One of the best magazine stories I’ve ever read is James B. Stewart’s “Professional Courtesy,” which first appeared in The New Yorker nearly a dozen years ago. The piece recounts the sordid tale of Michael Swango, a health-care worker whose favorite pastime was injecting elderly patients with lethal drug cocktails. Stewart tracked Swango’s whole career, starting with his early days as a paramedic who fed his comrades poison-laced KFC, and ending with a murderous stint in Zimbabwe. (The article was later expanded into a book.)
Ever since reading “Professional Courtesy,” I’ve had something of an unhealthy obsession with so-called Angel-of-Death cases. It’s an obsession that’s kept me quite busy, seeing as how these tragedies pop up with alarming regularity. Another one’s coming down the pike in Angelina County, Texas, where a nurse at a dialysis center stands accused of pumping several patients full of bleach.
The ubiquity of Angel-of-Death cases raises a chicken-or-egg question: does the health-care industry attract more than its fair share of murderous souls, or do otherwise ordinary folks develop their destructive impulses due to their constant proximity to death? According to a 2001 study, it’s all a question of opportunity:
When this information is combined with Kinnell’s observations on Shipman and Nesset, it begins to seem plausible that all walks of life have people with the potential to murder. The key difference may be opportunity. The features associated with risk noted above suggest that access and a low chance of observation are important. The difference between nurses and doctors may be that doctors also control the means of disposal—in the case of Nesset and Shipman, they also provided the death certificate. The reason for the difference in the number of reported deaths may simply relate to the doctors’ greater opportunity to remain undiscovered.
In other words, every industry has the same percentage of potentially homicidal maniacs in its workforce. Doctors and nurses just have more opportunities to act on their darkest impulses.
This raises yet another question: what percentage of any given population will harbor secret fantasies of murder? And, more importantly, how do I avoid these people?
Jordan // Apr 3, 2009 at 12:37 pm
My guess would be that part of it is also the fact that many of their victims have a higher than average chance of dying anyway. So as long as one of these people avoids doing their deeds too often or with too strong a pattern, the chance of getting caught is much, much lower. If a bunch of old people drop and no one bothers to do an autopsy, chances are no one is going to notice.
Now I’m glad that I work on the research rather than the medical side of a hospital.
Brendan I. Koerner // Apr 3, 2009 at 1:11 pm
What’s amazing (and disturbing) about the Swango case is that hospitals/hospices DID notice the unusual number of deaths that occurred on Swango’s watch. Stewart’s argument is that they simply looked the other way, in large part because they feared being sued. So Swango was allowed to hop from job to job and continue his evil deeds.
Jordan // Apr 3, 2009 at 3:54 pm
What we should really fear is a psychotic statistician. They would know exactly how often they could get away with killing people and not have the deaths shove the averages too far.
Brendan I. Koerner // Apr 3, 2009 at 4:03 pm
Sounds like a great idea for “Murder by Numbers 2”. I wonder what Sandra Bullock is up to nowadays…