Killer Minds: Serial Killers & True Crime Murders

Episode: SERIAL KILLER: The Killer Nurse Pt. 1

Hosts: Vanessa Richardson & Dr. Tristan Engels
Date: November 3, 2025

Episode Overview

This gripping first installment explores the chilling life and psychology of Charles Cullen, the so-called "Killer Nurse," regarded as one of America's most prolific serial killers. Hosts Vanessa Richardson and clinical and forensic psychologist Dr. Tristan Engels trace Cullen’s traumatic upbringing, early signs of dangerous behavior, and his calculated infiltration of the nursing profession as a vehicle for revenge against the healthcare system. The episode blends storytelling with expert psychological analysis, delving into what drove Cullen to literally “poison the system from within,” with chilling anecdotes and in-depth commentary on the warning signs that went unheeded.

Key Discussion Points & Insights

Early Life: Loss, Neglect, & Origin of Dysfunction

• Childhood Trauma:

  • Youngest of eight, born into a working-class Irish Catholic family (04:30).
  • Father died before Charles turned one; mother worked multiple jobs, leaving Charles feeling invisible and neglected.
  • Siblings' rotating presence and their troubled relationships introduced Charles to chaotic and abusive male figures.

• Neglect & Vulnerability:

  • Dr. Engels notes, "Losing his father and having an overwhelmed single parent amplified that invisibility...at high risk for an insecure attachment style...undermines emotion regulation, stress tolerance, and impulse control." (05:30)
  • Exposure to abuse at home led Charles to extreme coping strategies at an early age—attempting to poison an abusive boyfriend and then himself (06:18-07:43).

• Expert Analysis on Poisoning:

  • Dr. Engels emphasizes the significance: "Children who attempt to poison often do so because of neglectful environments, mental health issues like depression, or antisocial behavior... It's non-confrontational... practical for a small child." (07:43)
  • Early suicidal behavior in a child predicts chronic difficulties: "Early suicidal ideation also predicts higher lethality later if it goes untreated." (09:20)

The Impact of Loss & Mistrust

• Mother’s Death:

  • At age 17, Cullen’s mother dies in an accident; he is denied closure when told her body was already cremated (10:01).
  • Dr. Engels: "His mistrust in others only deepened...he cannot even verify that himself for closure...He lost trust in adult institutions, medical and psychiatric and their systems." (11:56)

• Aftermath:

  • Charles refuses psychiatric help, concludes he never really wanted to die due to religious beliefs (13:25).
  • Attempts to escape home life by joining the Navy; experiences social isolation and bullying, escalating substance abuse (14:47).

From Poison to Poisoner: Evolution of Dysfunctional Coping

• Manipulating the System for Escape:

  • Charles abuses cleaning solution, feigning a suicide attempt to escape the Navy (14:58).
  • Dr. Engels points to dependency red flags and notes that repeated failure to get help or escape only "festered resentment...towards healthcare workers." (14:47, 16:00)

• Turning to Nursing:

  • Driven by vendetta, Charles enrolls in nursing school—at the very hospital where his mother died (17:37).
  • Dr. Engels observes: "By choosing that location, he is gaining psychological control over the people he blamed as well as proximity to the loss he had." (17:37)

The “Killer Nurse” Emerges

• Methodical Infiltration:

  • Charles excels in nursing school, elected class president, hides his dark motives and troubled past (19:16).
  • Marries Adrienne, playing the role of devoted husband and soon, father.

• First Forays Into Medical Malfeasance:

  • Night shift in burn unit exposes Charles to suffering children—he projects his own trauma and disregards protocols, steals morphine for pediatric patients (20:00-21:55).
  • Dr. Engels links this to distortion and projection: "He's projecting his own pain onto these children...lets him frame killing as mercy. But it's a way to regain agency and control—masking revenge as care." (21:55)

• Escalation and Rationalization:

  • Defies hospital protocols under a ‘compassion’ facade—a classic case of moral disengagement.
  • Dr. Engels: "People who resent authority often recast their defiance as compassion...they reframe their harmful acts as justified, or they downplay the victim's suffering." (23:20)

First Murder and Attempts to Evade Detection

• First Confirmed Murder:

  • June 1988: Injects 72-year-old John Yango with a lethal dose of lidocaine "to show staff how incompetent they were" (25:30).
  • Dr. Engels discusses the logic: "Killing a recovering patient can be a way to resolve cognitive dissonance...allows him to make others share his misery or deny them hope...a need for control may be the primary driving force." (26:25)

• Spiking IV Bags, sowing chaos:

  • Tampering with IV bags using insulin; nearly kills patient Anna Byers, whose medical crisis is finally linked to Cullen’s sabotage (28:42-34:16).

• Pattern of Escalation:

  • Dr. Engels draws links to predatory behavior: "He selected vulnerable targets, used his clinical knowledge as his method and exploited routine workflows to move unseen...a reinforcing feedback loop." (32:16)

Evasion, Institutional Failures, and Early Warnings

• Investigation & Response:

  • Hospital investigation initiated only after numerous suspicious events; Cullen interviewed—flatly tells security, "You can't prove anything." (36:48)
  • Despite obvious suspicions, lack of hard evidence allows Cullen to slip away; simply taken off the schedule instead of being reported (38:46).

• Institutional Consequences—or Lack Thereof:

  • Dr. Engels: "Feeling successful and harming others reinforces the behavior for Charles and inadvertently confirms to him that his methods are working...can result in more refined methods." (38:46)

• Serial Manipulation and Escalating Control Needs:

  • New job at Warren Hospital thanks to favorable recommendations (39:55).
  • Marital breakdown, substance abuse, and attempted suicide gesture—Dr. Engels interprets as manipulation, an attempt to "regain control" over institutions and people (41:58).
  • Fixation on colleague Michelle—escalates to stalking and breaking into her home (44:13-46:04).
  • Dr. Engels: "This sequence of obsession, surveillance, and forced covert entry are strong predictors of future physical violence...likely ruminating over the loss of control." (46:04)

Systemic Issues and Missed Red Flags

• Institutional Support Despite Red Flags:

  • After brief institutionalization for stalking, Cullen is welcomed back to work; Michelle remains frightened, but the hospital does not intervene (47:32).

• Final Reflection:

  • Dr. Engels articulates: "He is now the incompetent and untrustworthy medical provider that families should fear," highlighting the tragic irony of his trajectory. (38:46)

Notable Quotes & Memorable Moments

• "He decided to wreak havoc on the institution he felt had wronged him and give them a taste of their own medicine." – Vanessa Richardson [00:49]
• "It's non-confrontational, meaning it doesn't require physical overpowering and it's otherwise concealed, which is practical for a small child." – Dr. Tristan Engels [07:43]
• "Foreclosure, Charles needed concrete proof to grieve because he didn't trust people to be truthful psychologically." – Dr. Tristan Engels [11:56]
• "He's also grooming an entire system, not just individual people or victims. And that's highly manipulative." – Dr. Tristan Engels [18:19]
• "[Cullen] never got reliable care or comfort...what he did when he was a child is he resorted to attempting suicide to end his pain. Clinically, what we're seeing here is projection plus identification with the aggressor." – Dr. Tristan Engels [21:55]
• "He is now the incompetent and untrustworthy medical provider that families should fear." – Dr. Tristan Engels [38:46]
• "Breaking into her home got her attention...by confessing she now knew what he was capable of. It was his version of signaling dominance, and it was his attempt at coercive control." – Dr. Tristan Engels [46:59]

Key Timestamps

• 04:30 – Charles Cullen’s early years and family background
• 05:30 – Dr. Engels on neglect and its psychological consequences
• 06:18 & 07:43 – Early poisoning attempts and child psychology of poisoners
• 09:20 – Risks of early suicidal behavior
• 11:56 – Dr. Engels on the impact of his mother’s death and loss of trust
• 13:25 – Religious beliefs and motivation for life
• 14:47 – Experiencing bullying and substance abuse in the Navy
• 17:37 – Cullen’s vengeful decision to enter nursing at the site of his grief
• 19:16 – Elects class president, crafts a false persona
• 21:55 – Administers illegal morphine to children; psychological projection explained
• 23:20 – Rationalizing harm under the guise of compassion
• 25:30 – First murder; Dr. Engels explains motives
• 32:16 – Behavioral escalation and victim selection
• 38:46 – Mishandled institutional response emboldens Cullen
• 41:58 – Manipulative suicide gestures and need for control
• 46:04 – Stalking and breaking into Michelle’s home as escalation
• 47:32 – No serious consequences, and return to work

Takeaways

• Failure to Intervene: Despite mounting evidence and multiple red flags, both domestic and institutional systems failed to protect Cullen’s victims or to intervene when he displayed obviously disturbed and dangerous behavior.
• Psychological Complexity: The interplay of trauma, projection, moral disengagement, and manipulation is expertly dissected, showing not just how serial killers operate, but why they may justify their actions to themselves.
• Systemic Vulnerabilities: Institutional reluctance to act on suspicion, lack of checks and balances, and the culture of silence surrounding medical professionals all contributed to Cullen’s ability to continue his crimes.
• Next Episode Preview: The episode closes with a teaser for part two, promising to continue the story of Cullen’s killing spree across multiple hospitals.

This episode is a chilling exploration of the making and methods of the "Killer Nurse," Charles Cullen, skillfully combining narrative, psychology, and real-world institutional lessons for all true crime enthusiasts.