How a Nuclear Lab Helped Catch a Serial Killer

Summary

Science Vs: How a Nuclear Lab Helped Catch a Serial Killer

Science Vs, hosted by Wendy Zuckerman and produced by Spotify Studios, delves into the intersection of science and real-world issues. In the gripping episode titled "How a Nuclear Lab Helped Catch a Serial Killer," released on November 28, 2024, the hosts explore the chilling case of Efren Saldivar, a respiratory therapist accused of murdering dozens of patients at Glendale Adventist Medical Center in California. This detailed summary captures the key points, discussions, insights, and conclusions from the episode, enhanced with notable quotes and timestamps.

---

1. Introducing the Mystery

The episode opens with Wendy Zuckerman introducing her co-host, Ashley Flowers from Crime Junkie, highlighting their shared background in biomedical science.

[00:01]
Wendy Zuckerman: "On the show, how a lab that designs nuclear weapons helped catch a serial killer."

[00:29]
Ashley Flowers: "I'm so excited to be here."

Their chemistry sets the stage for unraveling a true crime story intertwined with advanced forensic science.

---

2. The Spate of Suspicious Deaths

The narrative begins in late 1996 when several elderly patients at Glendale Adventist Medical Center die under seemingly natural circumstances. Initially dismissed as expected due to their chronic illnesses, the deaths of Salbi Asatrian, Eleanora Schlegel, and Jose Alfaro Sr. raise suspicions within the hospital staff.

[02:19]
Wendy Zuckerman: "It's two days after Christmas in 1996, and a woman named Salbi Asatrian is rushed to Glendale Adventist Medical Center..."

[03:14]
Ashley Flowers: "Oh, no."

[03:31]
Efren Saldivar emerges as the person of interest, with rumors suggesting he was purposefully injecting patients with harmful substances.

---

3. Efren Saldivar: From Biomedical Science to Crime

Efren's background is explored, revealing his oddball personality during high school and his eventual pivot from aspiring to be a doctor to focusing on research in respiratory therapy.

[06:24]
Ashley Flowers: "Hello."

[07:00]
Sarah Scholes (Science Journalist): "He worked at a grocery store. He played the oboe. He didn't have a ton of friends, but he was a pretty well liked kid and was kind of like the leader of the misfits."

Despite his likable demeanor, Efren's behavior at the hospital becomes increasingly questionable, leading to allegations of patient deaths being hastened by his actions.

[09:06]
Ashley Flowers: "Okay."

[09:07]
Wendy Zuckerman: "And so when Efren is just 19 years old, in 1989, he gets a job at Glendale Adventist Medical Center."

---

4. The Suspicions and Confession

A coworker notices Efren with suspicious drugs in his locker and reports him, but initial investigations find no higher mortality rates among his patients. However, in February 1998, under dubious circumstances and potential coercion, Efren confesses to murdering dozens of patients using drugs like Pavlon and succinylcholine.

[14:02]
Ashley Flowers: "Yeah, yeah, yeah, yeah, yeah, yeah. Gotcha, gotcha, gotcha, John."

[14:43]
John McKillop (Detective Sergeant): "I mean, they literally pulled me off the hockey rink to tell me, hey, your partner's on the phone. There's something going on."

Efren's confession, however, lacked physical evidence, invoking the legal principle of corpus delicti, which requires evidence beyond confession for a conviction.

---

5. The Quest for Physical Evidence

To secure a conviction, the authorities needed tangible proof of Efren's crimes. This is where the Lawrence Livermore National Laboratory (LLNL), known as the "Lab of Last Resort," steps in. The lab's forensic science center specializes in tracing minute chemical traces, making it pivotal in this case.

[24:53]
Wendy Zuckerman: "This lab is called the Lawrence Livermore National Laboratory... And why?"

[25:34]
John McKillop: "I don't know if you know about this place, but it's like, I mean, they weigh you when you go in to make sure your weight is consistent with what's on your ID and, you know, fingerprint you."

---

6. Overcoming Scientific Challenges

The main challenge was detecting Pavlon and succinylcholine in decomposed bodies years after death. Dr. Ian Musgrave explains the complexity of these drugs' breakdown and the absence of existing tests to identify them post-mortem.

[18:03]
Ashley Flowers: "Everything shuts down."

[19:27]
Ashley Flowers: "You can't convict someone just based on a confession."

LLNL scientists, including analytical chemist Armando Alcaraz, embark on developing a reliable test. They simulate the decomposition process using pig livers to create analogs for human tissues, dealing with overwhelming contamination from various sources like tobacco and embalming fluids.

[29:22]
Armando Alcaraz: "My God, are we going to find this stuff?"

---

7. Breakthrough at LLNL

After extensive experimentation, LLNL's team discovers a specific cartridge that effectively isolates Pavlon from the complex mixture of decomposed tissue chemicals. Utilizing mass spectrometry, they succeed in identifying Pavlon in exhumed bodies.

[36:54]
Ashley Flowers: "Wow."

[37:00]
Ashley Flowers: "Holy crap. That is incredible, isn't it?"

This breakthrough enabled the police to confirm Efren's involvement by matching the presence of Pavlon in the victims' systems.

---

8. Finalizing the Case

With the scientific evidence in hand, authorities exhume 20 highly suspicious cases to test for Pavlon. Although they couldn't test every patient, finding the drug in six individuals—including those initially suspected—strengthened the case against Efren.

[40:21]
John McKillop: "So finding the drug was a huge moment. We kind of erupted in clapping and, like, cheering type of thing."

Ultimately, Efren Saldivar was arrested again in January 2001, where he confessed to more crimes under pressure. Despite his initial claim of seeking the death penalty as a means to end his life, Efren was convicted for six murders and one attempted murder, receiving multiple life sentences.

[43:54]
John McKillop: "Well, I can kill 10 people per vial, and I probably had used 10 or 20 vials over the years. And so it was probably 100 to 200."

---

9. The Role of Science in Justice

The case of Efren Saldivar underscores the critical role of forensic science in the justice system. The collaboration between law enforcement and LLNL exemplifies how scientific advancements can bridge gaps in legal investigations, ensuring that evidence-based convictions uphold the integrity of the legal process.

[47:48]
Ashley Flowers: "I love it."

[48:10]
Wendy Zuckerman: "Science saved the day."

---

Conclusion

This episode of Science Vs masterfully illustrates the convergence of true crime and scientific innovation. Through meticulous investigation and pioneering forensic techniques, science not only unraveled a complex mystery but also delivered justice in a case that could have otherwise remained unresolved. The hosts highlight the importance of continuous scientific progress in addressing and solving intricate problems within society.

For more in-depth information about this case, listeners are encouraged to explore the episode's transcript and related resources linked in the show notes.

---

Notable Quotes:

• Wendy Zuckerman [00:01]: "How a lab that designs nuclear weapons helped catch a serial killer."

• John McKillop [15:30]: "They would have definitely felt it."

• Armando Alcaraz [29:22]: "My God, are we going to find this stuff?"

• Ashley Flowers [41:07]: "Wow."

• Wendy Zuckerman [47:48]: "Science saved the day."

---

References:

• Book Mentioned: Countdown: The Blinding Future of Nuclear Weapons by Sarah Scholes.
• Key Individuals:
  • Efren Saldivar: Respiratory therapist and convicted serial killer.
  • John McKillop: Detective Sergeant with Glendale Police Department.
  • Armando Alcaraz: Analytical Chemist at Lawrence Livermore National Laboratory.
  • Sarah Scholes: Science Journalist.

Produced by: Katie Foster Keys and Joel Werner
Edited by: Blythe Terrell
Mix and Sound Design: Sam Baer
Fact Checking: Diane Kelly
Music: Wiley, Bobby Lord, and Bumi Hidaka
Special Thanks: Roland Campos, Steve Wampler, Audrey Williams, and others.

For more episodes of Science Vs, listen on Spotify or your preferred podcast platform.

Transcript

[Wendy Zuckerman]

Hi, I'm Wendy Zuckerman, and you're listening to Science versus Today. On the show, how a lab that designs nuclear weapons helped catch a serial killer. And if you're going to do true crime, you better bring in the true crime queen, host of Crime Junkie Ashley Flowers. Welcome to Sidespresses. Hello.

[Ashley Flowers]

I'm so excited to be here.

[Wendy Zuckerman]

So something that a lot of people might not know about you is that you graduated from biomedical science. That was your degree.

[Ashley Flowers]

It was.

[Wendy Zuckerman]

And we are twinsies. We both have this degree.

[Ashley Flowers]

I thought I really wanted to be a doctor when I was young, and I was, I think, fortunate enough to have to work full time to put myself through school. And I worked at a hospital for all five years and went to school at night, and I got to work side by side with residents who you have to be before you're a doctor. And I was like, oh, that's not the life I want.

[Wendy Zuckerman]

Right.

[Ashley Flowers]

I made a bit of a pivot and I finished my degree with actually a focus in research.

[Wendy Zuckerman]

And so what do you like about science?

[Ashley Flowers]

I like facts. And I think so much in life can be so subjective. And what I love about science is it feels like there are real answers and not just opinions. Like there are. Sometimes things get to be black and white, and that's not very often. Do you get that?

[Wendy Zuckerman]

Yes. Yes. I think that's one of the reasons I love science, too. It's a way to understand the world.

[Ashley Flowers]

Yeah.

[Wendy Zuckerman]

If science is your side piece, I guess your true love is really mysteries. Yes. Then I've heard you say that you are obsessed with solving mysteries.

[Ashley Flowers]

Obsessed.

[Wendy Zuckerman]

What is it about a mystery that just grabs you and you cannot let go?

[Ashley Flowers]

I think I'm just overall, like a very curious person. The more that I've really drilled into it and I. I want to. I want the answers to everything. The universe. I want the answers to all the unsolved mysteries. Like, give them to me.

[Wendy Zuckerman]

Well, today we have a real mystery for you, and it's got a whole bunch of science in it. So should we jump in?

[Ashley Flowers]

Let's do it.

[Wendy Zuckerman]

It's two days after Christmas in 1996, and a woman named Salbi Asatrian is rushed to Glendale Adventist Medical center in California. She's 75 years old and is having trouble breathing. One hospital worker told the LA Times about her. He said, she's a sweet old lady. She got treatment at the hospital, and on December 30th, she's breathing on her own. Things are looking pretty good for her. But then three And a half hours later, Salby was dead. That same day, Eleanora Schlegel goes into Glendale Adventist. She has some chronic illnesses. A nasty case of pneumonia. On New Year's Eve, her son Larry, he said in a documentary that she was sitting upright and breathing as best as she could. They apparently have this toast and say, next year will be better.

[Ashley Flowers]

Oh, no.

[Wendy Zuckerman]

But on January 2nd, Larry sees a message on his answering machine, and it's from the hospital. His mum had died.

[Ashley Flowers]

And they're just toasting the day before.

[Wendy Zuckerman]

Yeah. Yeah.

[Ashley Flowers]

Oh, my gosh.

[Wendy Zuckerman]

Similar situation happens again. Jose Alfaro Sr. He was a father. He'd fought in World War II. He arrives at Glendale with severe pneumonia and two days later is found dead.

[Ashley Flowers]

Hmm.

[Wendy Zuckerman]

And at the time, these deaths are sad, of course, but they don't raise any eyebrows because these patients, they were sick, had chronic illnesses. You know, it's a hospital. People die.

[Ashley Flowers]

And how close together are all three of these? Like, pretty close.

[Wendy Zuckerman]

Really close. Within days of each other.

[Ashley Flowers]

Okay.

[Wendy Zuckerman]

A few months later, though, rumors have been circulating that the deaths of patients like these didn't happen just because they were sick and elderly, but that these people were killed on purpose by someone who works at the hospital. The rumor is that someone is injecting something into their iv. Ashley, tell me what your face is doing right now.

[Ashley Flowers]

Well, I'm just. What do you mean rumors? Like, I feel like this isn't something that should be a rumor if people know that someone's walking around, like, killing people.

[Wendy Zuckerman]

Yeah. We're gonna get into what these rumors are, who everyone is blaming.

[Ashley Flowers]

Okay.

[Wendy Zuckerman]

What on earth happened here and how the hell a lab that develops nuclear bombs got involved?

[Ashley Flowers]

Naturally.

[Wendy Zuckerman]

Naturally. Are you in?

[Ashley Flowers]

I'm in.

[Wendy Zuckerman]

We're gonna do this just after the break. This episode of Science Versus Is brought to you by Ford. There are few pickups more iconic than the F150. And the 2024 F150 Lightning truck is no exception. With an EPA estimated range of 320 miles. With the available extended range battery, it's the only EV that's an F150. Visit Ford.com to learn more. Excludes Platinum models. EPA Estimated Driving Range based on full charge. Actual driving range varies with conditions such as external environment, vehicle use, vehicle maintenance, high voltage battery age, and state of health.

[Ashley Flowers]

There's no better feeling than a personal win. And the State Farm Personal price Plan can help you do just that. Talk to a State Farm agent today to learn how you can bundle and save with the personal price Plan. Like a good neighbor State Farm is there. Prices are based on rating plans that vary by state. Coverage options are selected by the customer. Availability, amount of discounts, and savings and eligibility vary by state.

[Wendy Zuckerman]

Welcome back. We've just found out that patients at a hospital in California are dying under perhaps suspicious circumstances. Ashley Flowers, host of Crime Junkie, is here with us. Hey, Ashley.

[Ashley Flowers]

Hello.

[Wendy Zuckerman]

So it's now 1997. Whispers are going around that one guy might be killing these patients, and his name is Efren Saldivar. So we talked about him with science journalist Sarah Scholes, who wrote a book about nuclear weapons and stumbled across this case. So Sarah told us that back in Vertigo Hills High School, Efren was a bit of an oddball.

[Sarah Scholes]

He worked at a grocery store. He played the oboe. He didn't have a ton of friends, but he was a pretty well liked kid and was kind of like the leader of the misfits.

[Wendy Zuckerman]

In the senior Will's section of his high school yearbook at Vertigo Hills, he wrote, I ephron of great mind and hunk body, hereby will three quarters of Vertigo's FEMA population. My enduring love and passion, the right to preserve me in their hearts and souls for the rest of their lives and other times, eternally yours and mine. Efren, stud it large.

[Ashley Flowers]

Literally. Efren. No one asked, like, what?

[Wendy Zuckerman]

Efren, it's real oddball energy there was.

[Ashley Flowers]

He actually of hunk body.

[Wendy Zuckerman]

You know, it was the 80s. He was pretty nerdy. A hunk would not be if I was making a film, a high school film, he would not be cast in the hunk category. It would more be in sort of the dweeby oddball category.

[Ashley Flowers]

I love it.

[Wendy Zuckerman]

Ok, so Efren makes it through senior year, but ultimately drops out of high school. So he's working at a grocery store and one day his friend came in.

[Sarah Scholes]

Wearing a medical uniform. He had a friend who was working at a hospital and he, he just really liked this guy's uniform. And he was like, I guess I'll do that. I guess I'll get a medical career. I like the clothing.

[Ashley Flowers]

Scrubs.

[Wendy Zuckerman]

Yeah.

[Ashley Flowers]

Is he talking about scrubs?

[Wendy Zuckerman]

He liked the scrubs. Which might sound like a weird reason to go into the healthcare profession, but, you know, you're 18. Cute fit. It's as good as any reason.

[Ashley Flowers]

I like cute fit. I like it. It's pajamas. Like, I used to wear scrubs. They're pajamas.

[Wendy Zuckerman]

I think the person who came in also had a stethoscope, so that might be kind of cool as well.

[Ashley Flowers]

Just like radiating power. Yeah, I get it.

[Wendy Zuckerman]

So Efren enrolls in a respiratory therapy program, and respiratory therapists help patients who have trouble breathing. So they give patients drugs, oxygen and manage ventilators, stuff like that.

[Ashley Flowers]

Okay.

[Wendy Zuckerman]

And so when efren is just 19 years old, in 1989, he gets a job at Glendale Adventist Medical Center.

[Ashley Flowers]

I see where this is going.

[Wendy Zuckerman]

This is the place where the patients at the start of the episode died. So at Glendale Adventist, part of Efren's job was to take care of really sick elderly patients. And Efren is put on the graveyard shift. So he starts moonlighting and working at other jobs, too, during the day, other hospitals. So Evan is working all these jobs. He's a bit overwhelmed, and at one point, he starts gaining some notoriety at the hospital. So here's Sarah, our journalist again.

[Sarah Scholes]

He had a reputation at work for having a magic syringe.

[Wendy Zuckerman]

What did they mean by that?

[Sarah Scholes]

Not magic in the positive way, but magic in the deadly way. His patience died faster than other people's patients.

[Ashley Flowers]

That's not magic. That's murder. Right.

[Wendy Zuckerman]

Magic feels like a really weird word to describe it. And this is where from reporting about this hospital at the time, it seemed like the healthcare workers, particularly the respiratory therapists, had this really, you could call it a dark sense of humor. They just. They played practical jokes on each other.

[Ashley Flowers]

So having worked at a hospital, having worked with a ton of people in law enforcement, I have seen this in a place where you see a lot of death or there's like, a lot of trauma, having that, like, very dark sense of humor tends to be. I've seen a way that a lot of people deal with it. So it's not even super surprising to me to, like, see that in the hospital setting.

[Wendy Zuckerman]

Yeah.

[Ashley Flowers]

But still.

[Wendy Zuckerman]

And then sort of other things start happening that make it harder to pass off as a joke. So here's Sarah.

[Sarah Scholes]

Someone had seen him putting something in an IV line that they thought shouldn't be there.

[Wendy Zuckerman]

A coworker also says he sees an empty syringe and a bunch of drugs in Efren's locker. Drugs like morphine and this medication called succinylcholine, which is going to become important later. OK. And so in April of 1997, a coworker ends up reporting Efrin to a supervisor, but the supervisor doesn't know about the drugs in the locker, so they really don't have that much to go on. It's just kind of rumour in a place where there's a lot of rumors and jokes going around. But still, they look into the hospital records to see if Efren's patients are dying more often than other patients and.

[Sarah Scholes]

Didn'T find anything because his patients weren't actually dying at a higher rate than anyone else's.

[Wendy Zuckerman]

Oh, yeah. So they didn't find anything unusual here. They let it go. Efren keeps working. And it's not until almost a year later, in February 1998, that the hospital receives another tip from someone who says.

[Sarah Scholes]

That there is a respiratory therapist who the quote is, helped a patient die fast.

[Ashley Flowers]

And is this like a euthanasia situation or what does that like? What do they mean?

[Wendy Zuckerman]

The guy on the phone ends up being a pretty dodgy guy with a criminal record and seems to be implying that if he gets an extra $50,000, he'll give more information.

[Ashley Flowers]

Wow.

[Wendy Zuckerman]

He's basically extorting the hospital.

[Ashley Flowers]

Yeah.

[Wendy Zuckerman]

And so this time, the hospital calls in the Glendale Police Department. And by the way, we did reach out to the hospital to ask them about parts of this story.

[Ashley Flowers]

And let me guess. They didn't want to talk.

[Wendy Zuckerman]

Yeah, yeah, yeah, yeah. They said.

[Ashley Flowers]

Let me finish that for you.

[John McKillop]

Thank you.

[Wendy Zuckerman]

Y All questions should be directed at Glendale Police Department. So enter Detective Sergeant John McKillop from the Glendale Police Department. He is put onto this case, and John and his team start poking around. And John told us that he is actually not buying this idea that Efren is a killer.

[John McKillop]

I was a skeptic because it just seemed odd. The whole thing seemed odd.

[Wendy Zuckerman]

What was so odd about it?

[John McKillop]

Well, I mean, to be honest, you're talking about someone trying to extort money out of the hospital to give information versus I'm a major serial killer. I just thought it was a bunch of bull, so to speak.

[Wendy Zuckerman]

How are you feeling at this point, Ash? What's your spidey senses telling you?

[Ashley Flowers]

I mean, I under. Well, I understand what he's saying, and it's funny. Like, I feel like the way that I'm at least hearing this is that the hospital really brings in the police because of the extortion, not because of the threat of somebody actually killing their patients.

[Wendy Zuckerman]

Yeah, that's John's memory of it as well.

[Ashley Flowers]

Yeah, yeah, yeah, yeah, yeah, yeah. Gotcha, gotcha, gotcha, John. So I understand why he would just kind of come in with that thought of, like, well, this can't be true. It's just some guy. He wants $50,000 to out a serial killer. Like, there's no way. I would probably think the same thing too.

[Wendy Zuckerman]

Yeah. So but still, to sort everything out, on March 11, 1998, John's partner, Detective William Curry, calls Efren into the station just to ask him some questions. But John actually had something else to do that day.

[John McKillop]

Will was gonna bring Efren in to interview him. I'm like, I'm gonna go play hockey. So I went to my hockey game.

[Wendy Zuckerman]

You were so shocked that, like, this is silly.

[John McKillop]

Yeah, exactly.

[Wendy Zuckerman]

I love it, right?

[Ashley Flowers]

It's like, no need.

[Wendy Zuckerman]

I've got a hockey.

[Ashley Flowers]

You take care of this.

[Wendy Zuckerman]

But it turns out this was not silly. When the cops start questioning Efren, he confesses to killing dozens of patients.

[Ashley Flowers]

He just, like, all they had to do was ask some follow up questions, and the dude just folds pretty quickly.

[Wendy Zuckerman]

He says he killed 40 to 50 people. Yeah.

[Ashley Flowers]

Over, like, what span of time?

[Wendy Zuckerman]

It's pretty vague at this point. It's very. The cops just found it very strange, particularly given this attitude of, I'm gonna go play hockey. Sure, bring him in. They want him to do a polygraph. The way that the cops remember it is just all of a sudden, he starts talking. And they were in the room going.

[Ashley Flowers]

Oh, someone get a pen. Like, write this down.

[Wendy Zuckerman]

Exactly, exactly. And so John is playing hockey.

[John McKillop]

I mean, they literally pulled me off the hockey rink to tell me, hey, your partner's on the phone. There's something going on. You need to go. And when I picked up the phone, Will says, this guy's confessing. He's rolling over. You need to get in here right now. You know, now we're talking about murders.

[Ashley Flowers]

Oh, my God.

[Wendy Zuckerman]

So not only did he say that he killed patients, but he also told the cops how he did it. Like, sometimes he would kill them with these drugs. He said he either used a drug called Pavilion or one called succinylcholine, which.

[Ashley Flowers]

Is what they found in his locker. Wow.

[Wendy Zuckerman]

Exactly.

[Ashley Flowers]

Does he say why?

[Wendy Zuckerman]

At the time, he said that he did it to ease the suffering of these patients.

[Ashley Flowers]

But we had our homegirl over here who's like, cheersing to a brand new year.

[Wendy Zuckerman]

Yes, yes. It doesn't. It doesn't really make sense.

[Ashley Flowers]

Okay.

[Wendy Zuckerman]

He sort of fashions himself as a little bit of an angel of death type character in that room that he didn't like seeing the patients suffering, says things like that.

[Ashley Flowers]

Okay.

[Wendy Zuckerman]

So we wanted to know a little bit more about what these drugs do in the body and why they're used by healthcare workers. So we talked about this with Dr. Ian Musgrave, and he's a molecular pharmacologist at the University of Adelaide in Australia. He told us that pavlon and succinylcholine, they interfere with how a particular neurotransmitter works in our body. And ultimately, they can paralyze your muscles. They stop the nerve signaling, so your muscles just stop working. Now, you may be saying, okay, why would you want to paralyze respiratory muscles? That is, if you don't want to kill someone, why are we using these drugs in hospitals? And. Well, these drugs are sometimes given to patients before surgery, and it helps doctors to intubate them, you know, put the tube down their throats. It can stop you from gagging, or if you wake up during, let's say, surgery, it would keep you from moving around so a scalpel doesn't slip. But because these drugs paralyse the muscles that allow you to breathe, if you're using them in a medical setting, you have to give someone a breathing tube or a respirator. So you're giving them oxygen artificially, of course. If you give a paralysing dose of these drugs without putting in a breathing tube and without artificially respiring them, guess what happens?

[Ashley Flowers]

Everything shuts down.

[Wendy Zuckerman]

They die. They suffocate because they can't breathe. What would it be like to die like that? Incredibly horrible. You're paralysed and you can't move and you can't react and you're suffocating to death. If some of his victims weren't unconscious, they would have felt it.

[John McKillop]

They would have definitely felt it.

[Ashley Flowers]

Oh, just like silent suffering.

[Wendy Zuckerman]

Yeah, that's right. Because you. Ian, we talked about it, and he said it would be almost like drowning because you're not anesthetised necessarily. So these drugs don't conk you out or, you know, put you to sleep, so you just can't breathe and you.

[Ashley Flowers]

Can'T even, like, move or scream. Oh, my gosh. I can't imagine.

[Wendy Zuckerman]

Awful. Awful. Now, it is worth saying that in Efren's confession, according to the cops, he said that he would only do this to patients who are unconscious.

[Ashley Flowers]

I don't. Like, there's no way. All 40 of them.

[Wendy Zuckerman]

Yeah, I don't know how we can know that for sure. Exactly. So the cops hold Efren Saldivar on suspicion of murder. But even though he'd given this detailed confession, admitted to killing dozens of people in the us, that's not enough to go on because of this rule that's called corpus delicti. Yeah. So tell us about it. Body of the crime. Tell us what it is so the corpus delicti.

[Ashley Flowers]

You can't convict someone just based on a confession. Their confession has to actually match some kind of physical evidence, where basically, like, if you took the confession away, you have to still be able to prove that they did it by some other means, whether that's physical evidence, circumstantial evidence, other witnesses. But you should not be able to convict someone just by them saying, I did this thing.

[Wendy Zuckerman]

Yeah. And in this case, all they have is a confession. They don't have any physical evidence because these patients really just could have died because they were sick.

[Ashley Flowers]

Yeah. Okay.

[Wendy Zuckerman]

So John, the cops hold him for a couple of days while they're doing some detective work, but in 48 hours, what's she going to come up with? And so they have to let him go. And when he gets out, Efren goes on national television and says that he lied about the confession. And Sarah, our journalist, told us that Efren basically says, I didn't do it.

[Sarah Scholes]

I was depressed and suicidal and thought this was a way out. And the detective pressured me, and so I don't confess anymore.

[Ashley Flowers]

A way out of what?

[Wendy Zuckerman]

A way out of life. He sort of gave this idea that he was really depressed and basically suicidal and thought that if he confessed to these killings, then maybe he would be given the death penalty, and then that would be his way out.

[Ashley Flowers]

Okay. But then he changed his mind, he says.

[Wendy Zuckerman]

I guess so. I guess so. He also said at the time that he was taking Valium and other sedatives and barely remembered what he said to the cops. And even a hospital spokesman around that time said, quote, we don't know if anything happened, end quote.

[Ashley Flowers]

Mm, mm, mm. Did he get, you know, in a room and pressured? Like, that's an easy thing to say. Like, do you also say the thing that's been weighing on you? And then all of a sudden, when, like, the gravity of what that means and, like, what the consequences are, when of that sets in, the story changes. Like, oh, maybe I. Oh, gosh, I didn't know what I was like saying.

[Wendy Zuckerman]

Yeah. But meanwhile, the medical board responsible for respiratory therapists suspends Efren's license to practice, so he's no longer working at the hospital. And the cops, cops like John, they're not totally buying that his confession was a lie because it was just so specific, the drugs he used, you know? Yeah. How. Exactly how he did it, it felt like a weird thing to just say. So the cops stay on the case and actually create a task force to find out what is going on here, and they start going through every patient that died under Efren's watch, and they're looking for suspicious cases, and this is a huge task. It meant wading through more than a thousand complicated medical records.

[John McKillop]

Oh, it was completely cra. I mean, we're cops, we're not doctors. So we had to learn how to read medical charts and do all that stuff quickly, trying to become experts at something none of us had expertise in.

[Wendy Zuckerman]

But they talk to the doctors, and they learn fast. And they're looking for patients who weren't given Pavlon or succinylcholine legitimately at the time of their death, so they didn't need it for surgery. They start looking for patients as well, who, at the time of their death, had this particular pattern in their breathing and heart rate moments before they died that might suggest they were given Pavlon or succinylcholine. They're also on the hunt for situations like Salbiosatrians. And the other patients we talked about at the start of the show where they're doing better, and then suddenly they die for no clear reason. Mm.

[Ashley Flowers]

Like nosedive. Yeah.

[Wendy Zuckerman]

And so, after months of trawling through these records, they come up with 20 people whose deaths at the hospital were highly suspicious. And so now the plan is to exhume the bodies from a cemetery and search for the drugs that Efren had said he used to kill the patients.

[Ashley Flowers]

And are they the kind of thing that would last for a while, like, in the system? Like, would you still see him, Ashley?

[Wendy Zuckerman]

That is the question. Because the cops start asking around, and they realize that we do not have a good test to find these drugs in this situation. Basically, you can't pull out some easy peasy test off our forensic science shelf that would detect what's expected to be pretty low levels of pavilion or succinylcholine in a decomposing human body. So, bottom line, even if they exhumed those bodies from those graveyards, there's no reliable test to find these drugs inside them.

[Ashley Flowers]

They've got nothing. So now what?

[Wendy Zuckerman]

The story can't end here, obviously. Obviously. They get a tip that there is this place that just might be able to help them. It's a lab that some call the Lab of Last Resort.

[Ashley Flowers]

What a name.

[Wendy Zuckerman]

It's where we're at in this story, right?

[Ashley Flowers]

Yeah, true.

[Wendy Zuckerman]

This lab is called the Lawrence Livermore National Laboratory. It's this huge sprawling facility in California that was created in the early days of the Cold War and does some truly bonkers stuff. So they design nuclear warheads. They have one of the world's most powerful lasers. And they also have this forensic science centre that can trace tiny amounts of chemicals. Why?

[Ashley Flowers]

What are they doing at this lab?

[Wendy Zuckerman]

So they use it to find chemical weapons. Evidence of chemical weapons in an environment. Oh, and also alleged murderers. And here's how John describes this lab.

[John McKillop]

I don't know if you know about this place, but it's like, I mean, they weigh you when you go in to make sure your weight is consistent with what's on your ID and, you know, fingerprint you. And it's like a high, really super high level, high security kind of village.

[Wendy Zuckerman]

After the break, we'll get inside that high security village. The lab of last resort.

[Ashley Flowers]

Let's do it.

[Wendy Zuckerman]

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[Ashley Flowers]

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[Wendy Zuckerman]

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[Armando Alcaraz]

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[Wendy Zuckerman]

Use as directed. This episode is brought to you by Etsy. Oh, hear that?

[Ashley Flowers]

Okay, thank you.

[Wendy Zuckerman]

Etsy knows these aren't the sounds of holiday gifting. Well, not the ones you're hoping for. You want squeals of delight, happy tears.

[Ashley Flowers]

How did you.

[Wendy Zuckerman]

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[John McKillop]

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[Wendy Zuckerman]

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[Wendy Zuckerman]

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[Wendy Zuckerman]

Let's run there. Head to BrooksRunning.com to learn more. Welcome back. Today on the show, I'm here with Ashley Flowers, host of Crime Junkie. And we are cracking the case of Efren Saldivar, a healthcare worker who's suspected of killing dozens of patients. Wide open. Let's do it. So we're now heading to the Forensic Science center at Lawrence Livermore National Laboratory in California.

[Ashley Flowers]

The lab of last resort.

[Wendy Zuckerman]

And it's now up to some serious nerds to try to detect the tiny amounts of drugs in bodies that have been buried for years. Mm. Armando Alcaraz is an analytical chemist who works at Lawrence Livermore. And he was on the team who had to now create this test. And when he heard about what he had to do, he was like, oh.

[Armando Alcaraz]

My God, are we going to find this stuff? And I was a big skeptical. I thought it was still going to be enough contamination and at such low levels that we weren't going to be able to see it. And we would then have to sort of pull that needle, you know, out of a haystack.

[Wendy Zuckerman]

So here's what they have to do. Let me describe the needle in the haystack. So needle is the drugs. The haystack are the loads of other chemicals that would be in these decomposing bodies. Armando told us that some of the patients were smokers, so tobacco would have been contaminating the tissue. So would any embalming fluid used in the burying process. Dirty water would have been seeping into the coffins by now, leaching in all of these chemicals from the soil surrounding it. And it meant that if you were to look in liquid in their bladder.

[Armando Alcaraz]

At that point, you don't know whether it was actually real urine or whether water seepage had gotten into that coffin and there was moisture in it. And that's what you're analyzing.

[Ashley Flowers]

Ooh.

[Wendy Zuckerman]

Right.

[Ashley Flowers]

You don't even know if it's like body fluid or outside fluid or.

[Wendy Zuckerman]

Ugh. Exactly. So they get to work and they quickly realize that one of the drugs that Efren had said he used to kill patients, succinylcholine, that is basically a lost cause. It's just too hard to identify it in a human body after all this time.

[Armando Alcaraz]

And the reason is it breaks down real fast. And when it breaks down into the metabolites. Those metabolites can be found in the human body anyway. So how could you go into a court of law and say, well, here we found these metabolites. Well, the defense lawyers are going to go, well, and what does that mean? They're normally found in a human body anyway, but with Pavlon, there's no reason why a person should have that drug in their system unless they had a procedure or somebody injected them with it.

[Wendy Zuckerman]

So they zoom in and try to create a test to identify Pavlon. And because they don't want to be doing this work in human bodies, they start working with something that's pretty close to a human body. Pig. Pigs.

[Ashley Flowers]

They were.

[Wendy Zuckerman]

Yes, yes. So Armando and his colleague gets pig livers, and they add a tiny bit of pavilion, spike it, you know, put.

[Armando Alcaraz]

The chemical in it, and then just allow it to putrefy. And then you take it out and homogenize it. You basically put it in a blender and make milkshake out of it.

[Wendy Zuckerman]

Your face in this moment.

[Ashley Flowers]

I know. It's like the milkshake. Pig liver.

[Wendy Zuckerman]

Yeah. You can really feel it in your throat, can't you? Things are about to get a little bit grosser. So because they would take this pig liver, Pavlon milkshake, and in some cases let it sit and decay for months, making it more like what these bodies that have been decaying would be like. At this point, Armando and particularly his boss, Brian Andreessen, are up to their elbows in decomposing pig livers. Word on the street is that the lab did smell kind of gross. What did it smell like?

[Armando Alcaraz]

There's these two notorious chemicals, putrescine and cadaverine. So just the names themselves kind of give you an indication of what it smells like.

[Wendy Zuckerman]

Cadaverine. Is that what you say?

[Armando Alcaraz]

Cadaverine and putrescine.

[Ashley Flowers]

It had to have smelled so awful. I just went into my first morgue for the first time recently, and there weren't. Even if that was bad, I have no clue what this place would smell like.

[Wendy Zuckerman]

So decomposing bodies, whether it's pigs or humans or whatever, they emit these chemicals. And the two that he talked about, cadaverine and putrescine, they give off that particular smell of death, that smell that you described. And here's how Armando described it.

[Armando Alcaraz]

It's everything awful you could think of that's rotting. That's what it smells like. And so I have to tell you this story because I spoke to Brian and we would be working late at night you know, trying to get these samples through. And he would be, you know, blending these tissues up with the, with the blender. And even though we were doing all this in the chemical hoods, you could still smell that stuff. And it would penetrate your clothes, it would get into your clothes. And so it would already be maybe 9:30 at night, was late, you know, and he said, I'm, I'm gonna go. And I'd leave too. He'd go to the grocery store to go buy some stuff to E. And so he would be standing in line and people would start to just move away from him because he had sort of was, you know, that smell of death was just in his clothes and in his hair and everything.

[Ashley Flowers]

It stays on you. I've talked to detectives who have said that there are scenes that they come home from and they have to just like burn their clothes or throw away their clothes because no amount of washing will get it out. There is just like a level that is beyond anything I think most people know.

[Wendy Zuckerman]

Yeah, bad. So while covered with this smell of death, they take the. We're going to go back to the decaying pig milkshakes that have been spiked with Pavlon. And they pass them through this particular contraption that's called a solid phase extraction polymer. It looks a bit like a plastic syringe and it has a kind of filter in it or what's called a cartridge. And inside it, they're basically trying to separate Pavlon from all the other crap that is in these tissue samples. But what you have to know is that there's different cartridges out there that are used to isolate different chemicals. I had never thought about how one would isolate chemicals from a human body. Mm.

[Ashley Flowers]

Mm. Not what I've spent my brainpower on.

[Wendy Zuckerman]

No. And so basically they're pushing all tiny bits of samples through these little syringes. And what the game is to find the exact right cartridge that's gonna trap Pavlon but leave out everything else. Yeah, everything else, or as much as possible of everything else. And so Armando's colleague has been working on finding the right cartridge. Armando's focusing on another piece of this puzzle. It's really tough just passing this milkshake through these filters could take days. Depending on how decayed the tissue is or how much mucus is in it. May turns into June. They're pulling 16 hour days. It's just late night after late night.

[Armando Alcaraz]

They had that task force that was just sitting there waiting for the results so they could move forward. So that was putting a Lot of pressure on us, and that's why we were working late.

[Wendy Zuckerman]

They're not finding what they need. It's depressing. Nothing is working. No.

[Armando Alcaraz]

Boy, what the heck's going on? And so the instrument would start leaking on me, the solvents, and I'd be frustrated and just like, oh, pulling my hair out.

[Wendy Zuckerman]

But then one day, Brian is testing this cartridge that was designed to detect the residue of chemical weapons. And from across the room, Armando hears his colleague saying something.

[Armando Alcaraz]

He goes, I think we're there. It was solid. Actually. What the cartridge did was it acted like a magnet where it would just collect the drug or things similar to the drug, and sort of it gripped onto it, and then it allowed us to then wash off all of, like, the tobacco products and other biomaterials that were in the tissue, but the drug stayed attached.

[Ashley Flowers]

Wow.

[Armando Alcaraz]

But no. Yeah, that was amazing. That was a magic cartridge.

[Ashley Flowers]

Holy crap. That is incredible, isn't it?

[Wendy Zuckerman]

They found the magic cartridge. So Armando would now extract all the chemicals in the cartridge, and then using a bunch of tools like mass spectrometry. Oh, my God. This is why we call it mass specs, because it's such. There's so many Rs in that word. Using tools like mass spectrometry, which separates chemicals based on their weight, and then try to identify Pavlon in that sample. And here, Armando catches a break, because it turns out that Pavlon creates this really unique signature, which meant, yes, they can identify this drug. And so now it's time to see if what works in pig livers works in human bodies. So in the spring of 1999, the cops start driving out to the graveyards and bodies start getting exhumed. And John said, even for him, this. Pulling out bodies from the ground, this was. This was rough.

[John McKillop]

I've seen a lot of dead bodies, but when you exhume a body, it's unnatural. You're pulling the casket out of the ground, you're cracking open the casket, and you don't know what you're going to find. One time we opened a casket, and the maggots inside the casket were jumping out. Like, I can remember them landing on my protective gear on my chest.

[Ashley Flowers]

Oh, that is rough. That's, like, not part of the job description.

[Wendy Zuckerman]

Oh. So the caskets get opened, bodies removed, tissue samples are taken out and then sent to the lab of last resort. Finally, after all this time, Armando and his colleagues start testing their very first patient. And, you know, at this point, if they find Pavlon in these bodies, it really does mean, you know, there was no reason for Pavlon to be in their system unless Efren had put it in there. So they start testing patients.

[Armando Alcaraz]

We didn't see anything. I mean, there was no signal. Then the second set of samples for the second patient, and there was nothing there. And then, you know, the third one, nothing there. And then I'm thinking, oh, God, what's going on? Is there just nothing in some of these tissues? You start to doubt whether you're going to see anything.

[Wendy Zuckerman]

And then they test the fourth patient.

[Armando Alcaraz]

And I was like, I got something here. It's there. And so I ran over to Brian and I pretty much ran over there saying, you gotta look at this. We got a hit on this. It's confirmed. It's there. It was that. Yes, we did it. So then we were. We were on a roll, and we started looking at various tissues from that individual. And sure enough, we were getting positives, you know, on the kidney, on the bladder tissue, on the brain. So all of these. That one patient was hot.

[Ashley Flowers]

Wow.

[Wendy Zuckerman]

Yeah. They test another body, they don't find it, but then they get another hit and another hit, and they tell the cops, you know, these. Pavlon, we are finding it. And John remembers how he felt.

[John McKillop]

So finding the drug was a huge moment. We kind of erupted in clapping and, like, cheering type of thing. And then finding the drug in multiple patients, that was the. Then we knew. We knew we had it.

[Ashley Flowers]

They did it. They did it. So do they have to go exhume every single patient that he's ever come in contact with or, like, where do they go from there?

[Wendy Zuckerman]

Yeah. So they picked out the 20 patients that were most suspicious because they couldn't exhume 1,000 bodies. So these are the suspicious cases.

[Ashley Flowers]

And do they think that the others truly didn't have it in their system? Like, they would have. They would have detected that or they're unsure about the other ones, I think.

[Wendy Zuckerman]

We don't know. They could have been killed with succinylcholine instead. Or it could have been that the pavilion was at too low levels to detect, or it could be that maybe the rest of the patients actually weren't killed by Ephraim. We don't know. That's the thing. When you don't find the chemical, you just don't know what the answer is. But finding the chemical showed that at least with six patients, there was this drug in there.

[Ashley Flowers]

Wow.

[Wendy Zuckerman]

Because that's how many. How many patients? That's how many bodies that they found. Pavlon In. In the end, it was six, including Jose Alfaro, who fought in World War II, Salbia Satrian, and Eleonora Schlegel, who toasted to the New Year with her son. And still, after this test, the cops actually aren't ready to arrest Efren just yet, because this was happening just a few years after the O.J. simpson trial, and that case kind of fell on its face because the cops messed up and mishandled evidence. So Armando and his colleagues not only test the bodies for Pavlon, but then all kinds of stuff around the bodies, because there was this suggestion that maybe Pavlon would be in the soil or would have been in the crypt water or the embalming fluid, and then made its way into the bodies. And so they test that stuff. Everything's looking fine. You know, when Ian Musgrave, who was our pharmacologist, read details about their work, he said, and I have never heard an academic describe a paper like this, but he said it was like seeing an experienced figure skater. Every move is smooth and beautiful.

[Ashley Flowers]

I love that someone can appreciate the art. Yeah.

[Wendy Zuckerman]

Yes. And so in Jack. January 2001, this is three years after Efren's first confession. The cops arrest him on his way to work at a construction site. John brings him in for questioning. He tells Efren all the evidence that they have that Pavlon was found in six bodies.

[John McKillop]

Well, we kept asking them, how many do you think you killed? Oh, he's very soft spoken, and. And he could barely hear him. I think some. Sometimes he was, like, writing stuff down and passing notes to us in the interview.

[Wendy Zuckerman]

And as John remembers it, Efren confesses to killing the patients. And at first, he won't say how many he killed, and instead he tells John what it takes to kill patients using Pavlon. And he says, with just one vial, like, you can kill a lot of people.

[John McKillop]

Well, I can kill 10 people per vial, and I probably had used 10 or 20 vials over the years. And so it was probably 100 to 200.

[Wendy Zuckerman]

What? Yeah. Oh, my gosh. Your mouth fell agape when you heard these numbers. Tell me what you're thinking that's so prolific is.

[Ashley Flowers]

And it's. How do you even. Has he kept a record of who these people were? How do you even go back and try and find out who they were?

[Wendy Zuckerman]

No, he didn't remember the patients. I mean, he even said that he, like, lost count at 60 patients, and.

[Ashley Flowers]

He can't still be saying, like, he was, like, trying to save them. From their own suffering. Right.

[Wendy Zuckerman]

So as for the question of why he did it, John actually got. When I asked him, the cop, you know, what do people get wrong when they report this story? And he got quite passionate, and he just said, you know, this case has been reported as an angel of death case, that Efrem was trying to reduce their suffering. But for this case, I mean, John says that they were specifically looking for victims who were getting better, you know, like you said, who were toasting New Year's, who wanted to live. And in that confession room, Efren told John that there was a completely different reason for doing what he did.

[John McKillop]

He would get irritated that he would have to go tend to a patient. So bottom line with him was every patients were irritants. They disrupted his day. You know, patients in the hospital are very needy and clicking that button a lot. And so he confessed to killing because of workload.

[Ashley Flowers]

Sir, what did you think you were signing up for? Yeah, you could have worn scrubs at home. What the.

[Sarah Scholes]

I don't know if I want to.

[Ashley Flowers]

Swear on this, but.

[Wendy Zuckerman]

What the f. Yeah. Yeah, what? Yeah. He told the police that, quote, it was not something that gave me joy. And then he said, quote, only when I was only at my wit's end on the staffing, I'd look at the board, who we gotta get rid of. What? So callous. We talked to Sarah, our science journalist, about the victims.

[Sarah Scholes]

There was one woman who actually survived the attempt because he didn't give her enough, and she pressed the call button too much and annoyed him, and so he dosed her.

[Wendy Zuckerman]

There's like.

[Ashley Flowers]

That doesn't even, like. That doesn't even, like, register. I just like, can someone be that cold? It almost would make more sense if he, you know, did, like, get some kind of, like, joy or something from the actual killing. Like, that almost makes more sense to me than just being like, well, too many people today. So, like, which one's gonna lose their life? So we can, like, have a manageable schedule.

[Wendy Zuckerman]

Yeah. Efren took a plea deal and was eventually convicted of killing the six patients that Armando and his colleagues found Pavlon in. Efren was sentenced to six consecutive life terms without the possibility of parole for the murder counts and 15 years to life for the attempted murder of Jean Coyle, who was the woman who survived. And there is this extra weird twist to this story, Ashley, because if Efren had gone to trial instead of taking a plea deal, he might have been faced with the death penalty. And at that time, if he got the death penalty. Do you want to guess they would.

[Ashley Flowers]

Have used the same drug?

[Wendy Zuckerman]

Yes. One of the drugs that they would have used to kill him was Pavlon. Wow. So, Ashley, that's the case of how some nerds used some smooth and beautiful moves to catch a killer.

[Ashley Flowers]

I love it.

[Wendy Zuckerman]

Science saved the day.

[Ashley Flowers]

Yeah. I mean, I think science is always saving the day. Right? Like, in the world that we live in. And I love this because I love the idea that, oh, we didn't know what the test didn't exist. And so instead of being like, oh, sorry, there's nothing to do, that doesn't mean it can't happen. Science is, like, happening all the time around us. If we, like, make it happen. Just because the test doesn't exist today doesn't mean it won't tomorrow.

[Wendy Zuckerman]

Yeah, exactly. Well, thank you so much for joining the show, Ashley.

[Ashley Flowers]

Thank you for having me.

[Wendy Zuckerman]

If you want to know more about this case, then go check out our transcript. So in the show notes for this episode, there's a link to our transcript and it's fully cited. So there's links to Armando's amazing work that looks like a figure skater and also links to some amazing reporting that was done by staff at the LA Times who we used to help make this episode. Also, Sarah Skoll's book is called Countdown the Blinding Future of Nuclear Weapons and this story didn't make the cut. So it's called Countdown the Blinding Future of Nuclear Weapons. This episode. The episode was produced by Katie Foster Keys and Joel Werner with help from me, Wendy Zuckerman, along with Meryl Horn, Rose Rimler and Michelle Dang. We're edited by Blythe Terrell, Mix and sound design by Sam Baer. Fact checking by Diane Kelly. Music written by so Wiley, Bobby Lord and Bumi Hidaka. A special thanks to Roland Campos, Steve Wampler, Audrey Williams, the audio Chuck Team, Jasmine Kingston, Connor Sampson, Stupid Old Studios and Penny Greenhalch. Sign Science Versus is a Spotify Studios original. Listen to us for free on Spotify or wherever you get your podcasts. And if you are listening on Spotify, follow us and tap the bell icon so you'll get notifications when new episodes come out. Also, if you do like the show, we would love it if you would give us a five star review because it really helps new listeners find the show. I'm Wendy Zuckerman. Back to you next time.