The basement apartment had been shuttered while Charlie was away. Now he reclaimed his space, applying the Kirkbride style to his own private asylum. The lot directly adjacent to his building was empty; Charlie put his between-shift energies into converting the weedy plot into a garden. He soaked up sunshine while his store-bought seeds did the same. The flowers needed him. Here between his hedgerows, Charlie was in charge.
At Warren, he’d sometimes catch a glimpse of Michelle Tomlinson between the closing doors of the elevator, or a flash of her hair glossed by the yellow lights of the parking lot as she walked to her car, and each time he had to strangle the impulse to call out to her. But Michelle either never saw him, or pretended not to. It didn’t matter, because even if she had seen him, the restraining order prevented them from working together on the ICU—a point needlessly explained by Charlie’s new nursing supervisor, Connie Trembler. Charlie didn’t need someone telling him what he could and couldn’t do. He was determined to be good. Connie had gone on and on about the new rules but Charlie had kept his expression blank. He knew he’d messed up with Michelle. Silence was the best penance he could offer. And anyway, Connie had moved Charlie to a great posting next door, in Telemetry, which had its own secret rewards.
Telemetry was a halfway ward, a sort of purgatory between the eyes-on intensity of Intensive Care and the hotel-like existence of a regular hospital inpatient. The ward was primarily reserved for heart patients—not the critical ones but those on the mend, whose stability might suddenly nosedive. Such patients needed to be carefully watched.
Of course, from a patient’s perspective, purgatory was extremely annoying. They were strung with wires and IVs like marionettes, tethered to a beeping, flashing, and sometimes sighing machine, like the beeping thing in soap operas, the one that flatlines in the dramatic parts. As telemetry patients were not heavily sedated, the association made them nervous, which did nothing positive for their blood pressure, and sent the machine beeping double, which was where Charlie came in. His main skill was Patient Education, a one-on-one scripted pedagogy he enjoyed. Charlie was encyclopedic in his iteration of the technical details, and he had effective means to explain the devices. He explained that, Yes, fearful patient: you are hooked to a lie detector test, at least aspects of one.1 But when you understood how it worked, a polygraph wasn’t really all that frightening. And Charlie certainly knew; at this point, he understood better than most cops how they worked.
The electrocardiogram (EKG) contains an incredible amount of information. Blood comes in the top of the heart and flows out the bottom, pushed by the squeezing of the chambers, atria to ventricle. The squeeze is triggered by an electric impulse. The EKG translates those electrical pulses into a picture, drawn by an inked needle jerking across rolling graph paper.
Usually, Charlie explained all this as he applied the electrodes to the taut rib cages of the elderly, the dry eraser nipples, the merkin of hair.
In the healthy heart, the muscle rippled, moving blood through the heart like a farmer’s hand moves milk through a cow’s teat. On the EKG, the stages of a normal pulse looked something like a mountain range. The information lay in the size and spacing of the peaks. Some looked slurry or slouched or notched, others read as irregular as an earthquake. Looking at the paper, a nurse could tell which; beneath the johnny, behind the ribs, the heart was trembling like a bag full of mice.
Charlie’s pending divorce had led to two polygraphs that spring. The first was precipitated by Adrianne’s allegations that her husband was a dangerous alcoholic who drank while watching the children. This, and a restraining order, requested in the wake of her domestic-violence call to the police, formed the core arguments in her request for full custody of their children. The polygraph was Charlie’s idea. Arrangements were made on June 18, two months after Charlie was released from Greystone. According to the machine, Charlie passed the test; he was telling the truth. But this was only a small victory within the bizarre war he had been waging in the courtroom, and twelve days later Adrianne was granted a final restraining order against her husband.
If the divorce proceedings in the Warren County family court system were not going well for Charlie, neither was his case in the Northampton County Court of Common Pleas. Charlie had been charged with stalking, breaking and entering, and trespass and harassment. This was a criminal situation, far more complicated than his divorce, and pursued by an aggressive and intimidating government prosecutor. Charlie had initially decided to represent himself but quickly realized that he was in over his head.
Charlie needed to demonstrate financial need in order to qualify for a public defender. But while his application listed his necessary outside expenses, such as $1,460 a month in child support, psychological counseling fees, and credit card minimums, he neglected to list his most basic personal, day-to-day living expenses such as rent and food. It wasn’t a chance oversight—the droll expenses of his physical sustenance simply were not the needs that mattered. Charlie did not list them, because they did not exist for him. He was flat broke, but his net income appeared too healthy for the court, and his application for public counsel was denied. Now Charlie needed to pay for a defense lawyer, too, putting him further into debt.2 He picked one from the yellow pages and paid the retainer. The relationship lasted three days before the lawyer quit, claiming that Charles Cullen was “too difficult” a personality to represent as a client. With no outlet to vent his frustrations in the courtroom, Charlie directed his rage against his former lawyer instead. He wrote long, ranting letters to the court, comparing the legal profession to his own. Would a nurse simply walk out on a patient? he asked. No, he would not. Why not? It was unethical, and therefore unprofessional. The venting didn’t improve his situation. Now he had no choice but to represent himself.
Charlie was nearly incoherent in court, and he knew it. On August 10, he gave up and simply pleaded guilty to the lesser charge of harassment and defiant trespass. He was given a fine and probation but no jail time. He was free to go home, where he tried suicide again, this time with pills and wine, driving himself to Warren Hospital and admitting himself to the emergency room. The familiar combination of his own willful actions and his resulting helplessness relieved some of the stress, like a sneeze or a compulsion acted upon, but the relief was short-lived, and the next evening Charlie was released to drive back home in the fog.
The basement apartment was oddly cool, even in August. The only sound was the soft tchuckk, tchuckk, tchuckk of the stove clock, counting the seconds. Michelle had a phone, and he knew where she lived, but using either was a violation of his probation. He had been squashed and silenced, but still needed to speak. He was clicking in time with the clock again, teeth edges together, tchuckk. tchuckk. Winking one eye then the other, watching the wine bottles in their parallax dance, left, right, his elbows hard on the kitchen Formica as he put the words down on paper for the judge.
“Their was a sexual intamate [sic] relationship between Michelle Tomlinson and myself,”3 he wrote. This judge didn’t see him, not as Charlie wanted to be seen. But Charlie had seen judges. They had been his patients in the Saint Barnabas Burn Center—fragile men stripped of their robes, reduced to probabilities, breathing by the grace of a machine. He wrote until the sky was inky with morning. He brushed his teeth, spitting red into the sink, drove to hand-deliver a fat stack of handwritten motions. Then he went to see George, the court-appointed family services counselor who would determine Cullen’s future with his children.
Charlie very much wanted to keep his kids, especially now. His young children were the unquestioning fans of a certain select version of himself. They were dependents, just like the patients under his care in the ICU. He believed that in time he might actually become the man that his children imagined him to be: A caring father. A good friend. A compassionate caregiver. Some people saw him that way. Some of his fellow nurses saw him that way. His mother had seen him this way. Adrianne had, once, and so had Michelle. Maybe, he thought, if he kept his kids, he could make them love him; they’d seen him this way, too. If Charlie was satisfied by their attentions, he might not be willing to risk losing them again. Maybe he’d have no reason to keep dosing patients at the hospital, such as Ms. Natoli. Charlie would be the good father and the good nurse, an outcome he believed George and the family court should want. George’s recommendations held the key to this potential future, and so Charlie was always sober for their mandatory interviews.
Of course, George had no idea that Charlie was killing people. But he was very much aware that Charlie was regularly attempting to kill himself, or at least making grand gestures at it. George noted in Cullen’s file that suicide was “the most severe and ultimate form of abuse/neglect, rejection, and abandonment one could inflict on one’s children.” Later that week Adrianne’s lawyer used the report in family court. Combined with a host of other evidence regarding Charlie’s drinking, the police calls, and Adrianne’s concerns that if Charlie was left alone with their daughters, he would “impulsively take his life and theirs,” Charlie had no standing in the courtroom. The only arena in which he still had gravitas was in the hospital.