In the late 1980's, a quiet young man with began working as a nurse in a burn ward in New Jersey. Whether initially tempted by pity or a need for control, it was there that Charles Cullen, dubbed by the media as the Angel of Death, murdered his first patient with an insulin overdose. Over the course of the next sixteen years, he murdered many more, possibly over three hundred people all told, all within the sterile confines of hospital wards. Journalist Charles Graeber first encountered Cullen while writing an article about the murderer's desire to donate a kidney from prison, and now uses Cullen's exclusive testimony to explore his career as a murderer. Almost more terrifying than the killing, Graeber shows how hospital after hospital turned a blind eye to the mysterious deaths in their ward, sometimes asking Cullen to leave, but never reporting him to any state licensing board or conducting any official investigations. It was only due to the efforts of two homicide detectives, who tunneled through the lies and misdirections of the hospital administration, that Cullen was finally apprehended and the deaths could come to an end.
The twisted tale of Cullen's career as a nurse and killer is fascinating, but the meat of the horror really lays with the hospitals and their desperation to evade liability. Though the determined detectives and one very brave informant bring a catharsis of sorts, the end of the book left me with lingering uneasiness about the hospital system as a whole and about liability in particular. Additionally, while Graeber's style is matter-of-fact, it can veer into grisly descriptions at a moment's notice, underscoring the racking horror of suffering an insulin overdose or being fully conscious while you slowly expire under the influence of vecuronium bromide--images that also lingered long after the book was finished. This thought-provoking and gripping book will be enjoyed by true crime fans and narrative nonfiction fans alike, although readers should take note: it is not for the faint of heart...or stomach.