absence through witnesses or
Starting point is 00:43:46 other means, so he was likely ruminating on this. Taking himself there specifically and having them rescue him in his quote crisis is his way of testing their competence, gauging their level of suspicion and preserving plausible deniability in whatever way he could. He might have felt this would allow him to retain some influence over whatever came next, perhaps hoping this vulnerability he's showing will invoke some kind of sympathy and that will prevent consequences and perhaps in some distorted way, maybe even hoped it would allow him to return to work. It truly reads like his way of trying to regain control, which at the core was manipulative in nature. But regardless, it needs to be taken seriously. There have been multiple occasions when I did work in corrections
Starting point is 00:44:32 where an act of manipulative self-harm went too far. And as a result, the individual did almost die unintentionally. So any self-harm is always treated with the seriousness it deserves during the acute event and following it. We don't know how exactly Charles' co-workers reacted or if they even knew what happened since he didn't work in the emergency department. However, when Adrian heard what he did,
Starting point is 00:44:58 she didn't feel sympathy. All she saw was an erratic and, dangerous man. She filed for a restraining order. After that, Charles moved into a basement apartment, a few miles from the home he once shared with Adrian and their daughters. A few months later, in April of 1993, Charles set his sights on someone new. Her name was Michelle. She was also a nurse at Warren Hospital, and she happened to be going through a divorce, too. Charles became quickly enamored with Michelle. He felt they had a lot in common. He started bringing her sweets and other gifts at work and calling her at home at all hours of the night. Sometimes she
Starting point is 00:45:38 picked up and had polite conversations with him, but mostly she ignored his calls. Charles couldn't seem to realize that Michelle wasn't interested in him at all. He thought they had a budding relationship. So one night when she didn't answer the phone, Charles thought something was wrong. Maybe Michelle was sick. He wanted to check on her, so he drove to her house in the middle of the night. He knocked on her door, but she didn't answer. This only made Charles more concerned. Rather than call for help, Charles threw a brick through a window and broke into Michelle's house. He crept upstairs and found her asleep in bed. Charles stood over Michelle for a while, watching her sleep. Eventually, he left. In the morning, Michelle found the shattered window in all
Starting point is 00:46:27 of Charles's missed calls, she immediately knew what he'd done. She called him back and told him someone broke into her house the night before. Charles freely admitted that it was him. Charles clearly became fixated on Michelle and that escalated to entitlement and voyeuristic control. This sequence of obsession, surveillance, and forced covert entry are strong predictors of future physical violence. Now, we haven't covered any similar behavior like this, but I wouldn't be surprised if intimate partner violence was happening all throughout his marriage to Adrienne. He did, at the very least, start that relationship with her with love bombing, which can be an early indication of coercive behavior. Rejection from his employer, his wife, Adrian, and now Michelle, in addition to likely ruminating over the loss of control he was feeling with all of these things, including loss of access to victims, all likely amplified a need to regain control and power, which then really showed up in this behavior with Michelle.
Starting point is 00:47:30 I'm kind of surprised he would actually admit to breaking in. Why do you think he did that with her? I think this strengthens the argument that he was seeking control again. breaking into her home got her attention. She called him and told him about what happened, and in his mind he likely felt that he regained power. And in order to keep it, he confessed, because by confessing, she now knew what he was capable of.
Starting point is 00:47:53 It was his version of signaling dominance, and it was his attempt at coercive control. It's likely he felt this would coerce her into staying with him, but more importantly, intimidate her into being readily available and obedient going forward. Well, you're right. It seems like Charles found a way to control Michelle. He thought he did. Instead, when he told her what he'd done, she hung up the phone and called the police immediately. They issued a warrant for his arrest. And when Charles caught wind of it, he decided to turn himself in. However, before heading to the station, Charles washed down some pills with alcohol. Once authorities realized what he'd done, he was sent to a facility known as the New Jersey State Lunatic Association. While he was there, he learned that he was being charged for harassing and stalking Michelle. He was given a light fine and probation, but no jail time. Then Charles got some more good news. Warren Hospital wasn't going to punish him.
Starting point is 00:48:53 He was welcome to return to work. Charles once again felt like he'd gotten away with his misdeeds, with no more than a slap on the wrist. He was eager to go back to work and see Michelle. when he did, it was clear she had no sympathy for his mental health concerns. She wanted nothing to do with him. For the next few weeks, he kept his head down and left her alone. But anger and resentment were stewing inside Charles. He was going to show everyone what he was capable of through a healthy dose of revenge.
Starting point is 00:49:36 Thanks so much for listening. Come back next time for the conclusion of our story on serial killer, Charles Cullen. Killer Minds is a crimehouse original powered by Pave Studios. Here at Crime House, we want to thank each and every one of you for your support. If you like what you heard today, reach out on Instagram at Crimehouse. And don't forget to rate, review, and follow, Killer Minds, wherever you get your podcasts. Your feedback truly makes a difference.
Starting point is 00:50:11 And to enhance your listening experience, subscribe to Crime House Plus on Apple Podcasts. You'll get every episode of Killer Minds ad-free, along with early access to each thrilling two-part series and exciting crime house bonus content. Killer Minds is hosted by me, Vanessa Richardson, and Dr. Tristan Engels, and is a crime house original powered by Pave Studios.
Starting point is 00:50:36 This episode was brought to life by the Killer Minds team. Max Cutler, Ron Shapiro, Alex Benadon, Lori Marinelli, Natalie Pertzowski, Sarah Camp, Markey Lee, Sarah Tardif, and Carrie Murphy. Thank you for listening. Looking for your next Crime House listen, don't miss Crimes of with Sabrina DeAnna Roga and Corinne Vienne. Crimes of is a weekly series that explores a new theme each season, from Crimes of the Paranormal, Unsolved Murders, Mysterious Disappearances, and more.
Starting point is 00:51:15 Their first season is Crimes of Infamy, the true stories behind Hollywood's most iconic horror villains. And coming up next is Crimes of Paranormal, real-life cases where the line between the living and dead gets seriously blurry. Listen to Crimes of every Tuesday on Apple Podcasts, Spotify, Amazon Music, or wherever you listen to podcasts.

There aren't comments yet for this episode. Click on any sentence in the transcript to leave a comment.