S7 Ep.6: The Trial

Summary

Mind of a Monster: The Killer Nurse

Episode 6: The Trial

Host: Dr. Michelle Ward
Date: October 28, 2025

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Episode Overview

This gripping final episode of "Mind of a Monster: The Killer Nurse" focuses on the trial of Kristen Gilbert, a nurse accused of murdering patients at the Veterans Affairs Medical Center in Massachusetts from 1989 to 1995. Criminal psychologist Dr. Michelle Ward guides us through the complexity, drama, and emotional toll of the trial on all involved, including prosecutors, journalists, victims' families, and medical experts. The episode explores the psychological and systemic factors surrounding both Gilbert’s crimes and the healthcare system’s response.

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Key Discussion Points & Insights

Gilbert's Pre-Trial and Arrest (01:59–05:16)

• Initial Arrest: Gilbert is first arrested and charged for making bomb threats, not murder (02:15). She is kept under house arrest, barred from contacting loved ones, especially her sons.
• Evidence in Bomb Threat Trial: The prosecution, led by William Welch, presents strong evidence including a purchase receipt for a recording device and eyewitness testimony from her boyfriend, James Perrault (03:47–04:55).
• Verdict: Gilbert displays rare emotion when found guilty; she’s sentenced to 15 months (05:16).

"When she was convicted, there was this bit of a stunned look on her face...as if we had pulled the appropriate card from the house of cards that she had built, and it was beginning to tumble."
— William Welch (05:16)

Psychological Analyses and Personality Disorders (05:36–10:43)

• Dr. Ward analyzes testimony and evidence suggesting possible feigned suicide attempts and manipulations consistent with borderline personality disorder (BPD).
• Forensic psychologist Dr. Katherine Ramsland joins to discuss the overlap and distinction between BPD and psychopathy, especially in female offenders.

"To threaten self harm is highly manipulative. She doesn’t have a history of actual suicidal kinds of things...That’s why I started thinking this could be one of those cases...secondary psychopathy, which does feature a lot more emotionality."
— Dr. Katherine Ramsland (09:51)

Building the Murder Case (11:06–13:30)

• Exhumations and Toxicology: Investigators exhume bodies and work on toxicological tests, including distinguishing synthetic from natural epinephrine (11:06–12:02).
• Suspicious Findings: Discovery of ketamine—a drug uncommon in human hospitals—leads investigators to Gilbert’s purchases from veterinarians (12:02).

Charge Selection and Indictment (15:48–18:43)

• The prosecution selects cases most likely to yield convictions (16:15).
• In November 1998, Gilbert is indicted for three murders, with more charges added later (17:22–17:40).
• The trial was delayed by complex discovery and legal motions (18:05).

"We had a very tight, very interwoven circumstantial case that was very, very compelling."
— William Welch (18:05)

The Murder Trial: Courtroom Perspectives (19:07–25:21)

• Human Stories: Journalist Adam Gorlick emphasizes the trauma faced by families, who didn’t expect loved ones to die while hospitalized (19:14).
• Impactful Testimonies: Victims’ relatives and medical professionals share their experiences and emotions in facing Gilbert during the trial (20:49–24:44).
• Courtroom Demeanor: Gilbert is described as emotionless, presenting a “blank mask” even when her own family testifies (22:12, 24:20).

"You know, I was just looking at a mannequin."
— Medical Professional/Doctor on testifying against Gilbert (24:22)

Prosecution and Defense Strategies (25:48–27:10)

• Prosecution: Focuses on circumstantial and statistical evidence, eyewitness accounts, and testimony from whistleblowers (25:21–27:10).
• Defense: Argues deaths were due to natural causes, or possibly negligence—characterized as a “scattershot” approach (25:48).

"It was a bit of a scattershot defense, which I think was problematic. They should have just picked one and gone with it."
— William Welch (25:48)

The Verdict and Sentencing (27:59–41:32)

• Jury Deliberation: Lasts 12 days, the longest Judge Poncer ever experienced. Initial not guilty on a first-degree charge prompts suspense, but several guilty verdicts follow for second degree and other charges (28:45–30:09).
• Emotional Aftermath: Families express relief and a sense of justice, while the scale of Gilbert's crimes weighs heavily (31:14–32:10).
• Death Penalty Twist: Despite Massachusetts not having the death penalty, Gilbert faces it due to the federal nature of her crimes (34:42–41:32).
• Final Outcome: Jury votes 8-4 for death—failing to reach unanimity, Gilbert gets four consecutive life sentences without parole (42:30).

"I definitely wanted to see it...especially seeing on the federal level the death penalty is lethal injection. And I thought you couldn’t ask for anything more fitting."
— Christine Duquette, Victim’s Sister (37:07)

Aftermath and Systemic Reflection (43:23–47:38)

• True Victim Count Unknowable: Experts agree Gilbert likely killed more patients than those counted (43:23).
• Systemic Weaknesses: Healthcare whistleblowers face barriers, and hospitals are often hesitant to report suspicions to authorities (46:07).

"All you have to do is get them away from patients."
— Beatrice Yorker, Healthcare Expert (47:07)

• Victims Honored: Families advocate for remembrance and systemic change.

"Where is that any different than any other soldier? Just to see something that says in remembrance for the victims of Kristen Gilbert."
— Christine Duquette, Victim’s Sister (45:06)

Lasting Impact and Reflections (47:38–end)

• Victims Families: Christine Duquette’s statement to Gilbert underscores the lifelong pain caused by these crimes (47:38).
• Dr. Ward's Closing Thoughts: Emphasizes the unique horror of healthcare serial killings and the urgent need for detection methods.

"The place you go to rely on the hands of others while you are most vulnerable is also the most fertile ground for a person who aims just to kill. That is a terrifying reality... But the tragedy remains that the true number of victims that this monster took may never be known."
— Dr. Michelle Ward (48:27)

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Notable Quotes & Memorable Moments

• "Probability of this occurring by chance was 1 in 100 million."
  — William Welch (02:00)
• "She was about as cool of a cucumber I've seen of any defendant."
  — William Welch on Gilbert’s demeanor (03:47)
• "When she was convicted, there was this bit of a stunned look on her face..."
  — William Welch (05:16)
• "To threaten self-harm is highly manipulative."
  — Dr. Katherine Ramsland (09:51)
• "It’s a hard thing to wrap your head around...You can’t lose sight of the people that this affected."
  — Adam Gorlick (19:14)
• "I was just looking at a mannequin."
  — Trial doctor on testifying (24:22)
• "She can't suffer enough."
  — Christine Duquette (48:21)
• "We really don't know how extensive her murders are...the hard thing about healthcare serial killers is nailing them with evidence."
  — Dr. Katherine Ramsland (43:23)

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Timestamps for Key Segments

• Kristen arrested for bomb threats: 02:15
• Overview of bomb threat evidence: 03:47–04:55
• Guilty verdict and reaction: 05:16
• Discussion of psychological diagnoses: 05:36–10:43
• Building the murder case and reviewing exhumed evidence: 11:06–13:30
• Selecting murders to charge: 16:15–18:05
• Family and medical testimony on loss and trial atmosphere: 19:14–24:44
• Strategies and evidence in murder trial: 25:48–27:10
• Jury verdict sequence: 28:45–30:09
• Death penalty and sentencing explanation: 34:42–41:32
• Aftermath, systemic failures, and calls for remembrance: 43:23–47:38
• Christine Duquette's statement to Gilbert: 47:38

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Conclusion

This episode lays bare the horror, complexity, and emotional devastation wrought by Kristen Gilbert’s crimes and the healthcare system’s struggles to confront such evil. Through powerful interviews, expert insight, and firsthand accounts from families and professionals, the case is shown not only as one of rare legal and psychological intrigue, but also as a catalyst for system-wide change and remembrance for its many victims.

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If you want to understand not only the events of Kristen Gilbert's trial but also the human, institutional, and psychological aftermath, this episode is essential listening.

Transcript

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[Dr. Michelle Ward (Podcast Host)]

This podcast explores themes of violence, self harm and murder. Listener discretion is advised. Please note that some of the voices you hear in the series have been performed by actors. Previously on Mind of a Monster the Killer Nurse There are three explosive devices in building one. You have two hours. Nothing will compare us to what is going to happen tonight.

[William Welch (Prosecutor)]

So we had a expert statistician take a look and he said that the probability of this occurring by chance was 1 in 100 million.

[Medical Professional/Doctor]

They said. We think that Christian Gilbert is the most prolific mass murderer on the East Coast.

[Dr. Michelle Ward (Podcast Host)]

From ID and Arrow Media, I'm criminal psychologist Dr. Michelle Ward and this is Mind of a Monster the killer nurse Chapter 6 the trial It's October 8, 1996, and Kristen Gilbert has finally been arrested. But it's not for murder. It's for making bomb threats against a federal hospital which had seen dozens of vulnerable and sick patients evacuated from Wards. Kristen is sent to Hampton County Jail while authorities decide what to do with her. A week goes by, she's given an ankle monitor and the 28 year old mom and nurs is released into the custody of her parents who now live in Long Island. She's forbidden from making contact with anyone in the state of Massachusetts, including her boyfriend, James peralt, and Glenn Gilbert, who she's still in the process of divorcing. Crucially, the restriction also means that she's not allowed to see her two young sons. The only way she can communicate with them is through letters that are sent via her attorney and then passed on to the boys through therapist who decides whether to share the material with them. A year and a half goes by while preparation for the court case takes place. On January 7, 1998, Kristen is finally brought to court to stand trial for the bomb threats. William welch was the federal prosecutor on Kristen Gilbert's case.

[William Welch (Prosecutor)]

From our perspective, the case was simple, and our proof was very, very strong. We had, for example, trooper Kevin Murphy being able to essentially say that he saw one of the bomb threat calls come in. The defense was essentially that she didn't do it, and that even if she did do it, we didn't have enough evidence. And what struck me about Kristin and her Persona was she was about as cool of a cucumber I've seen of any defendant. Seemed very confident that she would be found not guilty.

[Dr. Michelle Ward (Podcast Host)]

Is Kristin right? Will she be able to manipulate her way out of a prison sentence? The defense's argument is simple. It wasn't her. She's not guilty. But the prosecution provides copious evidence, Including a receipt for the purchase of the talk boy and eyewitnesses placing her at the phone booth where the calls were made. They also have a star witness, James Perrault, testifying on the stand. He describes in vivid detail how the phone calls appeared to target him.

[William Welch (Prosecutor)]

It sounded taunting, provocative towards me. The caller sounded like they were hurt and upset.

[Dr. Michelle Ward (Podcast Host)]

The trial for the bomb threats lasts a week. Will her defense work? The jury deliberates and delivers its verdict. Guilty.

[William Welch (Prosecutor)]

When she was convicted, there was this bit of a stunned look on her face, which is probably the only time I've seen any semblance of emotion pass her face. But it was as if, at that time, we had pulled the appropriate card from the house of cards that she had built, and it was beginning to tumble.

[Dr. Michelle Ward (Podcast Host)]

What a great description. Before her sentencing, Kristin makes an extraordinary statement to the court. She claims she cannot remember anything that happened in the summer of 1996. I really don't have a very clear memory of that particular time period, except of bits and pieces of, really, that whole summer patches here and there. It was a very stressful, hectic time of my life. Sometimes it seems the mind chooses to block out things we don't want to remember. A lot of what I remember is what people have told me about my own behavior. And my own behavior was very erratic and whatever. I would never intentionally hurt anyone. But no one is buying it. Judge Michael Poncer sentences her to 15 months with a three year supervised release for calling in the fake bond threats. She's sent first to Danbury Federal Prison where she spends 10 months of her sentence. I've been reviewing the transcripts from Kristen's bomb trial and there are thousands of pages, but within them are some really interesting findings. Specifically, there was testimony from hospital staff members where Kristin had been admitted for her various suicide attempts. And they reported and testified that there were not toxic levels of drugs in her system. She hadn't taken the drugs that she'd said, which we kind of suspected. And in one case she even bit the finger of a nurse who was trying to intubate her, explaining she didn't need to be intubated, didn't need her stomach pumped because it was quote, unquote, been too long since she took the medication. But the reality is she probably didn't because all of the toxicology reports came back with non toxic levels of medication. And this is kind of what we suspected all along. And it goes along with what we've been entertaining, which is the idea of borderline, borderline personality disorder, which is characterized by, you know, suicide attempts, threaten, threatening suicide, threatening self harm. And the second interesting thing is the doctor who was hired for the defense to examine Kristin talked about her potentially having borderline personality disorder. And that's what we have been considering all along. And it's nice to know that even contemporaneously that was the diagnosis that was being considered at the time. I want to discuss this with forensic psychologist Dr. Katherine Ramsland.

[Dr. Katherine Ramsland (Forensic Psychologist)]

Supposedly she was diagnosed with borderline personality disorder. But I know when I was looking at the testimony of the defense psychiatrist, he wasn't buying that. He'd say, well, if I really could look at all of the data of her whole life, maybe I would say that, but I didn't. I really think she was suffering from an adjustment disorder, which is a temporary condition. But I will also say we're now finding that many females who've been diagnosed with this disorder actually qualify as psychopaths. But male psychologists and psychiatrists have been reluctant to put that label on them or have not even thought of using that label for them.

[Dr. Michelle Ward (Podcast Host)]

That's right.

[Dr. Katherine Ramsland (Forensic Psychologist)]

So it's unclear whether she might qualify as a psychopath. But no one to my knowledge, used the diagnostic device with her. So I wouldn't say that. But it's interesting at least that we know that psychopathy and borderline personality disorder in females has a lot of overlap.

[Dr. Michelle Ward (Podcast Host)]

This is music to my ears to hear somebody as esteemed as you agree that, you know, psychopathy in females looks different than it does in males. And a lot of it is this relational aggression and borderline. I mean, with the exception of like the self harm and this like fear of abandonment stuff. But the comorbidity of these two, whether they're distinct or not, I don't know anymore.

[Dr. Katherine Ramsland (Forensic Psychologist)]

Well, we don't know that she has self harming behavior. We only know that she has threats of it. That's not the same thing.

[Dr. Michelle Ward (Podcast Host)]

That's right.

[Dr. Katherine Ramsland (Forensic Psychologist)]

To threaten self harm is highly manipulative. She doesn't have a history of actual suicidal kinds of things. So, you know, or other, or other things like gambling disorder or, you know, alcoholism or. She doesn't have that self destructive side. So that's why I started thinking this could be one of those cases. And the overlap is what we call secondary psychopathy, which does feature a lot more emotionality than primary psychopathy, which is more of the cold, callous, you know, born psychopathic. The females tend to have that emotionality. And it's really, you're looking at not what did they do, but what did they threaten and for what reason?

[Dr. Michelle Ward (Podcast Host)]

What manipulation were they achieving?

[Dr. Katherine Ramsland (Forensic Psychologist)]

Yeah, exactly.

[Dr. Michelle Ward (Podcast Host)]

This is all speculation, of course. I've never assessed Kristen Gilbert myself, but like most serial killers, she is likely a psychopath. While Kristin Wallows in prison, William Welch and his team continue to build their case against her for the murders of patients at the Veterans Affairs Medical Center, Northampton. Okay, at this point, what's happening with the murder investigation?

[William Welch (Prosecutor)]

So bodies are being exhumed. You know, it takes some time to do the pathology, meaning examining the heart tissues. It takes some time to do toxicological testing. We are continuing to interview witnesses. We are presenting witnesses to the grand jury. We did spend a lot of time on the toxicology element of it because we were being told that our expert had a way of distinguishing synthetic versus naturally occurring epinephrine. So we were waiting and relying on some of the testing and sampling that that lab was conducting in order for us to have some degree of confidence in the reliability of their testing. And then once they felt confident that they could stand behind their work, then we were really in the stage where we could ultimately present the indictment for charges.

[Dr. Michelle Ward (Podcast Host)]

The toxicology reports initially bring up more questions than answers. They find that Ed Squirrel Sr. Who died on February 18, 1996, had the drug ketamine in his system. Ketamine is not something he would have ever had access to himself. In fact, it wasn't even a drug used by hospitals. It was mostly used by veterinarians. The Gilbert family had pets and investigators discover that Kristen Gilbert had made numerous trips to vets over the course of 1995. There were also receipts for pet medications that had been bought via mail order. Supposedly, Kristen was buying the medication for her pets to treat the animals herself. I wonder, could this have been how Ed Squirrel had ketamine in his system too?

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[Dr. Michelle Ward (Podcast Host)]

Join [e-mail] From 1989 to 1996, there have been a staggering 350 deaths at the Veterans Affairs Medical center in Northampton, Massachusetts. This is a huge number of potential victims. Ultimately, William Welch and his team have to decide which ones to take to trial.

[William Welch (Prosecutor)]

So we selected the ones that we felt were most provable in terms of, you know, securing convictions. And then we picked cases that complemented each other in terms of how one case brought a particular element to it that maybe another didn't and then another one that, you know, brought something to the entirety of the case that another one didn't. And for each one of them, we also needed all of the testifying witnesses to have that level of confidence that the death was very, very unusual. Because if I think you had any one witness that expressed reservations about the death being not natural, that would have been, you know, a very debilitated setback for us.

[Dr. Michelle Ward (Podcast Host)]

Absolutely. The case can fall apart on even losing control of a single witness and having them say that, I'm not totally sure. Then it's over because that's reasonable doubt. On November 24, 1998, Kristen Gilbert is in Hampton County Jail when the news breaks.

[Casefile Podcast Host (Casey)]

A 31 year old former nurse has been indicted on charges of murdering three.

[William Welch (Prosecutor)]

Patients and attempting to murder two others.

[Dr. Michelle Ward (Podcast Host)]

At the Veterans Affair Medical center in Massachusetts.

[Casefile Podcast Host (Casey)]

Massachusetts federal prosecutors alleged today that Kristen.

[Dr. Michelle Ward (Podcast Host)]

Gilbert injected a heart stimulant known as.

[Casefile Podcast Host (Casey)]

Epinephrine into the patients.

[Dr. Michelle Ward (Podcast Host)]

She is indicted for the murders of Ed Squirre, Kenny Cutting and Henry Houdon, as well as the attempted murders of Thomas Callahan and Angelo Vella. Six months later, more indictments are added to her charge sheet. The murder of Stanley Jagadowski and the attempted murder of Frances Murder Merrier. It's going to trial. And prosecutor William Welch will lead the government's case.

[William Welch (Prosecutor)]

It took about two years for the case to go to trial. A lot of that has to do with discovery. A lot of that has to do with a lot of the pre trial motions and jockeying that goes on to exclude evidence. We had a very strong case. Each victim had their own set of facts that they brought to the table. And each one of the strongest pieces of the case complemented all of the others. And so from my perspective, we had a very tight, very interwoven circumstantial case that was very, very compelling.

[Dr. Michelle Ward (Podcast Host)]

The trial finally takes place beginning on November 20, 2000.

[Narrator/Advertiser]

Ms. Gilbert denies each and every fact.

[Dr. Michelle Ward (Podcast Host)]

That'S essential to prove a claim of homicide.

[Narrator/Advertiser]

She didn't do it is what she says.

[William Welch (Prosecutor)]

There's been a lot of talk and a lot of allegations over the past several years and it's time now to see whether the government can prove what they've been accusing her of all these years.

[Dr. Michelle Ward (Podcast Host)]

Adam Gorlick is a young reporter working for the Associated Press. I talked to him about covering this sensational trial.

[Adam Gorlick (Journalist)]

One of my biggest memories of covering the trial was the families themselves and getting to know the families. I mean, the trauma of this is incredible. Obviously they were patients in a VA hospital. They weren't in perfect health, but they weren't expected to die. And the motivation that she had to create these emergencies so she could create a thrill for herself, I mean, it's just nuts. It's a hard thing to wrap your head around. You can't lose sight of the people that this affected. And that's something that I always tried to hold onto as a reporter. Shows you the worst of humanity. But you remember that there's the best of humanity embedded in the victims and these people are just people. And dealing with these unthinkable crimes and the kindnesses that they showed the reporters and me made a big impression on me that people could have a ton of grace under horrible, horrible circumstances.

[Dr. Michelle Ward (Podcast Host)]

This comment from Adam reminds me how important it is to keep the families of the victims at the forefront of the trial. I can't imagine how it must feel to go into such a long awaited trial and, and actually face the woman accused of murdering your loved one. Nearly five years after the murder of 35 year old veteran Henry Houdon, his sister Christine Duquette attends the trial.

[Christine Duquette (Victim's Sister)]

My best chance of knowing what happened to my brother, every little thing and why it happened was to sit in that courtroom every day. And it was almost a six month trial.

[Dr. Michelle Ward (Podcast Host)]

What was it like for you to see her?

[Christine Duquette (Victim's Sister)]

Well, the first time I saw her was in the Northampton. This is before it got to the federal level. I did go to the Northampton courthouse and she was very, very attractive, very young. The hair, she had bleached blonde hair. The style of the haircut was really sassy, minimal but professional makeup, very professionally casual dress. And I just looked at her and it, based on how she looked, it was very Hard to believe that she could do this, but sitting in the courtroom, she looked completely different. Hair, hair was longer, it was no longer bleached. There was no makeup. She definitely had gained weight. She looked very plain, simple.

[Dr. Michelle Ward (Podcast Host)]

I'm fascinated to hear more about Kristen's demeanor in the courtroom. How does Kristen react hearing the testimonies from the victims families? And what does she do when her own family takes the stand? Or her former lover, James Perrault? I go back to prosecutor Bill Welch to learn more.

[William Welch (Prosecutor)]

During the course of the trial, Kristen was markedly different than when I saw her at the Bom Thra trial. Was not confident, was not self assured, showed no emotion throughout the course of the guilt phase. So even when we had to call, for example, a potential family member or one of her co workers, it was like she had a blank mask on her face. She always had this kind of grayish color to her face, which, you know, could be as a result of just being in prison. But there was just never any emotion, no matter what who the individual was that she was either watching or interacting with, including her family.

[Dr. Michelle Ward (Podcast Host)]

Yikes. What was it like to hear from the families of the victims?

[William Welch (Prosecutor)]

You know, it was heart wrenching. We had been working, interacting with the victim families for two years, and we had a real sense of who all of the victims were. We knew their strengths, their weaknesses, their foibles, you know, kind of all of it. And then to hear them get up on the stand and talk about them with, you know, that warmth, it was difficult for me. So on the one hand, surprised me. On the other hand, it didn't surprise me. See? No emotion from Kristen Gilbert.

[Dr. Michelle Ward (Podcast Host)]

That's so interesting. Dr. Greg Blackman, who had been the doctor on duty when Henry Houdon was killed, is called to testify.

[Medical Professional/Doctor]

When it did go to trial. I remembered the details very clearly and was happy to testify.

[Dr. Michelle Ward (Podcast Host)]

Wow. And you must have been pissed, as you said.

[Medical Professional/Doctor]

I was beyond angry and remained so.

[Dr. Michelle Ward (Podcast Host)]

Absolutely. I hadn't thought about it so much from your perspective. Kind of steeped in talking to victims families. But as a professional whose job is, you know, to avoid that, that would be life altering. I mean, you know that you're gonna lose patience, you know that. But to that frustration of not knowing why. Tell me, what was it like to testify against Kristen in her murder trial?

[Medical Professional/Doctor]

What was interesting?

[Christine Duquette (Victim's Sister)]

She.

[Medical Professional/Doctor]

She had kind of a relatively stoic look on her face. And so she didn't seem emotional at all during the trial. I think we locked eyes once, but I mean, this certainly wasn't like a Friendly interaction or anything. You know, I was just looking at a mannequin.

[Dr. Michelle Ward (Podcast Host)]

Had you learned about the evidence that the prosecution had put together for this?

[Medical Professional/Doctor]

I knew that the statistics were pretty overwhelming. And the circumstantial evidence, the fact that, I mean, more than circumstantial, you know, EPI in her pocket, you know, the guy with the arm burning, all that, I mean, it really connected the dots well. And so to me, there's just zero doubt, zero doubt that she did it and did it over and over again.

[Dr. Michelle Ward (Podcast Host)]

The prosecution calls up many of Kristen's colleagues to testify, including the three whistleblowers, Kathy Ricks, John Wall, and Renee Walsh. The case is very strong, and while there are no eyewitnesses to Kristen's killings, the testimonies are pretty compelling. However, the defense team is also ready and willing to put up their fight to prove that Kristen did not murder any of her patients. William Welch.

[William Welch (Prosecutor)]

So the defense was basically all of the individuals were really sick, really old, and these are all individuals that died from natural causes that we became focused upon her as the perpetrator and didn't look to either other natural causes of death or non natural causes of death. There was a theory that perhaps overall there could have been just gross negligence by all of the medical professionals, but that really was the. The defense. It was a bit of a scattershot defense, which I think was problematic. They should have just picked one and gone with it.

[Dr. Michelle Ward (Podcast Host)]

And it certainly doesn't cover Henry Houdon, who didn't have any of those underlying conditions.

[William Welch (Prosecutor)]

That's right. And I think that's when that goes to the strength of our case. So, for example, if we go back to Stanley Jagadowski, the eyewitness account of her leaving the room is incredibly compelling, particularly for a registered nurse to be leaving someone in distress. We didn't have that for any of the other victims. Suddenly, all these become interconnected, and people can begin to see how each one of the cases on their own had strengths. They may have had weaknesses, but together they told a compelling story.

[Dr. Michelle Ward (Podcast Host)]

The courtroom is full of drama as both sides present strong arguments to try to convince the jury. Even Judge Poncer admits he has no clue which way the verdict will go. Journalist Adam Gorlick tells me more.

[Adam Gorlick (Journalist)]

I remember Bill Welch. He was a very, very passionate prosecutor. Very, very good. Amazing, super smart, really good guy.

[Dr. Michelle Ward (Podcast Host)]

He's very smart.

[Adam Gorlick (Journalist)]

And as was David Huse. Right. The two of them were beautiful to watch in a courtroom. Beautiful because they were just so good. They played off each other. But you know, they're like bitter enemies in the courtroom. But you could tell that there was always like that sense of respect.

[Dr. Michelle Ward (Podcast Host)]

The trial concludes on February 21, 2001. After four months of emotional testimony, heart wrenching toxicology report findings, even photos of exhumed bodies being presented to the court, the jury is finally dismissed to decide on a verdict. Jury deliberation. Timing is unpredictable. So waiting for the verdict is incredibly intense for everyone. Bill Welch, the victims families, the defense, especially Kristen Gilbert, who will learn her fate. Quoting Judge Michael Poncer. The 12 days of deliberation were the longest by far I have ever waded through. Finally, on March 14, 2001, the jury is ready to come back. William Welch.

[William Welch (Prosecutor)]

When the verdicts came down, meaning when the jury announced that they had verdicts, the courtroom was packed. We had an overflow room for other individuals who didn't make it into to the main courtroom. And the first verdict that was read was the first degree murder for Stanley Jagadowski. And that came back not guilty. And I can still feel, actually when I talk about it, sort of the pins and needles of hearing the not guilty and suddenly thinking, what's to follow? And you could hear a pin drop when that not guilty verdict came down. But then the second count for which we had charged her for Stanley Jagdowski's death was second degree murder, and they found her guilty of that. And as soon as I heard that, I knew that thereafter we would get guilty verdicts on virtually all of the other counts. And I give the jury a lot of credit. I think they gave her the benefit of the doubt on the very first one and said, maybe this wasn't intentional, maybe there really was some sort of accident. But you can't explain everything else that followed. To me, that was sort of brilliant on that part.

[Dr. Michelle Ward (Podcast Host)]

They deliberated properly. I can see a change in your face. You're red. Like all these years later, Tremendous, tremendous stress and anticipation. Assistant U.S. attorney William Welch has been building Kristen's case since it first landed on his desk in 1996. These guilty verdicts must bring a great feeling of satisfaction and confirmation that he did the best he could in that courtroom to get those verdicts, but most importantly, to bring some justice for the families, for the victims families. The guilty verdict can bring a lot of emotion. As they leave the courtroom, they are greeted by lots of press waiting to record their responses to the verdict. All my feelings altogether for the five years, what she put us through, you know, I mean, what she's done to us, she. She took away something from us that was very precious and that, you know, is hard to let go. I'm gonna go to cemetery tonight and I'm gonna say, Henry, you finally got do what's due you.

[William Welch (Prosecutor)]

The truth has come out and that's.

[Medical Professional/Doctor]

All that we wanted.

[Dr. Michelle Ward (Podcast Host)]

I go back to Edward Squeera Jr. To hear what he has to say about Kristen Gilbert finally being found guilty of murdering his father.

[Adam Gorlick (Journalist)]

When I heard Kristen was convicted, I was relieved. I communicated through the prison sentence system that I wanted to gain access to conversing with her and I was. She turned it down. So I was interested to get some insight into what she did and to why she did the things she did because it just defied logic why anybody who would go in the healthcare field would seek to harm people. I couldn't see it as a health care provider myself.

[Dr. Michelle Ward (Podcast Host)]

There is something about the nature of Kristen Gilbert's crimes that elevates this already sensational trial to a whole different level.

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[Beatrice Yorker (Healthcare Expert)]

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[Casefile Podcast Host (Casey)]

The.

[Narrator/Advertiser]

Case has been made by lead prosecutor William Welch and his team on a.

[Casefile Podcast Host (Casey)]

Total of 10 charges, including four counts of murder.

[Dr. Michelle Ward (Podcast Host)]

One first degree murder conviction requires a.

[Narrator/Advertiser]

Penalty phase trial where the jury will decide if Gilbert lives or dies.

[Dr. Michelle Ward (Podcast Host)]

Massachusetts does not have the death penalty. However, the fact that the VAMC is a federal building changes everything. Prosecutor William Welch describes how it came into play in Kristen's case. Explain to us how this being a federal case changes that.

[William Welch (Prosecutor)]

Yeah, the federal system is different. And if you charge a capital murder case in federal court, depending upon the nature of the crime, then the death penalty is a potentially eligible sentence. And that's what happened in this case.

[Dr. Michelle Ward (Podcast Host)]

And her criminal case is federal simply because she works at a VA hospital.

[William Welch (Prosecutor)]

Exactly. That was federal property. So the nature of the case certainly attracted a lot of media attention. But to add the death penalty in a state where the death penalty has been outlawed in state cases added another level of attention as well as complexity to the case. And so therefore we knew for sure that if she was going to be found guilty of any of the eligible first degree murder counts, she would also face the death penalty.

[Dr. Michelle Ward (Podcast Host)]

The last woman to be executed in Massachusetts was Rachel Wall. All the way back in 1789. She was executed for piracy in the same year that George Washington became the first president of the United States States. In other words, to have a woman facing the death penalty in Massachusetts in the year 2001 is nothing short of extraordinary. Adam Gorlick is just one of the many members of the media to write about this dramatic penalty phase to an already gripping trial.

[Adam Gorlick (Journalist)]

Well, that was very odd to have a death penalty case in Massachusetts. Prosecutors, I think, made a case clear from the get go that they wanted that option to press this. And it was fair to say socially it was an awkward thing to have in Massachusetts because politically you had people who felt very strongly against the death penalty. You also had people who felt very strongly for it.

[Dr. Michelle Ward (Podcast Host)]

I asked Christine Duquette about her thoughts on the death penalty. What were your thoughts about her facing the death penalty? What did you want to see?

[Christine Duquette (Victim's Sister)]

I definitely wanted to see it, especially seeing on the federal level the death penalty is lethal injection. And I thought you couldn't ask for anything more fitting.

[Dr. Michelle Ward (Podcast Host)]

Did you get receive any pushback for your position on that?

[Christine Duquette (Victim's Sister)]

Oh, yes, I lost friends.

[Dr. Michelle Ward (Podcast Host)]

What happened?

[Christine Duquette (Victim's Sister)]

I didn't realize that most people in Massachusetts feel that strongly about it. It's a whole, whole nother ball game. When it hits you to your immediate family and especially the circumstances of how and why she did it, it's like you, you don't deserve any leniency from anybody anywhere. And the whole thing was because the affair she was carrying on with, with the security guard, it was so they could meet one another.

[Dr. Michelle Ward (Podcast Host)]

The penalty phase gives families a chance to describe the impact that losing their loved ones has had on them. Nancy Cutting, Kenny's wife, gets up and shares what she remembers about visiting Kenny at the veterans hospital. If you did go see him there, we tried to walk in to uplift him, but he'd end up uplifting us by the time we left. I mean, he just, he was the sweetest person there. Nothing bothered him. It didn't his. He didn't let the disease get to him. This also invites members of Kristin's family to say what it would mean to them if Kristen were to be sentenced to death. One of the most emotional statements comes from Kristen's grandmother, who tells the jury what Kristin was like as a young girl and what they would do together when she babysat her granddaughter.

[Dr. Katherine Ramsland (Forensic Psychologist)]

She always used to like the fudge I made and she'd want me to make some fudge and she wanted me to teach her how to make it and I did.

[Dr. Michelle Ward (Podcast Host)]

Listening to her grandmother in court, Kristen becomes emotional for the first time. She breaks down in tears, possibly feeling nostalgic for her time spent with her grandmother, but probably also fearful for her future. The next person to speak from Kristen's family is Glenn Gilbert. However, Glenn doesn't speak in person. Instead, he delivers a statement in the form of a letter through a child psychologist who's been seeing the Gilberts boys, now 10 and 7, to help them deal with their trauma. The psychologist reads Glenn's powerful statement to the jury. Glenn Gilbert believes that when the children are emotionally and developmentally ready, it will be critically important for them for their mother to be alive, that she be physically available so that they can contact.

[Beatrice Yorker (Healthcare Expert)]

And speak and connect with her as.

[Dr. Michelle Ward (Podcast Host)]

Part of the process of their healing. He believes that the execution of their mother, Kristen Gilbert, would have a profound and profoundly detrimental impact on his children and their well being, including causing harm to his relationship with his children. Once the jurors hear from all of the family members on both sides, they are dismissed to make their final decision. I chat with Adam Gorlick, the journalist from the AP News, about this considerable task in front of the jury to decide whether Kristen lives or Dies a certain qualification that defense attorneys need to have if they're going to be defending a capitol can case. The same is true for jurors. You don't just get a regular jury to decide the penalty phase when it's. When death penalty is on the line. It has to be a death penalty qualified jury. And there is a lot of research indicating those jurors, those who are willing to invoke the death penalty, are more punitive.

[Medical Professional/Doctor]

Yeah.

[Dr. Michelle Ward (Podcast Host)]

So there's an argument that it should be a different jury. And often it is to decide the guilt and innocence phase versus the penalty phase.

[Adam Gorlick (Journalist)]

Yeah, yeah. And that's, you know, when you think of the jurors, what those people went through is just tremendous. And again, Michael Ponser, the judge, he was very, very aware of that. He was so concerned about his jury and making sure that those people, people were okay. I mean, so the trial started in November and it ended in March.

[Dr. Michelle Ward (Podcast Host)]

Wow, that's incredibly long. Judge Michael Poncer was also the judge presiding over Kristen's bomb threat trial at this stage. Sidebar Conversations between the prosecution, the defense and the judge go into minute detail. With stakes this high, the responsibility is huge. And the meaning and impact of single words can hold tremendous power. Judge Michael Poncer speaks to the jury ahead of the verdict decision.

[Narrator/Advertiser]

They have to find that the sentence of death is justified, and there isn't much help on what is meant by the word justified. But to me, the word justified means.

[William Welch (Prosecutor)]

That they have to find that that's.

[Narrator/Advertiser]

The, the only penalty that is appropriate and sufficient to do justice in this case. That's the approach I've taken in the instructions.

[Dr. Michelle Ward (Podcast Host)]

After the penalty phase deliberation, the jury is unable to reach a unanimous decision about Kristen's sentence. The final result is 8 to 4 in favor of her receiving the lethal injection. This means the death penalty, which requires unanimity, is now off the table. Judge Poncer sentences Kristen to four consecutive life sentences in federal prison without the possibility of parole. Kristen Gilbert is currently serving her life sentences in Carswell, Texas, a maximum security prison. Only Kristen knows the answer, and we may never learn how many patients she's currently killed. But we do know that statistically it's most likely she has killed a lot more than the four for which she was convicted. Dr. Catherine Ramsland tells me her thoughts.

[Dr. Katherine Ramsland (Forensic Psychologist)]

We really don't know how extensive her murders are. We know only the ones for which she was convicted. But the hard thing about healthcare serial killers is nailing them with evidence. We have a lot of cases where they Certainly committed more murders, but we can't bring forward any kind of indictment or conviction for a number of factors.

[Dr. Michelle Ward (Podcast Host)]

That's right.

[Dr. Katherine Ramsland (Forensic Psychologist)]

I wouldn't say she's responsible for 300 murders. Like I've seen some predictions, but I think that there are more in her background that she just wasn't caught for.

[Dr. Michelle Ward (Podcast Host)]

The trial may be over and just has been served in the form of a life imprisonment for Kristen. But the impact of her killings will have lifelong consequences on those affected. It doesn't just stop with the victims families. The nurses and doctors who worked with Kristen have been so deeply affected by her callous behavior.

[Medical Professional/Doctor]

I had heard an interview with a neurosurgeon and so they're more life and death than the average physician, of course. But they said that you had this little graveyard in your mind.

[Dr. Michelle Ward (Podcast Host)]

Oh, I wouldn't like that.

[Medical Professional/Doctor]

It stays with you. It stays with you. And so anyway, yeah, so Henry's in there.

[Dr. Michelle Ward (Podcast Host)]

Henry's in there. Christine Duquette.

[Christine Duquette (Victim's Sister)]

He didn't stand there with a gun in his hand with an enemy soldier.

[Dr. Michelle Ward (Podcast Host)]

In front of front of him.

[Christine Duquette (Victim's Sister)]

But hopefully maybe he helped save some people by lying there getting injections.

[Dr. Michelle Ward (Podcast Host)]

Wow, Christine.

[Christine Duquette (Victim's Sister)]

And that's why it bothers me so much that there isn't any kind of a monument for these people. They went through what they went through. It took their life. Where is that any different than any other soldier? Just to see something that says in remembrance for the victims of Kristen Gilbert.

[Dr. Michelle Ward (Podcast Host)]

Who served our country. The subject of healthcare serial killers has become important to me because it's an area I had not fully explored before. It seems there's a lot more that could and needs to be done to help protect more patients in hospitals settings. In this case, if it weren't for Kathy Ricks, Renee Walsh and John Wall having the courage to report their suspicions and follow through with them, who knows how long Kristen would have gotten away with murdering patients. Beatrice Yorker has a lot more to say on this subject. In your experience, what do you think happens when people suspect there's a killer in the hospital?

[Beatrice Yorker (Healthcare Expert)]

Rather than report to the authorities or go to law enforcement, they just fire the nurse and let them go to the next place. Which is what both Bruce Sackman and I want to change. We want to say to hospitals and the healthcare system, please do the right thing. Go to law enforcement, get an investigation going, start doing toxicology screens, pull the license of this person. If there are increased deaths when they're on duty, you pull them from duty. If the death rate goes back down to normal, you've got the separation test. You've got strong circumstantial evidence that the presence of this care provider caused an increase of codes. That's probable cause. Pull them from practice, do your investigation, and don't let them go back to practice. All you have to do is get them away from patients.

[Dr. Michelle Ward (Podcast Host)]

While analyzing Kristen Gilbert and talking about other healthcare serial killers out there, it's important we remember those whose lives have been taken. They're not just names of Kristen's victims. They're men who have families who had lives before they were sick and had to go to the hospital. And they were all dedicated to serving their country. Christine Duquette, Henry Houdon's sister, still has a lot of emotion about how her brother was taken too soon. If you could say anything to Kristen Gilbert, what would you say?

[Christine Duquette (Victim's Sister)]

It would be a lot. The bottom line is you have a window you can look out of. You have an outside you can go out to, you can exercise. You have a choice of a couple things of what you want to eat. You can chew your food, you can drink your water. And the worst thing of all, you can sit there like you are right now, taking one damn stinking breath after another. My brother hasn't been able to do that for 30 years and never will.

[Dr. Michelle Ward (Podcast Host)]

That was so beautifully said.

[Christine Duquette (Victim's Sister)]

So as far as I'm concerned, she can't suffer enough.

[Dr. Michelle Ward (Podcast Host)]

The sheer impact of healthcare serial killers has left me more shocked than I've been in a long time. It is a type of killing with incredible volume, and the opportunity is constantly there, and there's such a paucity of ways to even be aware it's happening. I'm floored by the lack of mathematical algorithms that in my mind should have already been said, set up to catch even the slightest outliers of a normal expected death rate at any given facility. I'm gobsmacked by this. The place you go to rely on the hands of others while you are most vulnerable is also the most fertile ground for a person who aims just to kill. That is a terrifying reality that as patients, we can't totally prevent. Thankfully, the systems are improving and healthcare professionals are more aware so that when there are irregularities, attention is brought to it much quicker. And at the end of the day, the vast majority of people who choose to go into healthcare professions are there to help others and save lives. Kristin Gilbert, the killer nurse, was thankfully caught and is behind bars for the crimes for which she was convicted. But the tragedy remains that the true number of victims that this monster took may never be Known Mind of a the Killer Nurse is produced by Aeromedia, a Fremantle company for id. The network Executive producer is Meredith Russell Aeromedia's producer is Rebecca Riddiel, Editor is Holly Griffin, audio engineering by Mahoney Audio Post Line producer is Sarah Tucker, production coordinator is Katie Whittington senior assistant Producer is Maddie Delaney, senior researcher is Yasmin Bowen Archive Producer is Ryan Hogan Aeromedia series producer is Linda McCarthy and executive producer is Stuart Pender. Kristen Gilbert voiceover by Sharon DiFronzo Glenn Gilbert voiceover by Ben Parks James Pralt voiceover by Carter Bellamy. 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.

[Narrator/Advertiser]

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[Beatrice Yorker (Healthcare Expert)]

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