Ep.3: Ward C

Summary

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Mind of a Monster: The Killer Nurse

Episode 3: Ward C

Host: Dr. Michelle Ward
Date: October 7, 2025

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Episode Overview

In this gripping installment, Dr. Michelle Ward explores the escalating pattern of deaths and emergency codes in Ward C at the Veterans Affairs Medical Center in Massachusetts, zeroing in on nurse Kristen Gilbert's increasingly suspicious behavior. The episode delves into how staff members began to suspect Kristen, the forensic methods used to detect medical serial killers, and the chilling motives that drive such crimes. Personal accounts from families, nurses, and psychological experts bring fresh insight into the culture of cover-up and the bravery of whistleblowers who stepped forward.

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Key Discussion Points & Insights

1. Strange Patterns in Patient Decline (03:33–06:02)

• Francis Marier’s Close Call: WWII veteran Francis Marier suffers an unexplained cardiac arrest shortly after Kristen’s intervention, despite no prior heart issues.
  • “It is unheard of for a patient to encounter serious heart issues following an injection of glucose. What has gone wrong?” – Dr. Michelle Ward [03:58]
• Statistical anomalies:
  • In 1995 there were four times as many deaths on Kristen’s evening shift (nearly 40), compared to 10 or fewer on other shifts.
  • Kristen activated the emergency alarm 72 times from 1989–1995, matching the total by all other nurses combined.

2. Colleague Suspicion & Recognition (06:02–12:26)

• Nurse Awareness:
  • Beatrice Yorker (criminal justice professor and nurse) explains why nurses notice irregularities before doctors:
    • “Nurses know each other. They know patients. Nurses know how hospitals are run, where things are kept, who comes and goes. Doctors come and go.” – Nurse Kathy Ricks [09:31]
• Building a Pattern:
  • Nurses like Kathy Ricks become alert to recurring codes on Kristen’s shifts, despite initial reluctance to suspect a colleague:
    • “She didn’t want to think it, but it was just. It was happening too often.” – Nurse Kathy Ricks [11:31]
• Obstacles:
  • Medical records are withheld or sent out, further stoking suspicion among families and staff.

3. How Killer Nurses Operate (14:27–20:03)

• Medical Murder Methods:
  • Most common is lethal injection via IV lines, with the favored drugs being potassium chloride, insulin, epinephrine, and even air.
  • Potassium chloride and epinephrine are difficult to detect in autopsies, making them popular with medical murderers.
  • “If you draw up a syringe with 10cc’s of air and you inject that air into an IV line, you will cause a heart attack.” – Beatrice Yorker [15:08]
• Motives & Modus Operandi:
  • Many are motivated by drama and attention, not mercy.
  • Creating “codes” allows the nurse to stand in the spotlight—either as savior or as instigator of chaos.

4. Patterns Recognized in Kristen’s Conduct (23:01–30:52)

• Escalation:
  • Multiple suspicious deaths under Kristen’s care are recounted:
    • Thomas Callahan goes into cardiac arrest with no clear cause [23:01–25:09]
    • Kenneth Cutting, a stable patient, dies abruptly after Kristen expresses a wish to leave early if he dies [29:31–30:19]
      • “Can I go home early if Kenneth dies tonight?” – Dr. Michelle Ward recounts Kristen’s words [29:31]
    • Lax record-keeping and casual possession of epinephrine by Kristen raise alarms.
  • Kristen is described as showing chilling lack of empathy and immediacy to resume her social life after deaths [30:19–30:52].

5. Psychological Profile and Motives (33:10–41:22)

• Common Traits in Medical Serial Killers:
  • Lie frequently, keep medications at home, skip between jobs, crave attention, prefer late shifts.
  • “They want to be the center of attention. They want to demonstrate their skills. These are not people who are slackers.” – Dr. Katherine Ramsland [34:05]
• The Munchausen by Proxy Link:
  • Motive often tied to “hero syndrome” or Munchausen by proxy—causing harm to draw attention and validation.
  • “I’m like those firefighters who set fires. That is the essence of...the Munchausen by proxy crisis causer.” – Reference to Richard Angelo, quoted by Beatrice Yorker [41:08]

6. The Whistleblowers Step In (41:22–47:29)

• Tracking the Drugs:
  • Kathy Ricks tracks epinephrine vials, noticing alarming depletion corresponding with Kristen’s shifts.
  • “Before she left, there were 18 vials...She checks again. There are now three.” – Dr. Michelle Ward [42:00–42:53]
• Final Straw & Reporting:
  • After another code and empty epinephrine stores, Kathy and others report Kristen to the nurse manager [46:40].
  • Episode closes with a tense meeting:
    • “Who here thinks Kristen Gilbert murdered the patients?...And all the investigators raised their hand.” – Narrator/Host [47:18]

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Notable Quotes & Memorable Moments

• “It is unheard of for a patient to encounter serious heart issues following an injection of glucose. What has gone wrong?”
  – Dr. Michelle Ward [03:58]

• “Nurses know how hospitals are run...the doctor typically isn’t as involved with hospital life as everybody thinks they are. We do everything that’s right, so we’re aware of everything. And when something is out of kilter...you know what became routine.”
  – Nurse Kathy Ricks [09:31–10:41]

• “If you draw up a syringe with 10cc’s of air and you inject that air into an IV line, you will cause a heart attack.”
  – Beatrice Yorker [15:08]

• “She didn’t want to think it, but it was just. It was happening too often. I mean, their unit started getting a reputation after a while. And she. She was curious.”
  – Nurse Kathy Ricks [11:31]

• “They want to be the center of attention. They want to demonstrate their skills...They are people who do, you know, overwork, who come in and take extra hours because they want to be around when these things happen.”
  – Dr. Katherine Ramsland [34:05]

• “Can I go home early if Kenneth dies tonight?”
  – Kristin Gilbert (recounted), [29:31]

• “I’m like those firefighters who set fires. That is the essence of...the Munchausen by proxy crisis causer.”
  – Beatrice Yorker, referencing Richard Angelo [41:08]

• “Who here thinks Kristen Gilbert murdered the patients?” — “And all the investigators raised their hand.”
  – Narrator/Host with Family Member/Relative [47:18]

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Timestamps for Important Segments

• 03:33 – Suspicious events with Francis Marier and sudden cardiac arrest
• 04:59 – Statistical overview: High death rate during Kristen’s shifts
• 06:02 – Nurse Beatrice Yorker describes resuscitation patterns as red flags in serial killings
• 09:31 – Insight into nurse awareness and hospital routines from Kathy Ricks
• 14:27 – Discussion about typical methods used by healthcare serial killers
• 23:01 – Case of Thomas Callahan and medication anomalies in the ICU
• 29:31 – The abrupt death of Kenneth Cutting and Kristen’s chilling request
• 33:10 – Dr. Katherine Ramsland on profiling medical serial killers
• 41:22 – Munchausen by proxy explained as a motive
• 42:00 – Depleting epinephrine supplies in the ICU linked to Kristen’s shifts
• 47:18 – Investigators collectively suspect Kristen following staff reporting

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Tone & Style

The episode is methodical, clinical, and compassionate in tone, reflective of Dr. Ward’s background as a psychologist. The narrative alternates between deeply personal recollections of families, the chilling matter-of-fact observations of medical staff, and forensic-level analysis. The frustration, disbelief, and mounting courage of whistleblowers are palpable, underscoring the gravity of the crisis in Ward C.

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This summary covers all critical developments in the episode—from the unraveling of Kristen Gilbert’s pattern of subterfuge, to the formation of a groundswell of suspicion and the brave, coordinated stand taken by staff to halt the killing spree. The expert interviews and personal stories combine to keep the listener riveted and deeply unsettled by the realities of medical serial killers.

Transcript

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[Dr. Michelle Ward]

This podcast explores themes of violence, self harm and murder. Listener discretion is advised. Please note some of the voices you hear in this series have been performed by actors. Previously on Mind of a Monster. The Killer Nurse.

[Narrator/Host]

Suddenly, Stanley Jagadowski began to scream out Stop. Stop. It's burning me. It hurts. I said I want an autopsy.

[Dr. Michelle Ward]

Kristen Gilbert is a health care serial killer convicted of murdering four patients, attempting to murder two more, and suspected of killing dozens of others. Her victim count could be as high as in the hundreds. From ID and Arrow Media, I'm criminal psychologist Dr. Michelle Ward and this is Mind of a the killer nurse. Chapter 3, Ward C. It's late December 1995 and as Christmas draws closer, 72 year old World War II veteran Francis Marier is admitted to Ward C. A diabetic, Marrier has been a frequent visitor to the medical facility for a long while. His Admittance this time is simply to treat ulcers. His heart is fine, so much so that the medical team doesn't see a need to fix him to a heart monitor. He's in a regular room, not the ICU, on December 20. All his signs that day have been normal. But something changes within an hour of nurse Kristen Gilbert taking over his care. Tonight, she has plans of her own. She wants to go out to socialize, but her request to leave has been denied by the charge nurse. Entering Mario's room, she notes that his blood sugar levels have dropped alarmingly low and claims to have administered a strong glucose injection to help bring the levels back up again. Only instead of helping, the injection she claims triggers a cardiac arrest. An emergency code is called, and the medical team descends. Marier pulls through. For a man who has survived D Day, it is another extremely close call. But like D Day, his sudden cardiac arrest defies all odds. It is unheard of for a patient to encounter serious heart issues following an injection of glucose. What has gone wrong? Christmas comes and goes, and Kristen's relationship with VAMC Veterans Affairs Medical Center Police officer James Perolt continues to develop. Soon after the possible poisoning of her husband, Glenn, in November 1995, Kristin moves out of the family home and into an apartment by herself. She and James spend almost all of their free time together.

[Narrator/Host]

James Perrault I had strong feelings for her. I wasn't in love with her at the time, but I was very attracted to her, and I thought that would potentially have something in the future. We would stop and have our meals and take our breaks together. I'd go up to see her in the ICU and she would come down to admissions and see me down there.

[Dr. Michelle Ward]

By early January 1996, we have two unexpected deaths linked to Kristen Gilbert, those of Stanley Jagadowski and Henry Houdon, plus the curious instance with Francis Marier.

[Dr. Katherine Ramsland]

Boy.

[Dr. Michelle Ward]

But I've been looking at the statistics related to this case, and the numbers are astonishing. During the year of 1995, there are four times as many deaths on Kristen's evening shift than either of the other two shifts on board C, close to 40, compared to 10 and less on each of the others. And it's not just the deaths that stand out. There's also this huge rise in emergency codes, too. From 1989 to 1995, Kristin activates the emergency alarm 72 times, compared to a total of 70 for all of the other nurses combined. Usually there are five or six members working on each shift, depending on the number of patients on the ward, meaning Kristen had around four times more deaths on her shift. Some are for patients who are resuscitated multiple times before dying. I can't help but think that this should be ringing more than just emergency alarm bells. Beatrice Yorker is a nurse and a professor of criminal justice at California State University.

[Narrator/Host]

I just want to point out, because this is common throughout the healthcare serial murders. When a patient flatlines, they die. They're dead. And that CPR is really only successful if something has altered the pattern of the heart's beat. For example, an electric shock struck by lightning, a drowning, something like that. For most patients, when you die, you die, and no amount of resuscitation will get you back. You're dead. So what is particularly interesting in the healthcare serial killers and what has tipped colleagues and co workers off is the fact that the number of resuscitations is significantly higher. And then people go, well, wait a minute. Why did this patient's heart stop? It wasn't because they were dying a natural death. Something caused their heart to flatline or to go into an arrhythmia.

[Dr. Michelle Ward]

That's fascinating. For Henry Houdon's sister Christine, who was a nurse herself, the circumstances of her brother's death, which include multiple flatlines and resuscitations, simply do not make sense. She wants answers and returns to Northampton.

[Narrator/Host]

Va. And I don't know what got into me because I have never. I've always been a fairly quiet person outside of when you're in a group with your friends or co workers. I never thought I would have had it in me. But I went back and it was just a day or two later after he passed away, and I asked for his medical record. Now, at the most, it was two days after, and I had to stand there and I'm waiting and I'm waiting, and it's almost an hour, and another.

[Nurse Kathy Ricks]

Woman finally comes out and she says.

[Narrator/Host]

You'Re gonna have to wait longer for them because his medical records have been sent to Washington.

[Dr. Michelle Ward]

That's curious.

[Nurse Kathy Ricks]

Why is that standard procedure?

[Narrator/Host]

She says, well, no, but somebody requested his records.

[Nurse Kathy Ricks]

At that point.

[Narrator/Host]

I was positive the doctor really messed up. I was positive of that.

[Dr. Michelle Ward]

Henry's death was not a result of his doctor's wrongdoing. But Christine is right to question the circumstances of her brother's death. Henry Houdon's autopsy is conducted on December 10, 1995, just two days after his death. It leaves the coroner perplexed. There is no visible cause of death. Since then, the coroner has sent numerous samples to the Massachusetts crime laboratory for toxicology testing. They have all come back clean or revealing tiny traces of drugs that the coroner already knows. Henry was administered during his stay at the vamc. Without a cause of death, he cannot release a death certificate. Toward the end of 1995. It's not just Christine and the coroner asking questions. A few nurses are starting to have serious concerns about the disturbing number of deaths in Ward C. Mary Sullivan is a former nurse and a pioneer in forensic nursing. So what is it about nurses that make them better able to pick up on these things than perhaps a doctor?

[Nurse Kathy Ricks]

Well, nurses know each other. They know patients. Nurses know how hospitals are run, where things are kept, who comes and goes. Doctors come and go. They make rounds. They see their patient. They might stay at the desk for a while and visit with somebody or. Or do their notes in the computer. But generally, they see their patients. They go back to their office or wherever and do their notes, and they're gone.

[Dr. Michelle Ward]

And they don't know the patient as intimately than as the nurse would, Right?

[Nurse Kathy Ricks]

Correct. And the nurse also knows the family and would ask, could ask the family what's typical with this person. The doctor typically isn't as involved with. With hospital life as everybody thinks they are. We do everything that's right, so we're aware of everything. And when something is out of kilter, you know, if you do the same thing every shift over and over, for those people who work steadily back then, you were hired for a shift, and that's what you worked unless you were assigned another shift. So you know what became routine.

[Dr. Michelle Ward]

From at least November 1995. Registered Nurse Cathy Ricks, who was on shift during Frances Marier's cardiac arrest, has been privately monitoring patient deaths and codes in ward circumstances. She's beginning to come to the uncomfortable realization that Kristen Gilbert, the nurse who knows codes and medication better than most, is the common denominator.

[Nurse Kathy Ricks]

And you know, what happens when the routine is broken.

[Dr. Michelle Ward]

Hmm.

[Nurse Kathy Ricks]

So when there were enough codes, Kathy started wondering, why are all these people coding on our shift? Why are we always the one that.

[Dr. Michelle Ward]

Are busy, you know, Interesting. And did she notice she was busier when Kristin was on?

[Nurse Kathy Ricks]

And then that's the next step. Then she noticed it was Kristin that was usually in the center of things.

[Dr. Michelle Ward]

Good for Kathy.

[Nurse Kathy Ricks]

And it was kind of, you know, like, oh, no, I don't want to think this. I don't want to. She fought it. She said she thought she didn't want to think it, but it was just. It was happening too often. I mean, their units started getting A reputation after a while. And she. She. She was curious.

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[Family Member/Relative]

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[Dr. Katherine Ramsland]

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[Dr. Michelle Ward]

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[Family Member/Relative]

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[Dr. Michelle Ward]

If Kristen is triggering cardiac events in patients. How is she getting away with it? And what Drugs is she using to do it? Beatrice Yorker is an expert on healthcare serial killers. I turn to her to help shed some light on how medical murderers typically kill, how prevalent they are, and where Kristen Gilbert fits in. How do medical serial killers usually kill and why?

[Narrator/Host]

All right, so the vast majority kill with injection, and the vast majority of those injections, injections are into an intravenous tube that is already in the patient. You don't even have to prick the patient.

[Dr. Michelle Ward]

I've heard of insulin being used before, but what else is used?

[Narrator/Host]

Then? We have the respiratory paralyzing agents, succinylcholine, which is used to intubate a patient, to stop them from fighting when the tube goes in, when you're going to take over their breathing, but paralyzes your breathing muscles. Okay, so that's very popular. Then we have potassium chloride. The wickedness of potassium chloride is that it's a normal electrolyte. We all need it in our bodies half the time. When you get an IV to rehydrate you or to fix your electrolyte imbalance, it's got potassium chloride in it. So potassium chloride also is very undetectable, as are insulin and epinephrine, which are normal hormones in our bodies. So to detect that, you know, is a lot harder. And what we are seeing on the increase is things like bleach and air. Now, air is not a toxic substance, but if you draw up a syringe with 10cc's of air and you inject that air into an IV line, you will cause a heart attack. It's why nurses are always just flicking every little bubble out of our tubing. We don't want even a bubble of air to go into a patient's bloodstream.

[Dr. Michelle Ward]

That little amount will cause 10 cc's.

[Narrator/Host]

Oh, five cc's of air. One of the first things you learn in nursing school is get the air out of the IV lines. We don't want air going into your bloodstream. And then there are some other methods. There's oral medications. So the nurses aides do not have access to IV medications. Nurses aides can give pills. And nurses aides are also put a tongue depressor on an older patient's tongue who's senile or with dementia, and pour water into their lungs.

[Dr. Michelle Ward]

I'm sorry, come again? Oh, my God.

[Narrator/Host]

That happened in Austria. And then there's smothering. So some nurses aides have just put pillows over the patient's faces and smothered them. My gosh.

[Dr. Michelle Ward]

I thought this. This was the rarest of Rare?

[Narrator/Host]

Oh, no, no. It's just covered up a lot and it's not even detected. And then there's that nurse who would go into the IV closet. Okay, so we have a closet that has IV bags, lots of them stacked up, bags of normal saline, bags of potassium chloride and mostly just fluid water. And they would inject into the bag, there's a little port so you can add medicines to the IV bag and drip them in slowly. These nurses would go into the closet, inject toxic amounts of potassium chloride or a respiratory paralyzing agent. And then they'd wonder, like roulette, which doctor, which nurse is going to pick up that IV bag and hang it in a patient and kill them? And it will not come back to me.

[Dr. Michelle Ward]

Was there more than one person doing this?

[Narrator/Host]

Yeah, yeah, there's a couple. We are calling these the chaos motive. That, yes, there's an element of creating a crisis, but they also are using their skills to create chaos. Where their colleagues are being suspected of killing patients because they hung a tainted IV bag. Okay.

[Dr. Michelle Ward]

Things you never knew, even after studying killers as long as I have. Wow, thank you. You've opened my eyes too. I'm not retiring yet. There's a lot left to do.

[Narrator/Host]

Wow.

[Dr. Michelle Ward]

So I'm just thinking about Kristin Gilbert and it seems to be the drama of the code and the attention it brings that really excites her.

[Narrator/Host]

Well, interestingly, that was her modus operandi. She loved the code. And Janine Jones in Texas, she loved the code. There's been quite a few of our healthcare series and right now we have a database of over 150 healthcare providers who have been prosecuted for serial murder of patients in their care.

[Dr. Michelle Ward]

One hundred and fifty.

[Narrator/Host]

One hundred and fifty and eighty six percent of them are nursing staff. The majority are registered nurses. There's a handful of practical nurses. And then, you know, some proportion of the nurses are nurses aides. 12% of the 150 are doctors like Dr. Harold Shipman and Swango, who was also in the VA system. And then 2% are respiratory therapists. If you remember Efren Saldivar at Glendale Hospital.

[Dr. Michelle Ward]

Yes, I do.

[Narrator/Host]

A respiratory therapist injected patients to cause them to stop breathing.

[Dr. Michelle Ward]

To give a little context to the individuals Beatrice and I are discussing, Dr. Harold Shipman was a British doctor and serial killer who is believed to have murdered upwards of 250 patients over 30 years, injecting them with diamorphine and then forging their wills to his benefit. Dr. Michael Swango is believed to have poisoned up to 60 patients in the US and Zimbabwe, changing his name to avoid record checks. And Efren Saldivar, who was an American respiratory therapist who. Who is believed to have murdered more than 200 patients. I'm out walking the dog and it's a bit of a busy street, so it might be noisy. But I wanted to capture my thoughts about that conversation I just had with Beatrice Yorker, the nurse, but also a professor of criminology. And she's really opened my eyes to an arena of violent crime that I hadn't totally considered before. And I can't help but think of this. 150 people in her database of killers. And that, for all we know, is just the tip of the iceberg. It's a terrifying fact. And they have so many weapons at their disposal in the healthcare fields. And the fact that these methods are so premeditated, sneaky, there's no chance that it's due to accident. So they're not just thinking about how to get away with the murder. They're thinking about how to disguise the fact that a murder had taken place at all. They're weaponizing not just the medicine that they have their fingertips, they're also weaponizing patient trust. And we know that Kristin is an exceptional killer in so many ways. But what I'm learning is that something that I thought was really rare, this health care serial killing is actually far more widespread than I've ever known. And it really makes me think long and hard about this case and also how difficult it must have been for these extraordinarily brave nurses and doctors to call out this bad behavior. They're putting their own careers at risk. There is an additional dimension as well that I haven't really considered yet. Kristin Gilbert is working within the Veterans Affairs Medical center, and her patients are more often than not men who have fought wars, experienced combat. So there is an interesting subversion of power that is coming into play as well. Special Investigator Bruce Sackman insightfully describes hospitals.

[Nurse Kathy Ricks]

As a place where the strong and.

[Narrator/Host]

Assertive become the meek and mild. You ever see a big construction worker, big tough construction worker in the emergency room, scared of this little nurse coming.

[Family Member/Relative]

Over with a big needle?

[Narrator/Host]

And they don't ask questions, they just kind of accept the treatment that they're getting.

[Dr. Michelle Ward]

Well, because they're hurting, they're vulnerable, they want help.

[Narrator/Host]

And if they don't have an advocate with them, you know.

[Dr. Michelle Ward]

Nurse Kathy Ricks is on shift again on January 22, 1996. Alongside Kristen Gilbert in the ICU is a 60 year old veteran named Thomas Callahan, who has been in the facility for a few days to treat pneumonia. Unsurprisingly, given his condition. He has a cough and he's agitated, but his heart rate is normal, and it is repeatedly noted as such. While under Kristen's direct care, Thomas Callahan suddenly goes into cardiac arrest. Kristen claims the episode was triggered by a sudden cough. The team manages to resuscitate him. But Kathy Ricks cannot shake the bizarreness of the cardiac arrest out of her mind. So she takes a look at the EKG strips, which are used to measure heart rate. The elevation is strikingly high, as she describes.

[Narrator/Host]

I went down to the unit to take a closer look at the strips that had happened while the patient had been in distress. It made me even more curious, and I wondered what could have happened to cause his heart rate to get that high.

[Dr. Michelle Ward]

Her colleague, nurse John Wall, who has been developing suspicions of his own, is also in the room.

[Narrator/Host]

John and I were both discussing what possibly happened to Mr. Callahan that evening and what might have precipitated it. We began to discuss what medication could have possibly been given to a patient that might have caused his heart to go into such a fast rhythm. I just looked around to see if there were any medications that might have been used. We thought perhaps potassium or epinephrine. Potassium is very hard on the heart. Epinephrine increases the heart rate.

[Dr. Michelle Ward]

Kathy Ricks checks the needle bin in the icu.

[Narrator/Host]

I saw epinephrine vials were broken and used. I was stunned. I didn't really expect to find anything. So when I saw them, I couldn't figure out why they would be there. We weren't using epinephrine on anybody.

[Dr. Michelle Ward]

Everything makes sense when epinephrine is taken into account. The unexpected deaths, the complaints of burning arms. To describe epinephrine. A return to Beatrice.

[Narrator/Host]

So epinephrine is adrenaline. Anybody who knows about being an adrenaline junkie, it's like you love that rapid heartbeat, that eyes wide open, that the world slows down. You jump off a bungee jump, something like that. It's a hormone and it's a neurotransmitter that are key to your fight or flight response. Epinephrine is therapeutic if you have severe asthma, if you have an anaphylactic reaction to peanuts, and if you code because you were struck by lightning or one of those things that causes your heart to stop. So you inject epinephrine and it just quick starts, jump, starts your heart back into a rapid heartbeat. But nevertheless, for an otherwise failing heart, epinephrine gives it a boost.

[Dr. Michelle Ward]

There are two more things you need to know about epinephrine. The first is that if it is used when not needed, it can literally force the heart to beat itself to death. The second is that it fades within a dead body. And because it's naturally occurring, it is rarely tested for in an autopsy. To clarify, although epinephrine is stored in the hospital, it is only ever used in very specific emergencies. Because the epinephrine isn't being used a lot, it's not being closely monitored in the storage closet. The only time stocks are replenished is by the pharmaceutical tech who comes into the hospital to replenish any meds being used. Nurses Kathy Ricks and John Wall confide in another nurse, Renee Walsh, who also shares their concerns. On January 25, 1996, Kathy Ricks goes on vacation. But before she leaves, she notes that there are 18 vials of epinephrine stored in the ICU. The next day, on January 28th, a young respiratory nurse, Bonnie, is on shift. 74 year old veteran Michel Cascone has been admitted to the ICU in ward C with pneumonia. He's been at the facility for two days and while Bonnie is working, he experiences multiple cardiac arrests triggering codes. Bonnie has asthma and has to rush over from a different ward every time the emergency is called. By the third code, she sees Kristen in the corridor. Bonnie tells Kristen, if I have to.

[Narrator/Host]

Keep running over here, I'm gonna start wheezing.

[Dr. Michelle Ward]

She describes Kristin's response.

[Narrator/Host]

She reached into her with her right hand. She reached into her pocket and pulled out something and asked me if I needed any epinephrine.

[Dr. Michelle Ward]

Epinephrine is not something that is issued by nurses as a matter of course. So why on earth would Kristin be carrying it around in her hospital scrubs? Bonnie is shocked and reports Kristen to the charge nurse, John Wall, who we already know is suspicious. Also on ward C at the end of January and early February is 40 year old Kenneth Cutting. Kenny is a well liked long term patient at the facility. He joined the army shortly after graduating high school, wanting to follow in his father's footsteps and serve his country. He enrolled at Fort Devens Army Reserve. But at the age of 21, he was diagnosed with Ms. Multiple sclerosis. Now 40, he has many health issues, but there's nothing to indicate a risk of death and he's making really good progress with a fever. His wife Nancy visits him often and is pleased after being told he will be discharged from ward C soon. But on 2-2-1996, Kristen Gilbert starts her shift at 4pm he is the only patient in the ICU and she has dinner plans.

[Narrator/Host]

James Peralt I was planning on going out because I was off that night and she said that she'd probably get the evening off early and I asked if I could go out or she could go out with me.

[Dr. Michelle Ward]

Kristen approaches the charge nurse who is her supervisor during the shift and asks if Kenneth dies tonight, can I go home early? Around 15 minutes later, Kristen notes in her chart that Kenny's heart rate dropped to a dangerous level. Nancy Cutting shared her memories of the day with reporters.

[Dr. Katherine Ramsland]

At 7 o' clock she went back and said her patient was dead.

[Dr. Michelle Ward]

She went home.

[Narrator/Host]

Before she was went home she called me to tell me that he had died.

[Nurse Kathy Ricks]

And you want to know what happened? The guy died and she was home by 9 o' clock that night and she killed him. She started a CO and that guy was stable in the ICU as I was told.

[Dr. Michelle Ward]

Kenneth Cutting was admitted to the VAMC because of a fever. The otherwise healthy and relatively young man dies in the hospital from carnival cardiac arrest. Kristin is out of that hospital by 8:15 ready for her date with James Peralt. The lack of empathy from Kristen here is absolutely chilling. She's just committed a murder and acts as if nothing has happened.

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[Dr. Michelle Ward]

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[Dr. Michelle Ward]

Of $45 per three month plan. $15 per month equivalent required. New customer offer first three months only then full price plan options available, taxes and fees extra. Seemintmobile.com I want to understand Kristin's motives and behavior better, so I speak to forensic psychologist Dr. Katherine Ramsland. When were you first made aware of the Kristen Gilbert case?

[Dr. Katherine Ramsland]

I was interested in this very specific subcategory of serial killer because. Because what sets them apart from most serial killers is that they can be proactively predicted. Some people call it profiling. It's not really profiling, but because we have a set of traits and behaviors that many of them share in common. I wanted to collect as many cases as I could and she was one of them. I mean, nurses have the highest percentage of healthcare serial killers. But she was an interesting one in that her motivation for whatever it was was unusual, was different from what we ordinarily see.

[Dr. Michelle Ward]

Do you mind talking to us about those characteristics that are common among these medical serial killers?

[Dr. Katherine Ramsland]

Some of the things that we have seen is that they in rooms of patients who unexpectedly die and they're not necessarily the nurse assigned to that patient. They like to predict that a patient will die, sometimes taking bets on it. They like to hang around when loved ones are told that the patient has died. They like to be part of that process. Sometimes they like to wash down the body. Some of them are aroused by this, but others just simply enjoy the emergency aspect of it. Sometimes they will put patients at risk so that they can revive them and be heroes. So you'd find a lot of codes on their shifts more than the average person and sometimes a lot more than the average person. They will have lied about things, sometimes about innocuous things like their birth date or their license plate number or something. They tend to have a constant set of lies going on in their lives. They skip from one facility to another. Quite often they get names like Dr. Death or angel of death or, you know, something like that. People jokingly refer to them that way. Patients will say they did something to them. So there are a number of things that we find among them. They'll have medications in their house that they really aren't authorized to have. They'll have books on medications, on poisons, such things as that. They'll often try to prevent others from checking on a patient. They'll choose late shifts where fewer people are around. They will complain about patients. They'll talk about patients being a burden. They'll say things like, we have too many patients now. Often they want to be the center of attention. They want to demonstrate their skills. These are not people who are slackers. They're typically people who do, you know, overwork, who come in and take extra hours because they want to be around when these things happen.

[Dr. Michelle Ward]

Wow. As I'm looking at it, Kristen had most of those.

[Dr. Katherine Ramsland]

Yeah. The high number of codes, the way she was around patients. We had an example of her wanting to leave early and saying, if this person dies, can I leave? And then suddenly he dies. So these are the kinds of things you're looking for. There's two kinds of health care. Serial killer. There's many kinds, but essentially, they might go into a health care facility as predators because they know it's a vulnerable place, a place that operates on trust. So they know they can exploit that and find easy victims that. We have had a few like that, but more often, it. It's something about the job. It's. It's opportunities that they find on the job. And maybe they'll start with a mercy killing, and then they'll continue to kill, but claim that it's mercy, you know, if they're caught. And inevitably, it's never mercy. In these cases, and in both situations, they are people who view patients as a means to an end. They don't value them as human beings. Even those who claim claimed they were doing the patient a favor, but they didn't ask the patient if they wanted this favor done. So they're not really treating their patients with any kind of respect. And in some cases, it's really just a pawn in their game.

[Dr. Michelle Ward]

I cannot ignore Kristin's violent and volatile past, the damage to her college boyfriend's car, the threats of suicide, the reports of violent behavior towards her husband, Glenn Gilbert. But my instinct is to put Kristin Gilbert in the latter box. I do not think she enters Nursing to specifically kill. I think that once she's in the hospital setting, she finds the perfect playground for her attention seeking tendencies. And codes become integral to that. I think triggering codes and killing her patients is something that Kristen discovers she likes and crucially finds she can get away with.

[Narrator/Host]

Beatrice Yorker and Kristen Gilbert is like many of the other nurses who've taken it into their own hands in that they see their patients as objects to further their need for attention, for control, for sadistic purposes.

[Dr. Michelle Ward]

I couldn't agree with you more. You believe that Kristin had a condition called Munchausen by proxy. Can you describe. Describe that condition and then afterward describe why you believe Kristen had it?

[Narrator/Host]

Munchausen by proxy is when instead of making yourself sick, you make a dependent in your care sick for the purpose of medical attention.

[Dr. Michelle Ward]

Why would somebody want unneeded medical attention?

[Narrator/Host]

Well, there's lots of reasons. Pretty much all children have fake being sick sometime in their lives. Okay, you did it.

[Nurse Kathy Ricks]

I did it.

[Narrator/Host]

We didn't want to go to school. We didn't want to go to church or synagogue, or we just wanted to stay home and watch TV and have mom make us chicken soup. So faking illness is a fairly normal behavior. However, there are some people for whom faking illness becomes exceedingly rewarding. It either gets them out of a very unpleasant situation, or it becomes their main source of validation as to who they are. It becomes the only way that they really feel cared for. It happens by people who have a self concept that is low and they go, I have to trick people into liking me.

[Dr. Michelle Ward]

Wow. So they get attention that they wouldn't get from their normal social connections. Do you see Munchausen by proxy with other serial killers? Other nurse serial killers?

[Narrator/Host]

Yes. Yes. So Richard Angelo in New York, he was injecting patients with epinephrine and causing codes. But anyway, so Richard Angelo confessed once he was caught, he was caught red handed. There was evidence. A patient pointed him out. There was an eyewitness. It was a done deal. But when he confessed, he talked about how he had experimented with injections on rats when he was younger and in college. And then he said the most telling thing. He said, I'm like those firefighters who set fires. That is the essence of, of the Munchausen and the Munchausen by proxy crisis causer. They like the excitement. It enlivens their work.

[Dr. Michelle Ward]

Kathy Ricks returns from her vacation on February 6, 1995. She's been away for 10 days. Remember before she left, there were 18 vials of epinephrine in the ICU's storage cupboard. She checks again. There are now three. There is no reason for this particular concentration of epinephrine to have been used in Ward C. She counts again on February 10, still three. As Valentine's Day arrives, patient mortality appears to be far from Kristen Gilbert's mind. She sends a gushing card to her lover, James Perrault.

[Narrator/Host]

I love you so much. So much, Jim.

[Dr. Michelle Ward]

Let's hope this will be only the first of many happy days together. Love, Kristen. On February 15th, Ed Squirrel Sr. Is admitted to Ward C of the VAMC. He's a new patient born in Holyoke, Massachusetts in 1927. He is yet another patient who is about to become a pawn in Kristen Gilbert's sadistic gang. His son, Ed Squirrel Jr. Tells his story.

[Family Member/Relative]

How would other people describe my dad? My dad was probably the greatest person most people knew because he was just, he was two different people. To the outside world he was a great guy and to his own family he was. Was a strange guy. My father joined the army shortly after the war because he wasn't old enough to go into combat. But he went to Europe during what they call the cleanup. This was World War II. My father's time in the army he spent as a mechanic and a driver, truck driver, which sort of led to his career. After the military, he was a truck driver later on.

[Dr. Michelle Ward]

Ed Squirrel Sr. S granddaughter Sarah remembers what she was told about her grandparents first meeting.

[Narrator/Host]

I think they met at a polka concert of some kind. And so I remember hearing about that. And my grandma listened to polka music all the time up until she passed. So it was a big part of their kind of life at home. My grandma would make him laugh a lot. Luckily she lived till she was 94 and only died a few years ago. And so I do remember them interacting and my grandpa finding her funny.

[Family Member/Relative]

I would describe my father as being tall and masculine, somebody powerful.

[Narrator/Host]

I don't know. Like I always thought my grandpa looked kind of like a movie star in his younger age. He was like very handsome and they were like a good looking couple, I.

[Dr. Michelle Ward]

Would say like a lot of veterans. Ed Squirrel Sr. Struggles with addiction issues. He's an alcoholic and has been treated as such at various medical centers over the years.

[Narrator/Host]

I don't think it was until I was a teenager that I understood he even went to the hospital because of alcoholism. I think I knew that he was an alcoholic, but I don't know if I knew to what extent.

[Dr. Michelle Ward]

Before arriving at the vamc, Ed Squirre has been at a facility in Worcester for detox treatment.

[Family Member/Relative]

I would always get these phone calls to take my father for detoxing. This particular time was not unlike other times.

[Dr. Michelle Ward]

Ed Squeeras Sr. Is transferred to the VAMC for specialist care. On the day of his arrival, February 15, Kathy Ricks checks the epinephrine storage in the ICU at 4pm There are still three. Kristen Gilbert is the only nurse working in the ICU, part of board C that shift. Ed Squirrel's heart rate begins to increase and an emergency code is called by Kristen.

[Family Member/Relative]

I got home that day and got a phone call that he had had a heart attack.

[Dr. Michelle Ward]

Squirre is stabilized, but his life hangs precariously in the balance. When Kathy Ricks gets to the icu, she immediately checks the epinephrine supplies. The store is empty, but next thing.

[Family Member/Relative]

I know they told me he was going to go to Bay State. They were transferring him there. So I drove to Bay State and they said that there wasn't anything they could do, that he had had a heart attack and that he had an aneurysm and there was nothing they could. There was no operation they could do to save him. So Ann anticipated he was going to die.

[Dr. Michelle Ward]

That evening, Kathy Ricks, John Wall and Renee Walsh make a call to the nurse manager. How many patients has Kristen used the epinephrine on? They cannot let her victim count grow any further. Coming up on Mind of a Monster, the Killer Nurse. Courageous whistleblowers step forward, risking their careers and reputations to expose the deadly truth lurking in Ward C. I knew better.

[Nurse Kathy Ricks]

At least as far as my brother is concerned.

[Narrator/Host]

This sounds pretty crazy. Like this can't really be going on. Who here thinks Kristen Gilbert murdered the patients?

[Family Member/Relative]

And all the investigators raised their hand.

[Narrator/Host]

Wow. Wow.

[Dr. Michelle Ward]

Mind of a the Killer Nurse is produced by Aeromedia, a Fremantle Company for ID. I'm your host, Dr. Michelle Ward. You can follow our show wherever you get your podcasts. And we'd love it if you could take a second to leave us a five star review on Apple Podcasts.

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[Nurse Kathy Ricks]

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[Narrator/Host]

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[Dr. Michelle Ward]

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[Nurse Kathy Ricks]

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