Perfect Poison (14 page)

Renee Walsh had given up on the notion of ever getting a good night's sleep. As a nurse with over fifteen years experience, concentrating on her normal everyday activities lately was becoming almost impossible. Like a shadow, wherever she went, whatever she did, the troubling notion that a colleague could be killing patients right under her nose haunted her, so much so that it pained Walsh to see Gilbert in a patient's room anymore.

Still, there was an outside chance Gilbert hadn't done anything at all. Walsh considered that perhaps she was just being paranoid, looking too deeply into what amounted to a set of circumstances that had placed Gilbert, simply by association, in the shadow of guilt. What if she were wrong? Gilbert had been employed at the VAMC for seven years. Not only would Walsh be an outcast for falsely accusing a colleague of being a murderer, but it would be impossible for her to work with her ever again.

Still, for the past few weeks, Walsh had looked under bed sheets, in garbage cans, in needle-disposal buckets, and anywhere else she thought might have been a good hiding place for evidence of a crime. She wasn't sure what she was looking for, but she knew there had to be an answer. The José Velasquez incident had been at the forefront of her mind, gnawing at her, for about two weeks now. Another near miss with Angelo Vella.

Who was next?

At first, Walsh was on the lookout for potassium. Potassium was another drug, she knew, that could wreak havoc on the human body if given in the form of an overdose. Walsh had no idea the VAMC had even stocked the 1:1000 ampoules of epinephrine.

Though she didn't find anything that night, Walsh became even more convinced of Gilbert's guilt after receiving a phone call from her one night shortly after that.

For most of the day, Walsh had cared for a patient who, being “very, very ill,” was probably going to die, she thought, within a few weeks, and she had expressed to many of her colleagues, including Gilbert, how much she would miss him.

A few hours after Walsh got home, Gilbert called.

“I just wanted to let you know that [your patient] died right after you left,” she said without emotion.

“What?”

“I know he was one of your favorite patients, Renee. I just wanted to call you and let you know.”

Hours after she had hung up, having trouble falling asleep, Walsh couldn't stop thinking about the worst.

 

 

For John Wall, Angelo Vella was “the final straw,” he later said. He and Kathy Rix were now talking almost daily about what they should do.

With Rix running around counting ampoules of epinephrine and Walsh looking under every nook and cranny of the ward for anything she could find, they feared Gilbert was going to catch on to what was they were up to soon enough, anyway.

And then what?

Walsh had an inkling that Rix was up to something. She had known Rix for quite a while, and was convinced by the second week of February that she wasn't herself since she had returned from vacation. For the past few days, Walsh had wanted to approach her with her own concerns, but she was having trouble finding the right words and place to do it.

But on February 13, the opportunity presented itself.

Staying late because they were shorthanded, Walsh entered the break room and saw Kathy Rix just sitting there alone, staring blankly into the muddy whirl of cream and sugar swirling around in her coffee cup. When Walsh thought about the events of the past few weeks hard enough, it seemed almost ridiculous that no one else had come forward, or at least said
some
thing. Since February 2, just eleven days ago, four patients had died on Ward C: Kenny Cutting, Leslie Smith, Jack Knightlinger and Henry Cormier.

How many more would it take?

Kathy Rix didn't say anything as Walsh entered the room and walked toward the counter to make a cup of coffee.

After ripping open a small pouch of sugar, Walsh turned and looked at Rix, who just stared back at her with an exhausted look on her face.

“You know how it's always kinda been a joke about Kristen being the angel of death . . . how we're always joking about it?”

“Yes,” Rix said, nodding her head slowly.

“Do you ever think that maybe it's not a joke? That maybe things are really going on?”

The silence in the room was deafening.

“I think about it all the time, Renee . . . all the time,” Rix said, dropping her head down on top of the table.

“Maybe we should talk.”

For the next few minutes, the two nurses swapped stories about what they had seen, heard, thought and felt. They left nothing out. It was like uncorking a bottle of demons that had built up for months. Yet, when everything set in and they realized what was going to have to happen next, that enormous weight had been replaced with a terrible sense of responsibility and confusion.

No sooner had Rix and Walsh begun to vent their concerns, than John Wall walked in as though the meeting had been preplanned.

But Walsh abruptly stopped talking. Even though Rix and Wall had been discussing what to do for some time, Walsh, who didn't know about it, was scared.

Rix then turned to Walsh and whispered, “I think we can trust John, Renee. He has his suspicions too. We've been talking about this for quite a while now.”

“Oh?” Walsh said, surprised.

“He has some of his own stories to tell.”

Worried that someone might walk in at any moment, the three nurses swapped a few stories and began discussing a plan.

“Should we go to Melodie?” Walsh asked. “The FBI? The Northampton Police Department? Who? Where?”

“No,” Wall said. “Who knows what she'll do with the information.”

The nurses had every reason to believe that Melodie Turner, being management, and, remarkably, oblivious to what had been going on, would somehow try to cover it up. They were scared. Confused. This was serious now. The entire thing was about to explode, and they were going to be at the center of it. It had to be done right. If security found out, James Perrault would know. And they couldn't chance that.

So they agreed to sleep on it for a few days and think about what needed to be done next.

Northampton High School graduate Melodie Turner began working at the VAMC in 1979, after spending eight years at Northampton State Hospital, a psychiatric facility. Beginning her VA career as a staff nurse in psychiatry, in 1981, she was transferred to the acute medical ward. In 1983, armed with a bachelor's degree in public health, Turner landed a position as nursing manager of psychiatry. Five years after that, the VA made her nursing manager of Ward C.

“But I don't have any medical nursing experience,” a coworker later recalled Turner telling her bosses when they approached her with the idea. “I have never worked in an ICU in my life!”

“We don't need a medical nurse; we need a manager. And you are a good manager . . . that's what we want.”

This was, perhaps, one of upper management's biggest mistakes: hiring a person who knew very little about what everyday life was supposed to be like on an acute medical ward to run the show.

So Melodie Turner, equipped with some rather impressive academic credentials, entered Ward C as nursing manager, according to some, knowing little about the medical side of nursing. She wasn't qualified in ACLS. She didn't know how to read a monitor or EKG. And she had no idea how to start an IV.

Now, however, she would be the person to decide if her staff was doing these basic nursing procedures accurately.

What was more, Turner had very little experience in codes and medical emergencies. Medical emergencies and codes rarely ever occurred on a hospital's psychiatric ward. And if they did, nurses would call in the medical personnel.

Ignorance, however, ran all the way up the VAMC management chain. Turner's bosses, others claimed, were no more knowledgeable in these areas of medicine than she was. The VAMC, for the most part, was a psychiatric hospital. In terms of beds, the psychiatric side of the hospital dwarfed the medical side by about three to one. Most of the people in management had been working at the VAMC—in the same office, in the same position—for their entire careers. As one nurse later put it, “They wouldn't know what death statistics were if you hit them over the head with [them].”

Turner usually worked the 7:00
A.M.
to 5:00
P.M.
shift, so her hours dovetailed with each of the three shifts she was now responsible for. She was married with two kids, and her husband also worked at the VAMC. In her late forties, tall and skinny, with bleached-blond hair that was turning gray as the years piled up, Turner was extremely high-strung and, from day one, relished the role of being head nurse.

“Drama queen,” is how one of her former underlings described her.

As the staff got to know her, they learned quickly that her preoccupation with her looks fell in line with her controlling managerial style. She was never, for instance, shy about letting her minions know who the boss was. She put high standards on most of the nurses she had seen promise in—particularly Kathy Rix, John Wall and Renee Walsh—and always kept an eye on how they conducted their business. For this, some of the staff applauded her. Yet others considered her one of the toughest bosses they had ever worked for and complained that she had often abused her power and took her responsibilities to an impossible level—especially where discipline was concerned.

“She loved chaos and things being stirred up,” recalled an old colleague of Turner's. “This way she could fix them—which she was really good at.”

“She could be intimidating,” another nurse later said. “Very, very controlling.”

At times, her managerial practices even bordered on harassment, and Turner often went out of her way to be overly insensitive while lecturing certain members of the staff.

“She would bring you to the point of tears, belittling you and your work, and then, when you started to cry, she'd tell you it was okay,” Rachel Webber later recalled.

Funny and witty, Turner enjoyed the larger-than-life persona she so desperately tried to project. Being estranged from her “mentally ill” mother for more than thirty years, some claimed, probably gave rise to her demanding absolute perfection from her staff.

One time, during the winter of 1993, personal phone calls became an issue on Ward C.

Earlier that day, Turner had been given a copy of all the long-distance phone calls that had been made on the evening shift for the past several weeks. After learning that some of the calls were as long as thirty minutes, she became “infuriated” and demanded to know who had been making the calls.

Rumor had it that one of the nurses, who had friends and family across country, had been calling home.

To find out who was responsible, Turner called each nurse into her office one by one. The nurses speculated that Turner knew who was making the calls, but couldn't, in all fairness, make accusations without any solid proof.

Living up the same code of silence many cops adhere to, the nurses got together beforehand and agreed they would play the “I have no idea” game and leave Turner guessing. It would likely enrage her to the point where she would leave them alone and forget about the incident. In turn, the guilty nurse would stop making the calls, and life would go on.

After getting nowhere with her interrogation, Turner came out of her office and called everyone to the nurse's station. She had something she wanted the staff to hear.

Pausing for a moment before speaking, Turner said,
“What
am I going to do with you guys?” Then, with a flip of her head, stormed off.

After that, whenever there was a problem and one nurse covered for the other, Turner would gather the staff together and, jokingly, say, “This evening shift is so close . . . [you guys] would probably cover up a murder.”

 

 

Not everyone agreed that Turner was so bad, however. One of her former colleagues recalled that although she didn't see Turner as the best boss she'd ever had in her decade and a half as a nurse, she certainly didn't agree with the sentiments of some of the others. The nurses who had problems with Turner were the same people who managed to piss her off in some way. Turner was, the nurse insisted, one hundred percent behind the nurses on Ward C—providing, that is, they stayed on her good side.

“She hated slackers and liars. If Melodie was behind you and respected your work, she would . . . stick up for you right down the line.”

 

 

By the beginning of 1996, Turner had had it with Gilbert. Although she saw her as an excellent code nurse, more knowledgeable in medicines than most, she had caught Gilbert in so many lies throughout the years that she'd lost any bit of professional respect she had left for her. She felt Gilbert could have been more “self-directed” and wanted her to seek out more work, responsibility, and uphold the “policies and frameworks” they had worked under to a greater degree.

Gilbert, of course, always let her down.

But besides noting it on Gilbert's performance evaluations, Turner never took it any further.

As far as Gilbert's name being on approximately seventy-five percent of the codes and fifty percent of the deaths since 1989, one might ask why Turner hadn't been compelled by the numbers at least to speak to Gilbert.

It seemed odd that she hadn't.

But what was even more peculiar was that for the past year Turner had sat on what was called the Medical Emergency Committee, along with representatives from the pharmacy, security, and supply and distribution departments. Headed by a physician, the group met once a month to review the previous month's medical emergencies “for needs that might have come up in carrying out the medical emergencies [and] the whole deportment of the medical emergency.” They would discuss how the codes and emergencies were played out. They would make sure there was enough medication on hand during the episode, make a judgment as to how the code team responded, and rate how the overall code had been carried out.

One would have to assume the increasing amount of codes would have raised a red flag during one of these meetings.

But it never did.

“The Medical Emergency Committee,” a member of law enforcement later said,
“including
Melodie Turner, didn't think that a serial killer was wandering through the halls of Ward C—so they certainly weren't looking at these codes with a suspicious eye.”

Nevertheless, the roof was about to cave in on Melodie Turner.