Charles Edmund CULLEN

Charles Edmund CULLEN

Classification: Serial killer
Characteristics: Nurse
Number of victims: 29 - 45
Date of murders: 1984 - 2003
Date of arrest: December 14, 2003
Date of birth: February 22, 1960
Victims profile: John W. Yengo Sr., 72 / Lucy Mugavero, 90 / Mary Natoli, 85 / Helen Dean, 91 / LeRoy Sinn, 71 / Earl Young, 76 / Catherine Dext, 49 / Frank Mazzacco, 66 / Jesse Eichlin, 81 / Ottomar Schramm, 78 / Matthew Mattern, 22 / Irene Krapf, 79 / William Park, 72 / Samuel Spangler, 80 / Daniel George, 82 / Edward O'Toole, 76 / Eleanor Stoecker, 60 / Joyce E. Mangini, 74 / Giacomino J. Toto, 89 / John J. Shanagher, 83 / Dorthea K. Hoagland, 80 / Melvin T. Simcoe, 66 / Michael T. Strenko, 21 / Florian J. Gall, 68 / Pasquale M. Napolitano, 80 / Christopher B. Hardgrove, 38 / Krishnakant Upadhyay, 70 / James R. Strickland, 83 / Edward P. Zizik, 73 (patients)
Method of murder: Poisoning (lethal overdose of medication)
Location: New Jersey/Pennsylvania, USA
Status: Pleaded guilty to murdering 22 people in New Jersey. Sentenced to 11 consecutive life terms on March 1, 2006. Sentenced to seven life sentences in prison for seven murders in Pennsylvania


Charles Cullen (born February 22, 1960) is a former nurse and the most prolific serial killer in New Jersey history. Cullen told authorities in December 2003 that he had murdered as many as 45 patients during the 16 years he worked at 10 hospitals in New Jersey and Pennsylvania.

Childhood and Early Life

Charles Cullen was born in West Orange, New Jersey, the youngest of eight children in a deeply religious Catholic family. His father was a bus driver and his mother stayed at home to raise her children. Cullen's father died when Cullen was an infant. Two of his siblings also died in adulthood. His father, Meme Cullen raped him as a child.

Cullen described his childhood as miserable. He first attempted suicide at the age of nine by drinking chemicals taken from a chemistry set. This would be the first of 20 such suicide attempts throughout his life. Later, working as a nurse, Cullen fantasized about stealing drugs from the hospital where he worked and using them to commit suicide. In one attempt he took a pair of scissors and jabbed them through his head. He was rushed to the hospital to have major surgery done.

When Cullen was 17, Cullen's mother died in an automobile accident; his sister was at the wheel. Devastated by his mother's death, Cullen dropped out of high school and enlisted in the U.S. Navy in 1978. He was assigned to the submarine corps, and served aboard the ballistic missile sub USS Woodrow Wilson. Cullen rose to the rank of petty officer third class as part of the team that operated the ship's Poseidon missiles.

Already, Cullen showed signs of mental instability. He once served a shift in a green surgical gown, surgical mask and latex gloves stolen from the ship's medical cabinet. He was transferred to the supply ship USS Canopus. Cullen tried to kill himself several times over the next few years. His last attempt led to his discharge from the Navy in March 1984.

After leaving the Navy, Cullen attended Mountainside School of Nursing and got a job at St. Barnabas Medical Center in Livingston, New Jersey, in 1987. That same year he married Adrienne Taub. The couple had two daughters.

Murders

Cullen committed his first murder on June 11, 1988. Judge John W. Yengo Sr., had been admitted to St. Barnabas Medical Center suffering from an allergic reaction to a blood-thinning drug. Cullen administered a lethal overdose of medication intravenously. Cullen admitted to killing 11 patients at St. Barnabas, including an AIDS patient who died after being given an overdose of insulin. Cullen quit his job at St. Barnabas in January 1992 when hospital authorities began investigating who might have tampered with bags of intravenous fluid.

Cullen took a job at Warren Hospital in Phillipsburg, New Jersey, in February 1992. He murdered three elderly women at the hospital by giving them overdoses of the heart medication digoxin. His final victim said that a "sneaky male nurse" had injected her as she slept, but family members and other healthcare workers dismissed her comments.

In January 1993, Adrienne Cullen filed for divorce. She later filed two domestic violence complaints against him. The divorce papers and domestic violence complaints depicted Cullen as an alcoholic, someone who abused pets by placing them in bowling bags and trash cans, poured lighter fluid into other people's drinks and made prank calls to funeral homes. Cullen had shared custody of his daughters and moved into a basement apartment on Shaffer Avenue in Phillips burg.

Cullen says he wanted to quit nursing in 1993, but court-ordered child support payments forced him to keep working.

In March 1993, he broke into a co-worker's home while she and her young son slept, but left without waking them. Cullen then started phoning her frequently, leaving numerous messages and following her at work and around town. The woman filed a complaint, and Cullen pleaded guilty to trespassing and was placed on a year's probation. The day after his arrest, Cullen attempted suicide. He took two months off work, and was treated for depression in two psychiatric facilities. He attempted suicide two more times before the end of the year.

Cullen left Warren Hospital in December 1993 and took a job at Hunter Medical Center in Rarity Township, New Jersey, early the next year. Cullen worked in the hospital's intensive care/cardiac care unit for three years. During his first two years, Cullen claims he did not murder anyone. But hospital records for the time period had already been destroyed at the time of his arrest in 2003, preventing any investigation into his claims. However, Cullen did admit to murdering five patients in the first nine months of 1996. Once more, Cullen administered overdoses of dioxin.

Cullen became a licensed nurse in Pennsylvania in 1994.

Cullen found work at Morris Memorial Hospital in Morris, New Jersey. He was fired in August 1997 for poor performance. He remained unemployed for six months and stopped making child-support payments.

In October 1997, Cullen appeared in the Warren Hospital emergency room and sought treatment for depression. He was admitted to a psychiatric facility, but left a short time later. His treatment had not improved his mental health. Neighbors said that he could be found chasing cats down the street in the dead of night, yelling or talking to himself, and making faces at people when he thought they weren't looking.

In February 1998, Cullen was hired by Liberty Nursing and Rehabilitation Center in Allentown, Pennsylvania. He worked in a ward for patients who needed ventilators to breathe. In May, Cullen filed for bankruptcy, claiming nearly $67,000 in debts. Liberty fired Cullen in October 1998 after he was seen entering a patient's room with syringes in his hand. The patient ended up with a broken arm, but apparently no injections were made. Cullen was accused of giving patients drugs at unscheduled times.

Cullen worked at Elston Hospital in Elston, Pennsylvania, from November 1998 to March 1999. On December 30, 1998, he murdered yet another patient with digoxin. A coroner's blood test showed lethal amounts of dioxin in the patient's blood, but an investigation was inconclusive and nothing pointed definitively to Cullen as the murderer.

Cullen continued to find work. A nationwide nursing shortage made it difficult for hospitals to recruit nurses, and no reporting mechanisms or other systems existed to identify nurses with mental health issues or employment problems. Cullen took a job at a burn unit at Lehigh Valley Hospital in Allentown, Pennsylvania, in March 1999. During his tenure at Lehigh Valley Hospital, Cullen murdered one patient and attempted to murder another.

In April 1999 Cullen voluntarily resigned from Le high Valley Hospital and took a job at St. Luke's Hospital in Bethlehem, Pennsylvania. Cullen worked in St. Luke's cardiac care unit. Over the next three years, he murdered five more patients and attempted to murder two.

In January 2000, Cullen attempted suicide again. He put a charcoal grill in his bath tub, lit it and hoped that the carbon monoxide gas would kill him. Neighbors smelled the smoke and called the fire department and police. Cullen was taken to a hospital and a psychiatric facility, but was back home the following day.

No one suspected Cullen was murdering patients at St. Luke's Hospital until a co-worker accidentally found vials of unused medications in a disposal bin. The drugs were not valuable outside the hospital, and were not used by recreational drug users, so their theft seemed curious. An investigation showed that Cullen had taken the medication, and he was fired and escorted from the building in June 2002.

Seven St. Luke's nurses who worked with Cullen later met with the Le high County district attorney to alert the authorities of their suspicions that Cullen had used drugs to kill patients. They pointed out that, between January and June 2002, Cullen had worked 20 percent of the hours on his unit but was present for nearly two-thirds of the deaths. But investigators never looked into Cullen's past, and the case was dropped nine months later for lack of evidence.

Cullen worked for a short time at Sacred Heart Hospital in Allentown, but did not get along with his co-workers and left.

In September 2002, Cullen found a job at Somerset Medical Center in Somerset, New Jersey. Cullen worked in Somerset's critical care unit. Cullen's depression worsened, even though he had begun dating a local woman. Cullen murdered eight more patients and attempted to murder another by June. Once more, his drugs of choice were dioxin and insulin.

On June 18, 2003, Cullen attempted to murder Philip Gregor, a patient at Somerset. Gregor survived and was discharged; he died six months later of natural causes.

Soon afterward, the hospital's computer systems showed that Cullen was accessing the records of patients he was not assigned to. Co-workers were seeing him in patient's rooms. Computerized drug-dispensing cabinets were showing that Cullen was requesting medications that patients had not been prescribed.

The executive director of the New Jersey Poison Information and Education System warned Somerset Medical Center officials in July 2003 that at least four of the suspicious overdoses indicated the possibility that an employee was killing patients. But the hospital put off contacting authorities until October. By then, Cullen had killed another five patients and attempted to kill a sixth.He then proceeded to have sex with the victims

State officials penalized the hospital for failing to report a nonfatal insulin overdose in August. The overdose had been administered by Cullen. When Cullen's final victim died of low blood sugar in October, the medical center alerted state authorities. An investigation into Cullen's employment history revealed past suspicions about his involvement with prior deaths.

Somerset Medical Center fired Cullen on October 31, 2003, for lying on his job application. Police kept him under surveillance for several weeks until they had finished their investigation.

Arrest and Guilty Plea

Cullen was arrested on one count of murder and one count of attempted murder at a restaurant December 14, 2003. On December 14, 2003, Cullen admitted to the murder of Rev. Florian Gall and the attempted murder of Tin Kyushu Han, both patients at Somerset.

In April 2004, Cullen pleaded guilty in a New Jersey court to killing 13 patients and attempting to kill two others by lethal injection while employed at Somerset. As part of his plea agreement, he promised to cooperate with authorities if they did not seek the death penalty for his crimes. A month later, he pleaded guilty to the murder of three more patients in New Jersey.

In November 2004, Cullen pleaded guilty in a Pennsylvania court to killing six patients and trying to kill three others.

As of July 2005, Cullen remained in the Somerset County Jail in New Jersey as authorities continued to investigate the possibility of his involvement in other deaths.

Cullen is currently serving a sentence of life in prison without parole for 30 years, to be served consecutively with his other sentences in Pennsylvania. On March 2, 2006, Cullen was sentenced to 11 consecutive life sentences in New Jersey, to be ineligible for parole for 397 years. He is held at New Jersey State Prison in Trenton, New Jersey.

On March 10, 2006 Cullen was brought into the courtroom of Lehigh County President Judge William Pratt for a sentencing hearing. Cullen, who was upset with the judge, kept repeating "Your honor, you need to step down" for 30 minutes until Platt had Cullen gagged with cloth and duct tape. Even after being gagged Cullen continued to try to repeat the phrase. In this hearing Pratt gave him an additional six life sentences. In addition to other sentences pronounced on the same day in another county, Cullen currently faces 18 life sentences

Motive

Cullen said he administered overdoses to patients to spare them from being "coded" -- going into cardiac or respiratory arrest and being listed as a "Code Blue" emergency. Cullen has told detectives that he could not bear to witness or hear about attempts at saving a victim's life. Cullen also claims that he gave patients overdoses so that he could end their "suffering" and prevent hospital personnel from "de-humanizing" them.

Investigators say that he is and may have caused patients themselves to suffer, but he appears not to realize that this contradicts his claims of wanting to save patients from further pain and suffering.

Similarly, Cullen has told investigators that although he often thought about murdering his victims over several days as he witnessed their "suffering," the decision to commit murder was performed on impulse.

He told detectives in December 2003 that he lived most of his life in a fog, and that he had blacked out the memory of murdering most of his victims. He said he could not recall how many of them there were or why he had chosen them. In some cases, Cullen has adamantly denied committing murders at a given facility. But after reviewing medical records, he later has admitted that he was involved in patient deaths there.

Legal Impact

Cullen was largely able to move from facility to facility undetected, experts say, because of lacking reporting requirements and inadequate legal protection for employers. New Jersey and Pennsylvania, like most states, required health care facilities to report suspicious deaths only in the most egregious cases, and penalties for failing to report incidents were minor. Many states did not give investigators the legal authority to discover where a worker had previously been employed. Employers feared to investigate incidents or give a bad employment reference for fear that such actions might trigger a lawsuit.

Prompted by the Cullen case, Pennsylvania, New Jersey and 35 other states adopted new laws which encourage employers to give honest appraisals of workers' job performance and which give employers immunity when they provide a truthful employee appraisal. Many of the laws, passed in 2004 and 2005, strengthen disclosure requirements for health care facilities, bolster legal protections for health care facilities that report improper patient care and require licensed health care professionals to undergo criminal background checks and be fingerprinted at their own cost.


Nurse who killed 29 sentenced to 11 life terms

New Jersey's worst serial killer escaped death penalty after plea deal

Msnbc.com

March 2, 2006

SOMERVILLE, N.J. - A nurse who killed at least 29 patients was sent to prison for the rest of his life Thursday after his victims’ loved ones angrily branded him “vermin,” “garbage” and a “monster” who ruined lives and shattered their faith in the medical profession.

Charles Cullen — one of the most prolific killers the U.S. health care industry has ever seen — escaped the death penalty after making a deal with prosecutors to tell them which patients he killed with hard-to-detect drug injections.

He received 11 consecutive life terms at a tense and sometimes turbulent hearing in which he came face-to-face with his victims’ families for the first time. Wearing a bulletproof vest under his sweater, Cullen sat quietly as relatives wept and yelled at him from a lectern about 15 feet from where he sat

“You betrayed the ancient foundations of the healing professions,” Superior Court Judge Paul Armstrong said as Cullen stood motionless, his eyes closed.

Cullen, 46, pleaded guilty to murdering 22 people in New Jersey and trying to kill three others. He will be sentenced later for seven murders and three attempted murders in Pennsylvania.

Career lasted 16 years

Cullen has claimed to have killed up to 40 people during a career that spanned 16 years and 10 nursing homes and hospitals.

He was fired from five nursing jobs and resigned from two others amid questions about his performance. But he always managed to find another job, in part because hospitals did not share their suspicions for fear of being sued.

New Jersey lawmakers have since passed legislation protecting nursing homes and hospitals from legal action when reporting disciplinary actions taken against employees.

About 60 relatives of the victims attended the sentencing, calling him “trash,” “one pathetic little man” and “an agent from the deepest depths of Hell.” As the family members spoke, he kept his eyes closed, frustrating some of the relatives.

“In case he forgot what my mother looked like, look into my eyes now,” said Richard J. Stoecker, whose mother was murdered in 2003.

Some family members said they wished Cullen could die as his victims did, by lethal injection.

“I want you to die tomorrow so that you can meet God tomorrow because guess what? There ain’t no door out of hell, baby,” said Debra Yetter Medina, the granddaughter of victim Mary Natoli.

Cullen declined to make a statement, telling the judge he had “nothing to say” and disappointing families who had hoped to hear him explain why he committed the crimes.

'We will never feel safe in a hospital'

John Shanagher, whose father was murdered, said his family “will never feel safe in a hospital again. We will never feel we can trust the medical profession again.”

Dolores Stasienko of Kitty Hawk, N.C., said Cullen “will always be known as the monster.” She held a photo of her father, Giacomino “Jack” Toto, 89, who was murdered in 2003.

“After today, we will finally toss aside his name and face, like the garbage he is,” said Emily Stoecker, whose mother-in-law, Eleanor, was killed.

Other relatives talked of how the killings ruined marriages, careers and report cards.

“My heart, it aches for my son,” said Mary Strenko, whose 21-year-old son was Charles Cullen’s youngest victim. “I walk around with a hole in my heart.”

Cullen has admitted to using lethal doses of medications — usually the heart medication digoxin — to kill patients. He told authorities when he was arrested in 2003 that he killed “very sick” patients, and described the slayings as mercy killings.

Deaths not seen as murder until later

Many of the deaths were not recognized as murders at the time, in part because many of the victims were old or sickly. Cullen was finally caught after officials at Somerset Medical Center in Somerville began noticing that patients who died or nearly did had unusually high levels of digoxin in their bodies.

Cullen agreed to help investigators solve his killings. In exchange, prosecutors in all seven counties where he worked agreed not to seek the death penalty.

Because of the frailties of his memory and imprecise — and in some cases, destroyed — medical records, it is unclear whether authorities have identified all of his victims. Investigations remain open in two New Jersey counties.

Twenty lawsuits have been filed against the facilities where Cullen worked.

In other similar cases around the country, nurse’s aide Donald Harvey pleaded guilty in 1987 to at least 34 murders in Ohio and Kentucky and was sentenced to life in prison, and coronary-care nurse Robert Diaz was convicted in 1984 of killing 12 elderly patients in California with lethal doses of heart drugs.

Some family members said they were satisfied with Cullen’s sentence, while others complained it will do little to end their suffering.

“There isn’t closure for the families. You just have to deal with it. I don’t think there ever will be closure,” said Lucille Gall, whose brother was murdered in 2003.


A List of Charles Cullen's Victims in New Jersey

ABCLocal.go.com

Thursday, March 02, 2006

Former nurse Charles Cullen was to be sentenced Thursday to life in prison for the 22 murders and three attempted murders he has admitted committing in New Jersey.

He has also pleaded guilty to seven murders and three attempted murders in Pennsylvania.

Below are all Cullen's victims listed in order of death, with names, ages, home towns, hospital involved and date of the death:

-John W. Yengo Sr., 72, of Jersey City, N.J., died June 11, 1988, St. Barnabas Hospital in Livingston. He was a Jersey City municipal judge who twice ran for mayor of his hometown

-Lucy Mugavero, 90, of Phillipsburg, N.J., died March 9, 1993, at Warren Hospital in Phillipsburg, N.J. A former garment worker with three children and eight grandchildren, one of whom later became the mayor of Phillipsburg and chairman of the Delaware River Joint Toll Bridge Commission.

-Mary Natoli, 85, of Phillipsburg, N.J., died July 23, 1993, at Warren Hospital. A former silk mill worker who was described by her family as a hardworking Italian grandmother.

-Helen Dean, 91, of Lopatcong Township, N.J., died Sept. 1, 1993, at Warren Hospital. Dean was in the hospital for breast cancer surgery. After her death, her son Larry vowed to find her killer but died of cancer in 2001.

-LeRoy Sinn, 71, hometown not disclosed, died Jan. 21, 1996 at Hunterdon Medical Center. A patent attorney and a member of a club called Gardeners of Somerset Valley. He used his legal knowledge to help the club set up a scholarship fund.

-Earl Young, 76, hometown not disclosed, died May 31, 1996 at Hunterdon Medical Center. Young worked as stock clerk at Flemington Cut Glass, where the owner described him as a reserved but easygoing person.

-Catherine Dext, 49, hometown not disclosed, died June 9, 1996 at Hunterdon Medical Center. Dext was a supervisor at the Edna Mahan Correctional Facility for Women in Union Township, where a colleague described her as a low-key person who always did her job.

-Frank Mazzacco, 66, hometown not disclosed, died June 24, 1996 at Hunterdon Medical Center. Mazzacco taught for 34 years in public schools in Trenton and at one time served as the teachers' union president.

-Jesse Eichlin, 81, hometown not disclosed, died July 10, 1996 at Hunterdon Medical Center. Eichlin was a farmer and carpenter who used his skills to help build a Sunday school wing for his Franklin Township church.

-Ottomar Schramm, 78, of Bethlehem, Pa., died Dec. 30, 1998, at Easton Hospital in Easton, Pa. Described by his daughter as a man who worked two jobs to provide for his wife and three children. Schramm was born in Nicaragua to missionaries.

-Matthew Mattern, 22, of Shamokin, Pa., died Aug. 31, 1999, at Lehigh Valley Hospital in Salisbury Township, Pa. One of Cullen's youngest victims who was in the hospital after being severely burned in a car accident.

-Irene Krapf, 79, of Tamaqua, Pa., died June 22, 2001, at St. Luke's Hospital in Fountain Hill, Pa. Krapf, who had eight children and 22 grandchildren, helped her husband run a taxi company out of the family's home.

-William Park, 72, of Lehighton, Pa., died Nov. 8, 2001, at St. Luke's Hospital. A self-employed upholsterer and a Korean war veteran who lived in Franklin Township.

-Samuel Spangler, 80, of Bethlehem, Pa., died Jan. 9, 2002, at St. Luke's Hospital. His son Ronald described his father as proud family man who was a former machine operator at Stroh Brewing Co.

-Daniel George, 82, of Bethlehem, Pa., died May 5, 2002, at St. Luke's Hospital. He owned George's Foodliner in Bethelhem and Danny's Restaurant and Lounge in Hanover Township. He had three daughters and three grandchildren.

-Edward O'Toole, 76, of Bethlehem, Pa., died June 2, 2002, at St. Luke's Hospital. He was a Navy veteran of World War II who worked 20 years as a district sales manager in Pennsylvania for A.O. Smith Water Heater Co. before retiring in 1990.

-Eleanor Stoecker, 60, Bedminster, N.J., died Feb. 12, 2003, at Somerset Medical Center in Somerville, N.J. A retired medical assistant and the mother of Philadelphia, New York and New Jersey radio personality Zach Martin.

-Joyce E. Mangini, 74, Raritan, N.J., died Feb. 23, 2003, at Somerset Medical Center. A homemaker who loved cooking and crocheting.

-Giacomino J. Toto, 89, Bridgewater, N.J., died Feb. 23, 2003, at Somerset Medical Center. Toto, known as "Jack," spent 25 years as a mechanic and operated a vegetable stand.

-John J. Shanagher, 83, Bridgewater, N.J., died March 11, 2003, at Somerset Medical Center. The World War II veteran worked as a milkman and mail carrier. Relatives said he often spoke of helping to liberate concentration camps in Europe.

-Dorthea K. Hoagland, 80, Middlesex, N.J., died April 6, 2003, at Somerset Medical Center. Hoagland was a homemaker.

-Melvin T. Simcoe, 66, Green Brook, N.J., died May 5, 2003, at Somerset Medical Center. Simcoe was a Korean War veteran and district manager for Bellcore of Livingston for 35 years. The father of four retired in the early 1990s and, his wife said, enjoyed growing flowers.

-Michael T. Strenko, 21, Manville, N.J., died May 15, 2003, at Somerset Medical Center. The former high school soccer and track team member worked packaging material for Fisher Scientific. His family said he was proud of his physique and his booming car stereo.

-Florian J. Gall, 68, Whitehouse Station, N.J., died June 28, 2003, at Somerset Medical Center. Gall was pastor of Our Lady of Lourdes Roman Catholic Church in Whitehouse Station and Hunterdon County vicar for the Diocese of Metuchen.

-Pasquale M. Napolitano, 80, Peapack-Gladstone, N.J., died July 13, 2003, at Somerset Medical Center. Napolitano was a World War II veteran worked for 30 years as security manager for Village Supermarkets of Bernardsville and Morristown.

-Christopher B. Hardgrove, 38, Somerville, N.J., died Aug. 11, 2003, at Somerset Medical Center. He was a carpenter and father of two daughters.

-Krishnakant Upadhyay, 70, Bridgewater, N.J., died Sept. 20, 2003, at Somerset Medical Center.

-James R. Strickland, 83, Bowie, Md., died Sept. 23, 2003, at Somerset Medical Center. Family said he was grieving for his wife when he was killed. He loved playing harmonica so much that one was buried with him.

-Edward P. Zizik, 73, Three Bridges, N.J., died Oct. 21, 2003, at Somerset Medical Center. He was an electrical engineer for 30 years and also volunteered at Somerset Medical Center.

The names, ages, residence of the patients involved and date of attempted murder, according to prosecutors:

-Stella Danielczyk, 73, of Larksville, Pa., attempted murder in February 2000 at Lehigh Valley Hospital.

-John Gallagher, 90, of Bethlehem, Pa., attempted murder on Feb. 8, 2001, at St. Luke's Hospital.

-Paul Galgon, 72, of Bethlehem, Pa., attempted murder on Dec. 28, 2001, at St. Luke's Hospital.

-Jin Kyung Han, 40, Basking Ridge, N.J., attempted murder on June 29, 2003, at Somerset Medical Center.

-Frances Agoada, 83, Franklin Township, N.J., attempted murder on Aug. 27, 2003, at Somerset Medical Center.

-Philip Gregor, 48, South Bound Brook, N.J., attempted murder at Somerset Medical Center of June 18, 2003.


The Tainted Kidney

Charles Cullen, who may be the most prolific serial killer America has ever seen, is serving eighteen consecutive life sentences in a New Jersey penitentiary. Behind bars, he can no longer take life, yet he’s found a way to give it—in the form of an organ transplant. But no one wants to give him the chance to play God again.

By Charles Graeber - NYmag.com

April 7, 2009

The Angel of Death looks sleepy. His face shows nothing. His eyes are closed. Charles Cullen sits motionless in the wooden defendant’s chair of the Somerset County Courthouse as, hour after hour, his victims’ families take the stand. They read poems and show photographs, they weep and yell. If Cullen hears them, he doesn’t say; he never does. During his three years in custody, Cullen has never apologized or made excuses. He has never issued a statement, offered a public word, never faced the families of his victims. In fact, the only reason he’s in court today is because he wants to give away one of his kidneys.

To that end, he has cut a deal with prosecutors, agreeing to appear at his sentencing on the condition that he be allowed to donate an organ to the dying relative of a former girlfriend. To many of the families of his victims, this deal is a personal insult—the man in shackles still calling the shots, the serial-killer nurse wanting to control the fate of yet another human life. But for the families of his New Jersey victims, this is the first and last chance to confront Charles Cullen. So they are here, and they are angry.

“My only consolation is that you will die a thousand deaths in the arms of Satan,” yells the daughter of a man Cullen spiked with insulin. “I hope, with all my heart, that you are someone’s bitch in prison.”

“You are a pathetic little man,” says the woman whose mother-in-law Cullen killed with digoxin. “In prison, perhaps someone will choose to play God with Mr. Cullen, as he has played God with so many others.”

“Charles!” cries a round woman in a lime-green pantsuit. Her body shakes in rage and grief; her hands grip a photograph of her 38-year-old son, a picture taken before Charles Cullen stopped his heart. She is screaming. “Charles, why don’t you look up at me, huh? What are you, asleep?”

In fact, Charles Cullen is very much awake. His shackled hands, which look from a distance as pale and still as sleeping doves, twitch slightly in his lap, counting off silent prayers, Jesus Christ, son of God, have mercy on me, as if on invisible rosary beads; the expressionless shield of his cheek still tics when “burn in hell” hits his ear. His eyes open slightly, like a child pretending to be asleep, Cullen can see only a twilight view of the table, the cups, the stenographer with her leg crossed over the other, light shining hard off her shoes.

“The state asks for thirteen life sentences,” says the assistant prosecutor, and there is a wrinkle on Charles Cullen’s brow, a flexed cheek enunciating “thir-teen,” then the blankness returns, and there is again just what Cullen can see in front of him: the wooden table, the stack of pastel Dixie cups, a black plastic pitcher, and beyond, lit by her own little spotlight of halogen, the stenographer, her hands bouncing like puppets. And then Judge Armstrong is asking if the defendant has anything to say on his own behalf, anything at all about these horrendous crimes against man and nature, and the stenographer’s hands stop and wait. Cullen has no comment. With a rap of the gavel and screeching of chairs, it is over. Charles Cullen is hustled into a back room with men in riot gear holding automatic weapons, then he is gone, leaving behind a courtroom full of questions.

As far as the law is concerned, there isn’t much left for Cullen to say. On December 12, 2003, Cullen was brought in for one first-degree murder and one attempted murder as a critical-care nurse at Somerset Medical Center in Somerville. The next day, he shocked Somerville detectives by confessing to many more murders. Cullen told detectives that he killed the sick in order to end their suffering, but at some point, as Cullen spiked bags of IV saline in supply closets and killed patients who were not terminal, his compassion became compulsion, and when his personal life became stressful, killing became his outlet.

Exactly how many patients he murdered, we will never know: His memory of his crimes, he says, “is foggy,” and he drank heavily to make it foggier. He worked graveyard shifts in intensive-care units, largely unsupervised in a dark punctuated only by the beeps and breaths of medical machines. Many of the medical charts are missing or incomplete; the dead are now dust. His method was to overdose with drugs so common that sorting Cullen’s private death toll from the general cadence of hospital mortality is nearly impossible.

Cullen guessed that he had killed 40 people. So far, investigators have positively identified 29 victims (confirmation of a 30th victim is currently pending). It’s unlikely that the tally will ever be complete; even Cullen’s lawyer, Johnnie Mask, told prosecutors they weren’t finished. Some investigators with an intimate knowledge of the case are convinced that the real number is over 300. By that reckoning, Charles Cullen would be the biggest serial killer in American history.

After Cullen was arrested, New Jersey prosecutors agreed to take the death penalty off the table in exchange for his full cooperation. Cullen would help identify his dead, then spend the rest of his life in prison. He was 44 years old.

Months turned to years at the Somerville jail, and Charles Cullen’s life assumed a regularity he had rarely known as a free man. He had his cell, his spy novels, time to exercise or shower. Uniformed men turned the light off and on, governing day from night. Once a week, he met with his Catholic deacon or the head chaplain, the Reverend Kathleen Roney, and every so often, he never knew when, the guards would escort him across the lawn to the prosecutor’s office, to pull through the case files.

Cullen studied the scrawled medical charts, the arrhythmic EKGs, the final flatlines, and the blood work afterward—the primary investigator in the search for his own victims. There were new charts nearly every week, boxes of them, covering sixteen years of death at nine hospitals. Winter became spring and winter again, but Cullen just kept squirreling through the files with a cup of black coffee, getting thinner, getting it done; eventually, when the investigations were closed and the shouting echoed out, he could take his life sentences into a cell and disappear completely.

Then in August 2005, an envelope arrived at the Somerville jail. By now, Cullen was inured to the interview requests and the hate mail, even the odd “fan letter.” He never answered any of them, of course, but this was something new—a story about a man named Ernie Peckham, clipped with kitchen scissors from a local newspaper on Long Island. In the margin was a note in a girlish cursive: “Can you help?”

Cullen knew about Ernie—a guy about ten years younger than Cullen, with four kids and a wife at home and a job shaping metal in Farmingdale. Ernie was the brother of Cullen’s estranged ex-girlfriend, who was the mother of Cullen’s youngest child—a little girl he had never seen. Maybe he and Ernie had said hi once at a wedding years ago; Cullen couldn’t recall, but they weren’t friends, they weren’t even acquaintances, they certainly weren’t close enough to share organs. But an organ is what Ernie Peckham needed.

Doctors don’t know exactly how or when, but at some point in 2002, Ernie contracted strep. Probably it was just a little scratch that got infected, the sort of thing that either swells up and goes away or takes you out for a week with a sore throat that can be treated with a dose of antibiotics. But Ernie didn’t notice the infection, and it spread, overloading the microscopic filters in both of his kidneys.

Normally, these filters would have been removing toxins from Ernie’s blood; now they were like a sink clogged with hair. Ernie’s body began to bloat with its own poisons, swelling his hands and face and turning his urine the color of cocoa. By the time he saw a doctor, his kidneys were dead. Untreated, he’d be next. Doctors could filter Ernie’s blood three times a week with dialysis, but this was a stopgap measure; what Ernie really needed was a new kidney. Unfortunately, so did 60,000 other Americans. As Ernie’s health deteriorated, the seven-year waiting list for a cadaver donor would become a death sentence.

His only other option was to receive a kidney from a living donor (although most everyone has two kidneys, you only need one). The best way to match kidney with recipient is through a blood relative—but nobody in Ernie’s family, nor any of his friends, was medically eligible to donate. His only chance was to find the perfect stranger. But how many people are willing to donate an organ to someone they don’t know? Worse, the odds that Peckham would be a perfect six-for-six tissue-typed match with any one random donor were incalculably small. Ernie Peckham actually had a better chance of being struck by lightning.

Ernie’s mother, Pat Peckham, contacted the local paper to run a public-interest item with Ernie’s blood type above the hospital’s donation-hotline number. No miracle donor called.

Pat was running out of options for saving her son. And what would it take except a stamp? So, without telling Ernie, she clipped the article out of the paper, stuck it in an envelope to the Somerville prison, and waited for her miracle.

The thing about miracles, you can’t really predict what form they might take. They might come from anyone, even the serial killer who had knocked up her daughter.

The Reverend Kathleen Roney wears rock-collection-size birthstone rings on her fingers and Celtic charms around her clerical collar and paint-on eyebrows that flick like conductor’s batons as she talks. Roney started ministering to Cullen soon after his arrest. She figured the meditation techniques of the Desert Fathers would be appropriate for a man spending life in prison: The “Jesus Prayer” Cullen recited through his Somerset sentencing came from one of Roney’s tutorials.

Over the course of nearly three years, Roney had gotten to know Cullen, but that didn’t mean she understood him. She didn’t, for instance, understand why Cullen had killed so many people—but her job wasn’t to comprehend the serial killer, only to minister to the man. And she couldn’t quite understand why, suddenly, he was so desperate for her help to donate a kidney; 22 years as a jail chaplain, and nobody had ever asked for anything like it. “So that night I went to the jail and questioned him,” she says. “To make sure I wasn’t being used.”

Roney isn’t a big woman, but she’s blessed with the bullhorn voice and big-girl swagger that jail work requires, and she can turn it on when she has to. She called for Cullen, who was reading in his cell, and she asked him: “Why this? Why now? Do you want it for fame, or to rehabilitate your public image? Do you think you’re making some deal with God, to save a life to wipe out the lives you took?” Or did he hope that he might die on the operating table in some sort of passive suicide attempt?

“The questions seemed to really hurt his feelings,” Reverend Roney says. “But that was okay. I needed to know his heart.”

Roney said she’d think about it, and drove through the dark to pray in front of her icons. Charles had told her he was serious, that he wanted to see if he was a match. He wanted to donate because he was asked, and it was good. But should she believe him? The more she examined the question, the simpler it became. She was a minister, a Christian, and there was a life at stake, a guy on Long Island named Ernie. Cullen could never orchestrate a donation alone from behind bars. He needed her help—they needed her help. How could a compatibility test be a moral dilemma?

The hospital sent color-coded tubes for Cullen to bleed into. She would be the blood mule; Stony Brook hospital on Long Island would test his antigens against Ernie’s. From what she read on the Internet, a match was an incredible long shot. But at least everybody could say they tried.

When she asked her friends to pray with her that weekend, she didn’t tell them what they were praying for or for whom. “We needed to keep it secret,” she says. “And besides, could you ask every person to pray for a serial killer?”

Every equinox, Reverend Roney and like-minded Celtic Christians spend a week at a Druid spiritual retreat in Pennsylvania. It’s a profound time for her, a time of dancing around bonfires and meditating before icons and spirit-voyaging through unbounded acres of blond American farmland. Every morning, she’d walk the hard earth between the corn stubble, reciting her prayers, feeling the ancient wisdom, looking for a sign. It was then that she felt the vibration.

That was her cell phone—they encourage silence at these things, so she had it on vibrate—and right away, she knew what had happened. And her prayer group knew, too. In fact, the whole spiritual retreat knew what had happened; they just felt it and started to cry, because they knew. And she thought, This is it, it’s meant to be.

She’s crying now, retelling the story over an iced tea, ruining her mascara, remembering how Cullen was a perfect six-for-six antigen match, a match like winning the Publisher’s Clearing House sweepstakes, and she wipes the tears away with a Starbucks napkin. “Honestly, we thought it was a miracle,” she says. There would be more tests, X-rays, cat scans, tests with machines you couldn’t send to the jail by mail. But these were trivial compared with this spotlight in the darkness, a sign of God’s larger plan.

In that halcyon moment, Reverend Roney couldn’t imagine the lost friendships of her fellow Christians; she thought it was as easy as helping Charles donate to save a dying man. It was September; if she acted fast, the kidney would be like an early Christmas present.

When Roney called Pat Peckham, Pat didn’t believe her. “Are you sure?” she asked. It was so improbable, it was so—then Pat started to scream. “Then I’m screaming, then she’s crying, then I’m crying,” Roney remembers.

Roney would have loved to have seen the look on Ernie Peckham’s face when Pat told him the news. But Pat wasn’t going to tell her son, not for a while, and she certainly wouldn’t tell him the name of the donor. As sick as Ernie was, Pat was sure Ernie wouldn’t accept a kidney if he learned it came from Charles Cullen.

The Somerset County jail is a redbrick building conveniently catty-corner to the Somerville courthouse. On the other side of the metal detector is a wall of two-way mirrored plate glass backlit by video surveillance. Beyond that is the nine-by-five-foot cell where Charles Cullen had spent the past two and a half years of his life.

The sergeant buzzes me through a series of doors into a hallway partitioned into stainless-steel booths. Guards escort Charles Cullen onto the opposite stool. We nod mutely to each other across the bulletproof divide, and take a phone.

“Hello? Hello?”

“Hello?” I say. “Can you hear me?”

“Yeah,” he says. “I can make you out.” His voice is flat and quiet. I press the plastic phone hard to my ear, and Cullen notices. “Did you get in all right?” he says, louder.

“It took two hours,” I say.

Cullen glances up, reading my expression before retreating to the corners of the glass. “That happens,” he says. He nods once. “It changes in here, week to week.”

In pictures taken soon after his arrest, Cullen looks a little like Kevin Costner or a hollowed-out George Clooney—perhaps a bit colder, yet still a handsome guy with a bad haircut. But now, in the mercury vapor lights of the Somerset jail visiting room, Cullen looks chapped and anemic. Never an eater, he has become skeletal in jail. His face seems to hang from his cheekbones like a wet sail. A crucifix dangles from a chain over his collarbone, mixing with the sprigs of graying chest hairs where his shaven neck meets his prison togs—essentially mustard-yellow versions of hospital scrubs, insulated with a layer of white flannel underwear. His eyes dart and flash like a man holding his breath, waiting to talk.

He tells me about the afternoon when Reverend Roney came to his cell, excited to tell him that he was an “excellent match” for Ernie Peckham. Cullen was happy, but his years in jail had taught him that nothing would ever be simple. “The match means the donation will happen—it’s meant to happen,” Roney told him. “Yeah,” Cullen responded. “Well, I hope the courts think that.”

Cullen knew that if word ever got out that he was trying to donate a kidney, the whole thing would probably be over right there. He needed to keep it secret; nobody could know. “I mean, it’s not like I’d want the publicity,” Cullen says. “But mostly I thought that if it got out, it would be bad for the donation. The way people think of me, they would think I was trying to do something. But someone leaked it—I think it was the D.A., but I don’t really know. And now … ” he rolls his eyes. The press was having a field day.

“I know people see me as trying to control things; they think I’m trying to get something out of it. But the idea that I was trading my appearance at sentencing for the donation are out-and-out lies,” he says. “I was told by my lawyer, Mr. Mask, that I didn’t have to appear.” He shakes his head, and almost smiles. “I mean, you know, who would want to go? All those people that you—but the donation was important. The detectives suggested that I offer to go, to speed the donation along. They said I needed to give them something. But that’s not me holding a gun to the prosecution. It’s the other way around!

“I grant that I certainly have done some very bad things—I’ve taken lives,” he says quickly. “But does that prevent me from doing something positive?” Cullen folds a pale arm tightly across his chest and studies the counter. “That’s the funny thing,” he says. “People think you’re crazy for doing something for someone else if you don’t know them personally.”

The New Jersey office of the Public Defender is two stories of red brick with handicapped spaces and shrub landscaping and 300-pound women in nightgown-size Tweety Bird T-shirts smoking menthols by the double glass doors. In the offices upstairs, there are families in sweatpants waiting under fluorescent lights and a hole in the Plexiglas where you can announce yourself by sticking your mouth in and yelling politely.

Johnnie Mask’s office is in the back. The deputy public defender looks something like an Old Testament James Earl Jones—a big man with broad leonine features and a gray Ishmael beard gone grayer over three years defending the biggest serial killer in New Jersey history.

It was a nice idea, giving a kidney, but Mask wasn’t in it for the karma. “My motives were purely selfish,” Mask says. “Charlie was absolutely intent on making this donation happen. I was worried that if he didn’t get his way, he’d mess up my case, and all my hard work would go down the drain. More work for me, more expenses for the state—there was no way I was going to let that happen.”

But right from the beginning, Mask saw signs that this thing might not go through. “Judge Armstrong signed the order for the blood test, but I don’t think anybody really expected he’d actually be a match for Ernie,” Mask says. “When he was, and it got into the papers, suddenly there are all these problems. The judge and the prosecutor and the victims’ families got up in arms about Cullen going into a hospital again—they figured he’d kill somebody, or probably himself. Then everyone would be cheated out of their ability to yell and scream at him.”

Mask was told that the donation was possible only after Cullen was sentenced. That was supposed to happen by December 2005, but a month later, two counties still hadn’t even finished their investigations. “That’s why on January 10, Charlie stopped cooperating with the prosecution, saying ‘Sentence me now.’ ” By breaking his plea agreement, Cullen seemed to be risking the death penalty for the donation, but really it was a tactical move by Mask. “It forced their hand. We realized that by the time they finished, Ernie might be dead.” (As of this printing, investigations in Essex and Morris counties are still open.)

They were months behind schedule, but, in theory, Cullen was about to be transported to Stony Brook Medical Center and donate his kidney side by side with Peckham. “But when [Attorney General Peter] Harvey wanted Cullen to cooperate, he was saying, you know, ‘We’ll work out the details later, but it will happen,’ ” Mask recalls. “We were counting on those promises, but he just wanted to wrap up the case before he took on his new job in the private sector.”

A few weeks later, weeks when Ernie Peckham’s condition continued to deteriorate, Mask walked by the desk of Vaughn McCoy, who was then the director of New Jersey’s Division of Criminal Justice. “I asked him what the status was. He pulled up some e-mails and said, ‘Well, apparently Stony Brook doesn’t want Mr. Cullen in their hospital.’ I tried to lean over and read it off his monitor, but he sort of blocked me.” Mask smiles joylessly. “Said it was confidential.”

By now it was February. “So what can you do? Then the old A.G. leaves, and the new attorney general’s office tells us Cullen can’t travel to New York anyway—it’s not legally feasible!” Mask shakes his head at what’s become an old joke.

“I don’t know what’s true now. We thought it would happen in January. Stony Brook keeps giving us new dates—they’re saying April now; before, it was March. And Charlie’s getting more aggravated every day. I think [allowing the] donation was always just a big dangling carrot to get Charlie to jump.” It was the only reason Cullen agreed to appear at the sentencing in New Jersey. Mask was still working toward the donation, but he’d bet Roney a dinner it would never happen.

It was a good bet, especially considering what was about to happen at Cullen’s next court appearance.

*****

The New Jersey courts were done with Charles Cullen, but Pennsylvania still had unfinished business, and so as Ernie Peckham’s condition worsened even more, Cullen was transported west to stand trial for the six murders and three attempted murders he committed in Lehigh County, while working at the hospitals surrounding Allentown.

Allentown is a poor steel town living in the ruins of a rich one, and the downtown is a grand, ceremonial public space of imported stone and soaring columns and busted crazies rooting for cans, joined now by a small parade of families in dark, formal clothes with little blue stickers from OfficeMax gummed to their lapels to show they’re families of the victims of the Angel of Death.

In a legal sense, sentencing Cullen for his Pennsylvania crimes is perfunctory—he won’t be finished serving his New Jersey sentence until the year 2347—but for the families of patients Cullen killed here, today’s sentencing is their only chance to confront the Angel of Death with their memories and their anger. It’s also an opportunity for Cullen, a final shot at showing the world that he is, as he claims, a killer with compassion. A public demonstration of that compassion would go a long way toward saving Ernie Peckham’s life. In Pennsylvania, Cullen could do what he hadn’t done in New Jersey.

Just like the victims’ families at Cullen’s New Jersey trial, the families who fill the Allentown jury box have brought poems and speeches and photographs of the dead and are prepared to exercise their right to confront the killer. But this time, Cullen rises to speak—reciting, from memory, statements Cullen believes have been hostile to him that the judge has made to the press.

“And for this reason, your honor,” Cullen says, “you need to step down.”

Judge William Platt is not amused. “Your motion to recuse is denied,” he says.

“No, no, your honor,” Cullen insists. “You need—you need to step down. Your honor, you need to step down.”

“If you continue this, I will gag and manacle you,” the judge warns.

Cullen shouts over him. “Your honor, you need to step down!” he says. “Your honor, you need to step down! Your honor…”

The high marble walls make this court a beautiful room but a terrible courtroom, amplifying and distorting all sound. Cullen fills this room. The families wait as Cullen gets to speed-shouting his statement ten times, 30, 40. He’s not going to stop, and now the court officers are on him.

They pull a spit mask over his head—a mesh veil that keeps a prisoner from hawking loogies on his captors—but the noise continues. They wrap the spit mask with a towel and screw it behind his head and now Cullen sounds like a man screaming into a pillow. The families of the victims try to read. “You are a total waste of a human body.” “You are the worst kind of monster, a son of the devil.” But soon the sergeant’s hands begin to cramp, and chorus by chorus, Cullen’s voice gets clearer. Judge Platt nods, and the sergeant produces a roll of duct tape the size of a dinner plate, and tapes a big cartoonish X over Cullen’s lips, which does nothing. And so the victims read their personal statements, and Cullen screams his, like a nightmarish version of “Row, Row, Row Your Boat.”

“If my grandmother was alive right now, she’s say to you, ‘I hope you rot in hell, you sick son of a bitch.’”

“Your honor, you must step down. Your honor, you must step down.”

“Six more life sentences, served concurrently with those already handed down.”

“Must step down. Your honor, you must…”

And with a final “Such that you will remain in prison for the rest of your natural life,” the court officers frog-march Cullen—bound, gagged, duct-taped—into a waiting elevator. He is still chanting when the doors close. The silence that follows is terrible, too.

Afterward, the families huddle in the hallway, shaken and unsatisfied. “I think he intentionally meant disrespect to everyone in that courtroom,” says Julie Sanders, a friend of one of Cullen’s victims. Sanders stabs her finger toward the hole in the air where Cullen had been. “He says he is a compassionate man, that he wants to donate a kidney to save someone’s life. I needed to say something to him: Where’s the compassion now? Does he know what he’s done to our lives?”

*****

Now what Mask and Roney had wasn’t a legal problem—they had a court order authorizing the donation from Judge Armstrong—it was bigger. “Basically, there’s not a lot of goodwill toward Charlie Cullen among the citizens of New Jersey,” Mask says. “Nobody wants to seem to be kowtowing to a serial killer’s requests. Some of the families see his donation request as a slap in the face. It’s like he’s asking them for a favor.”

After the scene at Allentown, Cullen’s kidney was simply too hot to handle. Roney would call the D.A.’s office, which told her to call the New Jersey Department of Corrections, who’d tell her to call the hospital. Months passed with no answers, no schedule, no deadline. If the donation was going to proceed, there were state and private institutions to coordinate, insurances to interface. The Corrections Department would need to guard Cullen in the hospital, against escape and vigilantes and, because he had already attempted suicide multiple times, Cullen himself. The only ones with real deadlines were Cullen and Ernie. Cullen’s donor test was valid for only a year; Ernie might not even survive that long.

And then there was the kidney, which would need to travel 125 miles from Cullen’s hospital in New Jersey to Peckham’s hospital on Long Island fast enough to keep it viable. Depending on traffic, that could be a bitch of a drive. A construction snarl or a fender bender or even a Hamptons rush hour could imperil Ernie’s life, but who was going to pay for a helicopter?

Ironing out the details would require a lot of hard, unpaid work by a great number of people, but at this point, Cullen was the last guy anyone wanted to do a favor for. That’s how they saw it, a favor to Cullen, not a way to save another man’s life. “It’s his choice, he’s a grown man, but realistically, the stuff he does in front of the victims’ families isn’t winning him any points either,” Mask says.

“And Charlie doesn’t really feel bad about any of this. He’s concerned how it affects his kids, but he doesn’t feel bad. And Charlie’s not the kind of guy to fake it,” says Mask. “It makes some people feel like he’s getting away with something.” Prison was supposed to take away his options. And yet there he was, still making demands.

After Allentown, his final sentencing, Cullen was shackled in the back of a windowless van. He was met at the Trenton prison by guards in riot gear. They strip-searched him, gave him prison clothes, and led him to the psych ward, where they took the clothes away and strip-searched him for a second time. He was handed a disposable gown like medical patients wear, but it was made from the stuff they wrap around new TV sets, and he was put into a padded room for a 72-hour observation period. The gown shredded after the first day. He tried not to listen to the “time for your insulin” comments from the guards, focusing instead on Psalm 25: “My enemies are many, they hate me. Deliver me, let me not be ashamed.” Then he was given clothes again and moved into DD Block, where he was to serve his now eighteen life sentences, and where I visit him again.

From the Trenton River Line train, the prison appears as a block of brick and razor wire across the highway from a McDonald’s. Another minute’s walk past the front gate gets you to a security check-in with a metal detector and a uniformed guard. After a pat-down, you’re buzzed through three bolted steel doors and into a guarded hallway partitioned into steel booths. I find Cullen waiting in the third one, waving a little hello. We nod mutely across the bulletproof divide, and plug in our phones. There is static, then breath.

Cullen and I had been communicating through letters for nearly a year, and I had learned a lot about the man—his accidental entry into nursing school and his first job scrubbing dead skin from burn victims, the depressions and suicide attempts and marital problems, his drinking and his hospitals and his sixteen-year murder spree. But even knowing the facts, I was still unable to fully connect the mild man across the glass with the serial killer and his monstrous crimes.

I tell him that some of the families of his victims are against the kidney donation, that they see it as special treatment for a serial killer, and nothing more. “I’m trying to get something? I’m in prison, I can’t control—there’s nothing to bargain for—no island off the coast of New Jersey that they send you to torture you, no Guantánamo Bay. All I can do is sit in a cell. And I know that New Jersey doesn’t make license plates anymore, so what would the families rather I did, just sit and watch TV?”

Cullen is indignant at a system that he said was willing to sacrifice an Ernie Peckham to punish a Charles Cullen. Saving a relative stranger’s life is undoubtedly heroic—would you give up a kidney?

Of course, heroic compassion is easier to talk about than mass murder. I can admire Cullen for the one and hate him for the other, but I have no idea how to connect the two—they seemed to be the actions of two very different men. And so I ask him: Is it any wonder people question your motives? You’re in prison for having taken dozens of lives, and yet now you’re fighting to save one. It seems … inconsistent.

Cullen is only a foot away, on the other side of the glass, but I cannot decipher his expression. Then he glances to the side of the glass, as if reading there, and slowly begins to speak.

“If you’re asking if I knew what I was doing was wrong,” he says, “I saw that I was stopping pain, removing pain. I saw it as shortening the duration of the pain, ending pain. Sometimes the pain was patients who were suffering and terminal; sometimes it was the pain of families being ripped apart; sometimes it was the lives of patients that would only be tied up in an endless series of procedures and complications and pain.

“But if you’re asking—well, I knew that it was illegal,” Cullen says. “And that it wasn’t my choice to make. But it’s how I thought about it. I felt compelled to do what I did. I didn’t see it as bad. I did know it was illegal.”

Cullen is looking at the table but not looking at it. I don’t know what he sees. “But, if you’re asking, when I was asked to donate a kidney, I felt that I did what I would normally do, in any circumstance. To be helpful. It was something that I could do. It was something that was needed. I was asked to do it, and it’s possible. And I felt compelled to, because I could do it and I was asked to.”

I don’t know what I expected from his answer. Ultimately, the only answer to the question of “why” is, simply, “because.” Cullen did what he felt he needed to, or wanted to, or could; at some point, they had become the same thing. In such a tyranny, bad and good don’t figure. It’s a simple answer, but it’s the only one that makes sense.

Cullen fixes me with a look, then takes his glance away, as if to study my response in private. “I know a lot of people find it surprising that someone like me would want to do this, donate. But for me, it’s totally consistent. For me, as a nurse, it’s what I would do, what I would have always done. It’s who I am. But if you need to wonder why I should, or why someone like me would, well, it really depends on how you think of people. And what you think people are capable of.”

As it happens, it was a Tuesday when the waiting ended. They came for Cullen in the night, guards with keys and handcuffs. He was going to the prison’s medical center at St. Francis hospital. If they knew why, they wouldn’t say. They gave him the paper gown again, drew his blood, cuffed him to the bed. The television in the corner was always on, local news, Oprah. A day passed, and he thought, Here we go again. He had only fourteen more days before his donor tests expired, but this wasn’t the donation. It was something else.

The guards came again in the morning. They were taking him downstairs; they didn’t say why. He was instructed to respond only to direct questions. He was told that Charles Cullen was not his name. His name was now Jonny Quest. The doctor called him Mr. Quest. It was a security measure, but also someone’s idea of a joke. Cullen thought it was funny. “It could have been worse,” he said later. “Saddam Hussein or something.”

They gave him something to relax him, Valium, he thinks; they wouldn’t say. It made him woozy. They gave him forms to sign. He held the pen, unsure of which name to use. “Use the one you’re supposed to,” the doctor said. He’d watched the cartoons as a kid, he remembered the handsome blond boy and his adventures, a helpful boy with skills, full of potential. He signed the paper “Jonny Quest.” It wasn’t legally binding, of course, so they gave him another form that he was to sign “Charles Cullen, a.k.a. Jonny Quest.” The nurse looked away when he did this. It was supposed to be a secret. Then they gave him another shot, and now he was feeling kinda gone.

An hour later, Jonny Quest’s kidney was tucked into a cooler and readied for its journey. It would have been crazy to risk traffic, so it likely flew via a Life Star helicopter, northeast from Trenton, keeping Manhattan on its left, banking up Long Island. That day the traffic far below was heavy with Hamptons weekenders, a line of lights leading past the massive Stony Brook medical complex, lit on the dark hillside like Bilbao under construction.

I parked in the C lot. On weekend nights, hospitals are usually busy only after the bars close and usually only in the emergency room. At 8 p.m., the main lobby was as quiet as a dead department store. A guard read yesterday’s newspaper again; the gift shop was just Mylar balloons in darkness. Surgery is on the fourth floor, with the burn unit and radiology. The kidney took the back elevator; I took the front.

In the surgical waiting room, the TV is always on, approximating normality for the families camped there, the children and their mothers holding each other, the men clutching Dunkin’ Donuts cups. This TV played the movie Freaky Friday, two people switching bodies and identities and, it being Hollywood and Disney at that, coming closer together as a result. But that was just a movie. For transplants, parts are parts. You take what you can get to survive.

And so, while Jamie Lee Curtis and Lindsay Lohan had their first mother-daughter argument about whose life was more difficult, Ernie Peckham lay face up on a table, anesthetized and encircled by masked strangers in disposable blue clothes. Some traced a curved incision through the fat of his abdomen, others parted the draped muscles of his belly wall with cool steel clamps. Johnny Quest’s kidney was about the size of a surgeon’s hand, a quivering bean shape mottled in yellowish fat that nested neatly into the half-shell of Peckham’s pelvis. A stump of renal artery, pruned only hours before from its owner’s aortal stalk, was patched into Ernie’s blood supply with 5-0 suture wire; vein was stitched to vein. And later, as Jamie Lee and Lindsay, back in their own bodies again, smiled knowingly at each other across a climactic concert scene, a surgical clamp was removed from an external iliac artery, and Jonny Quest’s kidney swelled pink with oxygenated blood, alive again—Ernie Peckham’s kidney now.

Underneath the xenon lamps, this medical miracle didn’t look like much more than cauterized gristle in a blue paper hole. It showed nothing of the millions of tiny tubules stacked inside its medulla, or the arterial branches, as infinite as crystals in frost, that would filter his blood as a brain filters choices, sorting bad from good as well as humanly possible.