Serial Killer Moms, Angels of Death, and Other Murdering Caregivers
The first person we all meet on Earth is our mother. From then on, most of us—the lucky ones—perceive women automatically as sources of love, care, and nourishment. Our mothers’ care, we learn as we grow up, is supplemented by the professional care of babysitters, nurses, and teachers. Nurses, in particular, we see as professionals dedicated to healing and easing pain. Yet some women use these very identities to disguise their repeated, raging, homicidal acts.
Genene Jones—the Baby-Killing Nurse
You never know when or where you’ll meet your serial killer. United States Army Sergeant First Class Gabriel Garcia, a crew chief with 507th Medical Company, would later testify how he met his serial killer in the back of a UH-1 “Dustoff” Medevac Huey Bell helicopter cruising at 125 mph at 4,000 feet on a civilian air ambulance mission into San Antonio, Texas.
Garcia served in an army MAST unit—Military Assistance to Safety and Traffic, a highly specialized branch that supplied medical air evacuation services for both military personnel and civilian communities near their bases. On August 30, 1982, at 12:32 p.m., his unit got a call with a request to transport to San Antonio two gravely ill children from a hospital in the town of Kerrville, about sixty miles away. Garcia and his platoon leader, Sergeant David Maywhort, were highly trained and experienced elite emergency medics who had flown many similar missions together. Piloted by David Butler, the helicopter scrambled and landed at Kerrville about forty minutes later, a mile from the hospital. A waiting ambulance took Maywhort and Garcia into town to pick up the two patients.
MAST crews had a lot of discretion whether to accept civilian patients for an air transport. It would be their call whether they felt a patient was stable enough to endure the noisy and bumpy forty-minute helicopter flight back to San Antonio. Upon their arrival at the hospital in Kerrville, Maywhort and Garcia went in to see the two patients for themselves. They were met by Dr. Kathleen Holland, a recently graduated doctor who had just opened a pediatric clinic of her own a week ago in the town. She showed them the first patient, Christopher Parker, a 6-month-old baby boy whose mother had brought him in when his breathing became raspy. Dr. Holland had checked his air passages and found them constricted. She felt the infant should be transported to a San Antonio hospital for observation. The child was stable and calm.
The second child was a 7-year-old boy, Jimmy Pearson, suffering from a host of chronic conditions. The child was severely retarded, unable to speak, and had skeletal deformities that twisted his tiny, twenty-two-pound body into a misshapen contortion. That morning, his family brought him into the hospital when Jimmy began to experience continuous, uncontrollable seizures. Kathleen stabilized his seizures with an injection of drugs through his intravenous line and then attached a breathing apparatus to the boy’s face, which blew a steady stream of oxygen into his lungs. Jimmy also appeared to be stable, calm, and sleeping.
Maywhort and Garcia accepted the patients for the flight. Dr. Holland introduced Garcia to her clinic nurse, Genene Jones, who would accompany the two patients on the flight to San Antonio. Jones was a chunky, big-boned, mousy-haired woman in her thirties with a determined jaw, a large, hooked nose, and a frown-set mouth with intensely clever hazel-colored eyes set in a doughy face—the smart, ugly, bossy girl in school, who at the end of the day never failed to remind the teacher that she forgot to assign homework. She exuded uncompromising competence.
When Garcia began to brief Genene on helicopter ambulance procedure, he did not get very far. He later testified:
I didn’t go into a lot of detail, because my impression was that she was an experienced nurse—in every way she presented herself as a highly competent, flight-practiced RN [registered nurse]…I also told her exactly what we’d expect from her if there was some kind of emergency, be it aircraft failure or medical problems. I reminded her about how the headset worked once connected, and about how she shouldn’t interrupt the pilots unless absolutely necessary. It was just a quick briefing. She gave me the impression that she knew all about it already.184
Sergeant Garcia saw that Jones had a paper bag with her. Wanting to know what other supplies would be available to him in case of an emergency, he asked if he could have a look at what she had in it. In the bag he found a laryngoscope—an instrument inserted through a patient’s mouth and used to examine a person’s air passage, usually prior to inserting breathing tubes—some sterile breathing tubes, a bagging mask for ventilating a patient’s air passage, and a preloaded 3-cc syringe, which Genene told him contained Neo-Synephrine, a vascular constrictor, and a container of lidocaine, a local anesthetic used to combat irregular heartbeat.
Garcia recalled that Genene smiled at him gravely and said, “I think we may have some trouble with the Pearson boy. I think he may go sour.”
Satisfied that the two boys were secured into berths fixed perpendicularly inside the helicopter’s cabin, the 6-month-old baby Christopher Parker on the bottom and the handicapped boy Jimmy Pearson on top, the pilot began to prepare for takeoff. Nurse Jones and Sergeant Garcia strapped into a bench seat facing the patients, inches away from their knees, and put on their communication headsets. Sergeant Maywhort got in on the other side of the stretchers into the gunner’s port, from where he would assist in keeping his eye on the patients and on air traffic to the sides of the helicopter.
As the helicopter took off and attained a cruising speed at a 4,000-foot altitude, Maywhort looked back into the cabin to ensure the patients were still calm and stable. The infant, who was hooked up to a heart-monitoring system built into the helicopter, appeared to be sleeping calmly. Maywhort decided to switch the system over to Jimmy Pearson instead, and asked Garcia to do it. Garcia deftly hooked up the boy to the heart monitor, probably without Nurse Jones realizing it. He checked the readout on the screen—Pearson’s heartbeat was normal and stable.
Approximately five minutes later, Maywhort threw a glance back into the cabin and saw that Genene was leaning over the Pearson boy, listening intently to his heart through her stethoscope. While Maywhort could observe her from the gun port, Garcia—on the other side of the stretchers—could only see the nurse with her back turned to him. Maywhort signaled Garcia to lean forward and find out what was wrong.
Garcia unstrapped, got up next to Genene, and observed her with the stethoscope pressed against the boy’s chest. He asked her what was she doing. He was taken a little aback when she only threw him a contemptuous look of exasperation—like “Mind your own business, I know what I’m doing.”
As Garcia looked at her listening intently with her stethoscope, a wave of apprehension swept over him. He recalled, “I was sort of stunned, really. I looked at her trying to use her stethoscope on this poor kid, and it was just absurd.”
It was absurd because the patients lie on berths directly connected to the helicopter’s airframe and the powerful engine transferred noise and vibration right through the stretcher into a patient’s body. Through a stethoscope one would hear nothing but the gut-heaving, heavy thump-thump-thump-thump of the helicopter rotors and engine noise, racket and vibration.
Garcia said, “You can’t do that.”
Genene, thinking he was challenging her authority, barked back, “Of course I can.”
Garcia explained, “But you can’t hear anything through that.”
Genene replied, “I can hear fine,” and then began to gesture dramatically and yelled, “He’s going bad. He’s in trouble. He’s having another seizure. Look at him, he’s turning black. He’s going to arrest just like I said he would.”
Maywhort later stated that Jones looked agitated. “Not upset or anything, just agitated. Kind of excited, like something important or, well, exciting was going on.”
Garcia and Maywhort looked at the heart-monitor screen—Pearson’s heart rate appeared to be normal. The boy appeared calm and stable, breathing normally. Genene was still up over the patient, appearing to listen intently through her stethoscope. Maywhort and Garcia exchanged glances—this woman was crazy! As Maywhort looked back into the cabin, he saw Genene bring up a syringe and tap the air out of it.
Reacting instantly, Maywhort shouted to Garcia, “Stop her!”
But it was too late. Genene injected the contents of the syringe into the boy’s IV line. Knowing something was wrong, Maywhort alerted the pilot, “Mark time,” letting him know something significant had happened in the cabin and that he should note the time. Genene yelled to Maywhort that it was “no big deal” and that she had just injected him with something to dry his mucus and help him breath easier. She threw the used syringe into her paper bag.
Maywhort and Garcia did not know what to think. The Pearson boy was clearly not convulsing or having problems breathing. He had appeared so far quite calm and stable. He did not need any additional medication. But what freaked the two veteran medics out the most was that the nurse was clearly pretending to hear the boy’s heartbeat through her stethoscope. They knew that was impossible. What the hell was going on?
Several minutes passed in anxious silence when Garcia began noticing a change in the boy. His chest movement became erratic and his skin began to mottle and turn blue as his respiration grew shallow and increased in pace. Genene flew out of her seat shouting, “He’s having a seizure!”
Observing the monitor, Garcia saw that in fact the boy was having a heart attack. He ordered a “Mayday”—an immediate landing of the helicopter so that they had the freedom of movement inside the cabin to assist the arresting child. As they went down toward a farm pasture for an emergency landing, Garcia punched a button on the heart-monitoring system, which printed out a record of the scope’s readings. By now Jimmy Pearson had stopped breathing and the monitor registered a fading heartbeat.
Genene Jones pushed Garcia aside and attempted to place a resuscitation mask on Jimmy’s face, but because of his deformities she could not get a tight fit. Maywhort stood up on his seat in the gunner’s port and leaned over the boy’s stretcher. He began to give him mouth-to-mouth resuscitation as the helicopter dropped to the ground.
Once they landed, the medics whisked Pearson out of the berth and laid him down on the cabin floor. Genene pulled out the endotracheal breathing tube from her paper bag and attempted to pass it into the boy’s breathing passage. She was clumsy and could not do it, so Garcia had to take the tube from her hand and properly insert it, attaching it to an air pump with which he would ventilate the boy’s lungs.
With Maywhort and Garcia in the cabin both working on the boy, the helicopter lifted off. Garcia ordered the pilot to fly to the nearest hospital in San Antonio as he gave Jimmy cardiac compression while Maywhort concentrated on the ABC—airway, breathing, and circulation. As the helicopter cruised toward the hospital, Garcia testified to observing that Genene seemed to be in a state of excitation:
She seemed a little pale and appeared to be going through some kind of hyperventilation syndrome. It looked like she was, well, it’s hard to describe. Sure, it was a frightening experience, and anybody might pant, but she looked more, well, you know, excited.
Jimmy’s mother, who was already in San Antonio, had arrived at the hospital before the helicopter landed. She saw her child rushed into Emergency by the medics. Genene Jones walked over to her when she saw her.
The mother would testify:
What I remember most vividly is her appearance. She was trembling. She was pale. She had an unusual—I can’t explain the look she had in her eyes. It was something I’ve never seen before. She was “up.”
The mother said Genene told her Jimmy was fine and that she had given him some Valium for his seizures. She also said that later in the flight he had stopped breathing; they had had to go down in a cow pasture to revive him. She continued:
Then I remember she made a sort of joke about the cows not producing milk for the next twenty years because of Jimmy and the helicopter. And then—I’ll never forget—she looked at me and said, “It was one of the most exciting afternoons of my life.”
None of the events of the trip ended up being reported. Garcia remembers the printout from the heart monitor being put into the paper bag that Genene had, but cannot recall who had the bag—it was never seen again. Dr. Holland never got a followup report on the flight emergency because Jimmy Pearson was not her regular patient. Jimmy would die seven weeks later, shortly after his eighth birthday, from an infection and complications caused by his previous illnesses. But throughout the eight years of his grave medical history, he suffered a respiratory or cardiac arrest only once—on the day he flew with nurse Genene Jones. Jimmy Pearson did not live long after his encounter with Genene, but he survived her at least. Investigators would later suspect that as many as forty-seven other sick children were not that lucky.
Dr. Kathleen Holland, for whom Genene worked, had a somewhat unconventional career history of her own by the time she opened her pediatric clinic on August 22, 1982, in the small town of Kerrville, an hour’s drive from San Antonio. Dr. Holland already had a failed marriage behind her and was preparing to be a Ph.D. medical researcher when a conflict with her advisor forced her to rethink her options. She decided to become a practicing physician. She was older and more mature than the average medical resident and used to doing things her way. She had successfully completed her three-year pediatrics residency in June at San Antonio’s Bexar County Hospital, affiliated with the University of Texas’s Health Science Center medical school and research facility. Having previously carefully researched the availability of pediatric care in Texas, she picked the town of Kerrville to open her own private clinic. She had wanted to hire an RN for her clinic, but realized she could not afford the salary rate. A less trained LVN—a Licensed Vocational Nurse—was all her startup budget allowed.
Residents were moved around a hospital every few weeks to different shifts and departments, but Dr. Holland recalled working with an LVN in the Pediatric Intensive Care Unit (PICU) by the name of Genene Jones a few times—a super nurse who she recalled was as take-charge and as competent as the RNs. She was a little bossy and outspoken, sometimes even ordering doctors around, it was said, and there were rumors of personality clashes in the PICU and a lot of strange gossip about Genene. Apparently, Genene had become so fed up with what she said was jealous backstabbing that she had quit. This made the slightly rebellious and unconventional Dr. Kathleen Holland even more interested in hiring Genene for her clinic. She wanted somebody who would be passionate about the practice she intended to build in Kerrville. In the spring of 1982, Kathleen contacted the personnel office at the hospital where Genene had worked and informed them she was considering hiring her—was there anything she should know about Nurse Jones’s past employment record at the hospital? Any problems or sanctions to report?
Genene’s Childhood and Youth
Genene Ann Jones was born on July 13, 1950, in San Antonio and was immediately given up for adoption. She was taken into a family of three other children adopted by Dick and Gladys Jones. Her father, Dick, made a fortune running the Kit Kat Club, a shady San Antonio nightclub with illegal gambling in the backrooms. The family lived just outside the city limits in a huge hilltop mansion with landscaped gardens, swimming pool, private tennis courts, and stables for horses. From their hilltop, the Jones family could see downtown San Antonio ten miles away. Genene’s mother and father lived an extravagant lifestyle—they took time to travel and both had acquired pilot licenses.
By the time Genene was 13 years old, Dick Jones was having trouble with his business. The Kit Kat Club was failing, despite his attempts to turn it into a family-oriented restaurant. Jones converted part of the acreage at their house into a trailer park, but nothing could turn his declining fortunes. In the end, Dick Jones sold off the Kit Kat Club property and went into a new business—billboards. He sited, built, and maintained a string of billboards in the San Antonio area.
The adopted children were paired by age: Genene’s older brother Wiley and older sister, Lisa, were respectively four and seven years older than Genene, while her brother Travis, with whom she was very close, was two years younger. Travis had a learning disability. Genene doted on him and was deeply attached to him.
Genene reportedly was the cleverest of all the children and very assertive, often insisting on dominating conversations. She was skilled in sewing, crochet, and baking, and was a talented piano player. She liked to tell stories and be the center of attention. But Genene was very sensitive—the slightest criticism would send her to tears. She resented her older sister, Lisa, convinced that her parents favored her. There was constant conflict between the two sisters until Lisa married and moved away. After that, Genene battled her strong-willed mother. Home life was never tranquil, and Genene would later recall that her happiest moments were riding around with her father in the countryside as he maintained the billboards he had put up.
Genene Jones entered high school in 1965. As a teenager she was no more attractive than she would be when she became an adult. At five foot four inches she was thirty pounds overweight and clumsy as a hippo. She did not walk anywhere, it was said, she rushed. Her lack of looks was only surpassed by her obnoxious and bossy personality. She worked a number of menial part-time jobs around the school and berated her fellow workers if she thought they were not doing their jobs correctly.
Some classmates recall her claiming that she was ostracized because her father was a former gambler. She complained that her parents favored her older sister. Her lack of popularity bothered her. She was desperate for recognition and craved esteem.
She told outlandish lies, claiming that she was related to Mickey Dolenz from the super pop group The Monkees, and that she would frequently chat with him on the telephone. She claimed that her parents never loved her enough to adopt her legally, unlike her other three siblings. She lied about anything and everything. “To her, lying was just like talking,” one classmate recalled.185
To compensate for her lack of popularity, Genene developed a reputation for reckless driving, often challenging boys to drag race from behind the wheel of her father’s El Camino. She was reckless enough to often win the races.
When Genene was sixteen, tragedy struck their home. Her younger brother was toying with a homemade pipe bomb when it detonated, sending metal shards into his head. He died later that day in hospital. Genene bought a flower wreath of her own for the funeral and shrieked, wept, and collapsed at the service. But her classmates recall that immediately after the morning burial service, Genene had returned to school and milked the sympathy and attention of her friends.
In 1968, when Genene was seventeen, her father died from cancer. Genene would later claim that the day he died “her world went dark,” but, in fact, she was planning to get married about six weeks after her father’s death. Genene had met the one boy who paid attention to her—a high school dropout named Jimmy DeLany—and she was intent on marrying him. Her mother intensely disliked the dropout Jimmy and withheld her permission—required for the minor Genene—until Genene had graduated, hoping that by then Genene would think better of it.
In June 1968, Genene graduated with a mediocre 78.61 percent—197th in a class of 274. Fourteen days later, almost as if to challenge her mother, Genene married the hapless Jimmy. Her mother paid for the wedding and the couple’s honeymoon. Her hated sister, Lisa, was the matron of honor. After the honeymoon, the couple moved into a guesthouse on the family estate.
Jimmy was only interested in cars and partying. He sporadically worked at gas stations, enough to only earn gas and beer money. Genene and Jimmy argued and squabbled. Jimmy was upset to learn that Genene raced his cars while he was away at work. After seven months of partying, drinking beer, and racing cars, the marriage began to stall. Jimmy enlisted in the navy. While Jimmy was away in basic training, Genene found a new route to popularity: She had a string of sexual liaisons with other men. One was the recently married husband of Genene’s friend from high school.186
Genene’s widowed mother sold off the estate on which Genene lived and moved into a house of her own. Genene was forced to find an apartment for herself, but her mother continued to pay her rent and support her. Nonetheless, she urged Genene to find herself some sort of employment. Genene enrolled in a beauty college to train as a beautician.
Before long, Jimmy returned home after he was given an early discharge from his enlistment. He returned to live with Genene, working as a mechanic while she found work as a beautician. In January 1972, Genene gave birth to her first child, a son. Six months later she filed for divorce, but two months after that changed her mind and reconciled with Jimmy. In February 1974, she filed for divorce again and this time it was finalized in June 1974. Genene was 23 and a single mother. She returned to the use of her family name.
Genene Goes to Nursing School
In 1976, Genene became pregnant again. She never clearly identified the father, but it might have been her ex-husband, Jimmy. Genene’s older brother, in the meantime, contracted testicular cancer and died. Genene became obsessed with the fear of developing cancer and submitted herself to tests every time she had a rash or a cough. Genene was working in a beauty shop in a hospital in San Antonio when she decided that medicine might be the career for her. When she developed a skin rash that she claimed was caused by beauty products she handled at work, she convinced her mother to pay her way through nursing school. Genene decided to take an LVN’s training program. LVNs were not paid as much as RNs, but the training was half as long and Genene wanted to go to work as soon as possible.
Genene had a natural aptitude for nursing, scoring grades in the nineties. Unlike her experience in high school, Genene was popular in nursing school, often cutting and styling her classmates’ hair. But students recall she was not very serious. She did not study during her breaks, she made jokes with the instructors during lectures, and in anatomy class she drew caricatures of male genitalia. Nevertheless, Genene graduated in May 1977, one of sixteen students out of fifty-eight to earn honors with her diploma. She was seven months pregnant. In July she gave birth to her second child, a daughter.
When Genene wrote her licensing exam, she scored 559—more than two hundred points bove the minimum passing grade. Genene’s mother did everything possible to help launch her youngest daughter’s career in nursing—helped her financially and took care of her kids.
“Genene Could Start an IV in a Friggin’ Fly.”
In September 1977, Genene Jones sufficiently recovered from the birth of her daughter to go to work in her first nursing job. She was hired at the Methodist hospital in San Antonio and assigned to the cardiac intensive care unit. She would last only seven months before being fired. At first Genene impressed her supervisors with her enthusiasm, her energy, and willingness to work additional shifts. But a five-month review warned, “Ms. Jones tends to make judgments that she has neither the experience nor authority to make.”
In April 26, 1978, Genene was fired. A cardiac patient had complained that Genene treated her rudely and roughly. When informed of this, Genene asked the supervisor if she could speak with the patient. The supervisor told her absolutely not, but Genene immediately went and confronted the patient, making a scene that resulted in the heart patient requiring sedatives. Genene was dismissed for “improper or unprofessional conduct on duty.”
With a desperate nationwide shortage of nurses, Genene Jones had no problems immediately finding another nursing position in the smaller, private Community Hospital on May 15. She lasted there until October 16, when without having accumulated sick leave she had to resign to take time off to have elective surgery. Genene had her tubes tied—she would not be able to have children from then on.
Two weeks later, Genene found her third hospital job in thirteen months after answering an ad calling for nurses at the huge, recently rebuilt—and amalgamated with the University of Texas Medical School—Bexar County Hospital. It has been speculated that the shortage of nurses was so acute that, despite her lack of experience and spotty employment record, she was hired. Genene was assigned to one of the most sensitive areas in the hospital—the PICU. This was a small unit, specially fitted with emergency equipment and drugs, where the most gravely ill children were put in cubicles with glass windows where they could be observed around the clock by a team of nurses and doctors.
Nurses in the PICU are a particular breed. The work requires a high degree of concentration through hours of focused monitoring and care of patients combined with a decisive, steely cool when a patient “codes”—when they go into a respiratory or cardiac arrest and a Code Blue is called on the hospital communications system. Nurses and doctors rush to the patient, wheeling a “crash cart” with emergency medicine and equipment in a desperate bid to revive them. The most experienced PICU nurses have an uncanny ability to spot an oncoming problem in a patient and intervene before they code. They are the SWAT teams of nursing, proud and aggressive.
Immediately upon her arrival at the PICU, Genene became a source of concern. One of the RNs who gave Genene her orientation was disturbed by her behavior from the very beginning. Genene was put in charge very briefly of a 6-day-old infant with a fatal intestinal disease. He died very quickly after his arrival in the PICU. Genene had hardly any contact with the infant, but the nurse recalls that Genene “went berserk” at his death. She broke into deep, dramatic sobs, moved a stool into the dead baby’s cubicle, and sat weeping over the baby for hours. This was not normal.
Despite the misgivings, Genene impressed her supervisors. Assigned to the 3–11 p.m. shift—the busiest—she impressed the RNs, who normally looked down at the LVNs, with her enthusiasm, knowledge, and technical skills. She knew a lot more about anatomy and physiology than the average LVN, and if she did not understand something, she would be seen looking it up in medical textbooks.
What distinguished Genene the most was her extraordinary talent for putting in intravenous lines. Never an easy task with an adult patient with veins that move and shift under a person’s skin, it was even harder with children and infants—their veins as thin as a thread, some nurses never managed to master inserting an IV line. Genene was a master, never missing a vein, and soon was called by other nurses to help them start an IV with their patients. The saying went around the PICU that “Genene could start an IV in a friggin’ fly.”
Genene had her champions, among them the chief nurse at the hospital and the doctor in charge of the PICU. Impressed by Genene’s technical skills and knowledge, they both encouraged Genene to go back to nursing school and become an RN. The only problem with Genene, the chief nurse noted in her evaluation, was that she needed to maintain “better control of her emotionalism.”
One thing that doctors did not like about Genene was that she constantly called them to attend to patients with problems she thought they were having. She had a tendency to page weary doctors four times more often than the other nurses. This was particularly irritating to interns, who often worked straight thirty-hour shifts and would try to catch a few minutes of sleep between calls. Not when Genene was on duty.
But as time went by, Genene developed a reputation for that uncanny ability to recognize a patient about to code. When Genene told you that a patient was on the brink of a seizure or arrest, even if they appeared to be calmly sleeping, she was frequently correct. Strangely enough, despite this developing skill, Genene began to accumulate an increasing collection of serious errors in her record—eight in the first year. She failed to obey a doctor’s order to give a child a drug. She did not notice a malfunctioning IV on one of her patients. She set an IV solution at an improperly high rate on another. She overdosed another patient by ten times the normal dosage. When Genene was called into “informal guidance” to discuss these errors, she denied she had made them or submitted elaborate explanations for her error. After her fourth medication error in twelve months, Genene was ordered to repeat a special class on drug administration. She twice failed to show up to the class.
Genene began attaching herself to certain patients and staying with them beyond her shift. She was told with one patient, a ten-month girl with heart trouble, to go home at the end of her shift, but refused. A higher-level nursing administrator was called to the ward to order her to go home, but Genene argued that the patient needed her. She wrote in her response to the complaint, “I felt that seeing her through this crisis, her biggest, was very important, not only to me but for her.” She was placed on notice that a similar failure to obey orders would result in her suspension and probable dismissal.
Two months later, after completing her previous shift, Genene showed up at 5:00 a.m. in the PICU unexpectedly and went to the bedside of another child patient she was assigned to on her own shift, fetched a syringe, and began to tinker with the child’s IV line. Smelling alcohol on her breath, doctors and nurses on the floor ordered Genene out. Genene was cited for “very poor judgment,” but allowed to return to work.
In her personnel file, along with the reports of errors and misconduct, were commendations for “meritorious contributions.” According to the report, “Over the last four months when the PICU was going through a severe staffing shortage, Ms. Jones worked in excess of twelve extra shifts to help cover the unit; these extra shifts often involved sacrificing days off…Ms. Jones is to be commended for her support and dedication to the PICU.”
“It Was Like She Knew What Was Going to Happen.”
The PICU became divided over Genene Jones. She had her champions and supporters and she had her detractors. She maintained a close rapport with the patient’s parents and often was there to console them when their children died. Among fellow staff she was crude and coarse, often telling dirty jokes or cursing loudly. She was free with her opinions of other doctors and nurses.
As in high school, Genene liked to be in the center of attention and told exaggerated stories about herself—that she had been in a coma after a car accident; that she had shot her brother-in-law in the groin after he had beaten her sister.
It is remarkable how similar the personalities of Genene Jones and Jane Toppan are over the gulf of one hundred years—the exaggerated stories, the hostility, and the division of opinion between those who supervised her and those who had to work with her all day.
She became very bossy of the staff. If one doctor rejected her advice, she would call another. She questioned medication, dosages, and treatments. When her recommendations were ignored, she predicted disaster, telling one doctor, “This kid is going to die if you don’t do this.”
On shift changes, nurses would gather to report on the conditions of their patients. During these meetings, Genene would issue dire pronouncements on certain patients, forewarning that they may die that night. As one RN recalled, “It wasn’t like she was predicting it. It was like she knew what was going to happen.”
All throughout this, Genene Jones was herself a frequent patient. During her first twenty-seven months at Bexar County Hospital, she made thirty visits to the outpatient clinic or the emergency ward where she complained of an extraordinarily diverse catalog of problems: diarrhea and cramps, vomiting, acute gastroenteritis, indigestion, belching, and “burning up” constipation. She experienced shooting chest pains and dizziness. Her thumb had been cut, her hands itched. Excessive menstrual bleeding and lack of menstrual bleeding. Sore throat, allergic reaction to medication. Neck pain, knee pain, abdominal pain, lower back pain.
Early in 1981, Genene began asking to be assigned to only the sickest children. She actually demanded it, refusing to care for patients who she thought had only routine illnesses. Genene had come to dominate the PICU, breaking rules with no consequences. She would choose her own patients, coming in early and penciling in her name to the charts of patients she was interested in. Her choice of patients ensured that she was involved in more frequent Code Blue calls, the excitement of which she thrived on. Genene would later say of these emergencies, “It’s an incredible experience. Oh, shit, it’s frightening. You’re aware of everything, but you only tune in to two or three different people…you really have to control your physical abilities, because you really get keyed up.”187
When her patients died, Genene would break down and weep. Nurses have been known to cry over patients with whom they had developed relationships, but Genene wept over every patient who died—and there were increasingly many. She would ask the doctor to wait before informing the parents, all the while rocking the infant’s body. Nurses would normally wheel the dead on stretchers to the morgue in the basement, but Genene, with tears streaming down her face, carried them down in her arms, resembling a grieving mother.
At home, Genene was mostly ignoring her own two children, leaving them to her mother to care for. Her oldest child, the boy, was roaming the streets of his neighborhood alone, showing up at neighbor’s houses and suspected by them of stealing things.
Gotten Rid of but “Eligible for Re-Employment”
The number of patients in her care that Genene prognosed would die and did so began to accumulate beyond a reasonable number. Doctors, mostly residents who rotated in and out of the PICU, did not detect any unusual patterns—only the nurses did. When nurses began to voice their concerns to a supervisor, she dismissed them, championing Genene. She accused them of jealousy and threatened to discipline any nurse who dared to raise the issue again without providing solid evidence. One of the nurses did so, collecting statistical data on the death rate in the PICU and whose patients they were. Despite the skewed figure, the chief nurse continued to defend Genene, reminding everybody that Genene was volunteering for the most critically ill patients—of course her death rate would be higher. But in the end, the numbers proved to go way beyond that explanation.
When the statistics were gathered, they revealed that there were a total of forty-three deaths in the PICU between January 1, 1981, and March 17, 1982. Fifteen different nurses were assigned to those patients, including Genene Jones. Her patients accounted for a staggering twenty-two out of the forty-three deaths—about 50 percent. Moreover, Genene was present at the deaths of an additional seven patients, having volunteered her services. This could not be ignored. Finally, three months after nurses began to formally voice their concerns over the deaths of patients in Genene’s care, an internal hospital investigation was launched.
The investigation concluded that either Genene Jones was grossly incompetent or she was deliberately killing the patients but could not find any specific evidence. “Either way, the biggest problem facing the hospital, the investigative team was advised by the hospital’s attorney, was the possibility of being sued by Genene if they could not come up with sufficient evidence for their suspicions.” Things had to be quietly resolved and hushed up.
The problem was what to do with Genene Jones. Judging by her reactions to past complaints entered into her record, Genene was not going to quietly allow herself to be fired nor did she appear to be predisposed to resigning. Cleverly, the investigative board suggested a ploy: upgrade the qualifications for nurses in the PICU to RNs and thus remove the LVN Genene Jones from the unit. When the time came to reassign the former PICU LVNs to new wards, only Genene and the nurse who pursued the complaints against her could not be found new positions. Genene was sent packing in March 1982 with no grounds for complaint, although she did so anyway and is suspected of sending threatening notes to some of the hospital staff. In her hospital employment records, Genene was designated as “eligible for re-employment” and supplied with letters of recommendation.
So when in the spring of 1982, Dr. Kathleen Holland contacted the hospital administration to confirm Genene Jones’s status for employment in her own clinic when it opened in August, she was told Genene was classified “eligible for re-employment.” Although other doctors from the hospital privately warned Holland that there were problems with Genene, they never got into any detail beyond the gossip and her tendency to be bossy. Dr. Kathleen Holland went ahead and hired Genene. Not only did she do that, but she also rented a house with Genene: They would be living together along with Genene’s two children.
Again the similarity between Genene Jones in the 1980s and Jane Toppan in the 1880s is haunting. Just like Genene, Toppan was shuffled off with letters of recommendation to other hospitals as a student despite the inexplicably high death rate among the patients she cared for. Toppan was finally gotten rid of by her nursing certificate being withheld in ambiguous circumstances, allegedly after her dismissal for leaving a ward without permission—even though she had passed her exams already.
“I Figured It Would Be Okay to Let Her Take Chelsea for a Few Minutes.”
After freelancing for a few months while waiting for the clinic to open, Genene began work in Dr. Holland’s clinic on Monday, August 23, 1982. That day the clinic had only one patient. The next day they would have their second patient.
Petti and Reid McClellan, both 27 years old, lived fifteen miles outside of Kerrville. They were exactly the type of people that Dr. Holland had hoped her clinic would serve. In June of the previous year, Petti had given birth to a girl four weeks premature, whom they named Chelsea. The baby suffered from respiratory problems typical of premature infants with underdeveloped lungs and she needed to be hospitalized in San Antonio. After twenty-one days, her condition improved. Her weight climbed and the McClellans took Chelsea home. In May 1982, when Chelsea was ten months old, her parents rushed her to the emergency ward in San Antonio when she was having problems breathing. The baby was diagnosed with pneumonia, treated for several days, and sent home with her parents, who were cautioned to observe her breathing carefully. Otherwise, she was a normal and healthy baby.
Petti and Reid were overjoyed when they heard that Kerrville was going to have its own pediatric clinic. San Antonio was sixty miles away and the local hospital did not have any specialized pediatricians. So when Chelsea, who was 14 months old, appeared to have a case of “the sniffles” Petti decided to take advantage of the clinic that had just opened in town the day before. At about 1:00 p.m. on Tuesday, August 24, she brought Chelsea in to see Dr. Holland.
As Holland interviewed Petti in her office about Chelsea’s medical history, the baby wiggled out of her mother’s arms and began grabbing at things on Holland’s desk. Petti recalled that a smiling woman stuck her head into the office through the open door and said, “Mrs. McClellan, why don’t you let me take Chelsea while you and Dr. Holland finish talking.”
“It was the office nurse,” Petti would later recall. “I’d never met her before that, but I figured it would be okay to let her take Chelsea for a few minutes.”
Genene Jones carried the giggling girl away, cooing to her, “Come on you, let’s go play.”
Petti was recounting to Dr. Holland her daughter’s medical history and was sort of embarrassed about bringing in Chelsea with minor sniffles, but better safe than sorry. Dr. Holland assured her she did the right thing. She would later testify that then she heard something from the examination room down the hall that would break her concentration—she could no longer focus on what Petti was saying, but only on Genene’s voice, which she had heard say in the other room, “Don’t go to sleep, baby. Wake up. Wake up, Chelsea. Don’t go to sleep.”
It was freaky, because five minutes earlier Chelsea had been twisting and giggling in her office. Holland attempted to ignore the growing wave of anxiety rising up in her and refocused on Petti, who was still talking. Then Holland heard Genene call her, “Dr. Holland, could you come out here now, please.” There was clearly a cold sense of urgency in her voice.
Chelsea was draped over the examining room table unconscious and Genene was holding an oxygen mask over her face. “She had a seizure,” Genene said. “She stopped breathing.”
Kathleen began performing an emergency intubation of Chelsea, with Genene smoothly finding and opening the sterile packages of breathing tubes and handing them to Kathleen. As she performed the procedure, Kathleen congratulated herself on her choice of clinic nurse. Genene was performing like a crack surgical nurse, cool and efficient under pressure. Genene started up an IV on the child as ordered by Kathleen, injecting into Chelsea a drug to counteract acidity building up in her failing circulatory system. Paramedics were called and Chelsea was rushed off to the emergency ward at the local Sid Peterson Memorial Hospital in Kerrville where she was admitted at 1:35.
Two and a half hours later, Chelsea was sitting up in her bed and smiling, leaving everybody perplexed. For the next ten days, almost every conceivable test was run on the 14-month-old girl but nothing could be diagnosed. Chelsea was finally sent home. Petti was grateful for the quick response of Dr. Holland and her nurse, Genene Jones. She praised the clinic, telling all the parents she knew that they should take their kids there.
On Friday, August 27, 18-year-old Nelda Benites brought in her 3-month-old daughter, Brandy, who was suffering from dark and bloody diarrhea. After examining the infant, Dr. Holland decided she should be transferred to Sid Peterson Memorial Hospital for observation. She put an oxygen mask on Brandy and told Genene to start up an IV to prepare her for a routine transfer to the hospital, about a five-minute drive away. Running an IV was a procedure that Kathleen Holland decided would be routine on any transfer of her patients to Sid Peterson. She wanted her patients to arrive there already prepped, with samples of their blood drawn, and on an IV, so there would be no delays at the small hospital. She then left the child alone with Genene to call the hospital and arrange for the baby’s transfer.
When Kathleen returned five minutes later, she was alarmed to see that Brandy appeared to be in worse condition: her face had turned ashen, her finger and toes were turning blue, and her breathing was slowing. Emergency procedures were immediately invoked and the run to the local hospital became an urgent one.
At Sid Peterson, Kathleen Holland stabilized Brandy, but could not explain the cause of the respiratory arrest. She decided to transfer the baby to a pediatric unit in San Antonio. Still breathing on her own, Brandy was put on an IV line, intubated, attached to a cardiac machine, and loaded into an ambulance for the trip to San Antonio. Genene Jones, paramedic Phillip Kneese, and RN Sarah Mauldin from the hospital rode in the back of the ambulance with Brandy. Because Dr. Holland suffered from motion sickness, she followed behind the ambulance in her own car. As they departed the hospital parking lot, RN Mauldin recalled that Brandy was breathing normally.
In the middle of the trip, Brandy suddenly had a cardiac arrest. The ambulance pulled over to the side of the road and Dr. Holland got on board. She gave Brandy CPR, restarting the child’s heartbeat. She then returned to her car and they continued on their run into San Antonio. On board the ambulance, despite the fact that Sarah Mauldin was the more qualified RN, Genene Jones took charge. She started up a second IV into Brandy’s foot.
The ambulance paramedic later testified: “Since the ambulance didn’t carry any IV sets, she had to have brought it with her…It’s hard to explain, but she was aggressive in the sense that at all times she gave the impression that she knew exactly what she was doing. I just figure the kid needed it for some reason which I wasn’t aware of.”
Sarah testified that Genene turned to her and looked her in the eyes, and “with a kind of breathy excitement, said: ‘The kid’s gone bad. Bag like crazy.’ And I did.”
“Bagging” meant manually pumping a balloonlike bag with oxygen running through it attached to the tubes running into a patient’s airway. Brandy barely survived her trip to San Antonio.
Dr. Holland’s clinic had had two cardiopulmonary arrests occur in its first four days. Kathleen Holland was a new and inexperienced doctor. Her experience to date had been in a big-city hospital with gravely ill patients—she had no way of knowing just how statistically exceptional these events were in a small-town clinic like hers. She did not know that Kerrville’s oldest doctor had only one pediatric respiratory arrest occur in his practice in a span of forty years.
The next Tuesday, on August 30, Genene went on the MAST helicopter ambulance run, where a third patient suffered a cardiac arrest.
On Friday, September 3, 19-year-old Kay Reichenau brought her 21-month-old daughter, Misty, to the clinic complaining of mouth sores and a high fever. Dr. Holland examined the child with Genene assisting her. Genene pointed out that the child appeared to have a stiff neck and Dr. Holland agreed. This and the other symptoms could have been early signals of meningitis, and Dr. Holland decided to transfer Misty to the hospital for routine observation. She left the child alone with Genene to prepare an IV line for her transfer and take her blood samples. It was not long before the child suffered a respiratory arrest, with all the ensuing emergency treatment in the examining room before the baby was rushed off to the emergency ward at Sid Peterson Hospital. Again, despite a battery of tests, the cause of the arrest could not be diagnosed.
On Saturday, September 11, Nurse Mary Morris, who worked at the Sid Peterson Hospital, heard they were getting a patient in by the name of Genene Jones. She had gone to LVN school with Genene and wondered if it was the same person. It was. Genene was in complaining of a painful ulcer.
Mary and Genene chatted and she was surprised to learn that Genene was employed right there in Kerrville as the nurse in Kathleen Holland’s newly opened clinic. Genene then said something strange—that she was also in Kerrville because she was going to help the hospital start up a PICU and she would be put in charge of it.
Mary thought it was a ridiculous notion. First, Genene was only an LVN and not likely to be put in charge of a PICU, and second, Kerrville hardly had enough sick children to justify a PICU. She said to Genene that she had worked in Kerrville for two years and “sure, we have sick children, but I don’t know if there are enough sick children here in the area to constitute a need for a PICU.”
Genene responded, “Oh, they’re out there. All you have to do is go out and find them.”
But sometimes, they were just brought straight into Genene’s hands.
On Friday, September 17, Petti had brought back Chelsea for her second visit to Dr. Holland’s clinic, along with her brother Cameron. It was a routine appointment and Chelsea was scheduled to receive her immunization shots. Chelsea had recovered well from the last month’s episode and was bouncy and alert that morning.
After examining Chelsea and seeing everything was normal, Dr. Holland told Genene to go ahead and give the girl the two routine infant immunizations: a diphtheria/tetnus and an MMR.
Genene said to Petti, “Why don’t you wait outside, Mrs. McClellan. I know most mothers don’t like to see their babies get shots.”
Petti recalled that she told Genene it did not bother her at all and she would come in with them. Petti later testified that Genene did not seem to be at all happy about this and that, “she got sort of huffy.”
Cradling Chelsea in her arms, Petti followed Genene into the examination room. She saw that there were two filled syringes already prepared. Petti recalled that Chelsea reacted within seconds after the first injection. “My God, I thought, what’s happening. It seemed to me she wasn’t breathing right, and her eyes were looking at me funny. She was sort of whimpering—it was as if she was trying to say, ‘Help me,’ but couldn’t.”
Petti immediately told Genene that something was wrong, but Genene dismissed her, saying “She’s just mad about having to get the shots. It’s nothing. She’s reacting to the pain.”
Petti protested, “No, stop. She’s not acting right. She’s having another seizure!”
But Genene would not stop. Mumbling something like, “I have to give her this other shot,” she stuck the child with the second syringe and plunged its contents into the girl.
Petti said that Chelsea stopped breathing and began to turn blue. She testified in court:
I looked at her and I could see she was trying to say “Mama.” I thought, Oh God, she wants to say “Mama.”
Chelsea then went limp; just like a rag doll, just like Raggedy Ann—that’s exactly what she looked like, just limp. She was still looking at me, but it didn’t look like she could see me. Her eyes were all strange looking and they weren’t like they were supposed to be. They weren’t like they were supposed to be.
Again there were emergency procedures in the examination room; the ambulance run to Sid Peterson Hospital. In the emergency room Chelsea’s color, breathing, and heart rate began to return to normal. Kathleen Holland decided to transfer Chelsea to San Antonio and called the MAST unit. They were busy, so instead she scheduled her transfer in an ambulance by ground rather than wait for the MAST helicopter to become available. As before, Genene would go along in the ambulance while Kathleen Holland would follow in the car. While Dr. Holland was phoning the hospital in San Antonio, one of the nurses at the hospital drove Petti back to the clinic where she had left Cameron and her car. Genene asked for a ride back with them to the clinic to get her and Dr. Holland’s purses, she said.
As Petti explained to Cameron that his grandmother was going to pick him up while she went to San Antonio, she saw Genene rushing about the clinic packing medical supplies into her bag. Genene returned to the hospital and boarded the ambulance transporting Chelsea to San Antonio. Holland followed in her car, and Petti, who was by now joined by her husband, Reid, brought up the rear in their vehicle.
In the back of the ambulance, paramedic Tommy James pumped the respiratory bag to assist Chelsea with her breathing, while Genene monitored the child’s blood pressure and heartbeat through an electronic monitor. Ten minutes into the drive, the monitor began to give an alarm—Chelsea was having a heart attack.
The ambulance stopped and Holland rushed into the cabin to find the paramedic bagging Chelsea while Genene was performing CPR. “She’s flatlined!” Genene shouted, meaning that the cardio-monitor was showing a flat green line on the scope—no heartbeat.
Dr. Holland stopped everyone for a minute and listened for a heartbeat. There wasn’t any. She ordered Genene to begin emergency drug injections. Genene pulled out a number of syringes from her bag and injected Chelsea with epinephrine, calcium chloride, and sodium bicarbonate. There was no response in Chelsea.
Holland ordered the ambulance to proceed to the nearest available hospital. This was Comfort Community Hospital about ten minutes away. The ambulance radioed for them to prepare for a Code Blue arrival. They arrived at 1:05 and quickly wheeled Chelsea into the emergency room. There Kathleen Holland and the hospital doctor, assisted by the paramedic, Genene, and the hospital nurses, attempted to revive Chelsea with rounds of injections of various cardiotonic drugs. The only thing left to do was to attempt to give her an electric shock, but the paddles were too large for the size of the child’s body. At 1:20 p.m., Chelsea was pronounced dead.
Although Kathleen Holland said she was in a state of shock and did not remember this, others recall that Genene Jones emerged with the dead child wrapped in a blanket and handed her to Petti, who broke down weeping.
Later, Genene took Chelsea’s corpse into her own arms, and cradling the dead child to her breast, rode sobbing in the ambulance all the way back to the hospital in Kerrville, where she logged the body into the morgue.
When Genene returned to the clinic that afternoon, she wrote in big, bold letters in the office log:
…CPR DISCONTINUED. PARENTS INFORMED OF DEATH BY DR. HOLLAND. BABY TRANSPORTED FROM COMFORT TO SID PETERSON HOSPITAL BY EMS AND MYSELF, AND TAKEN TO MORGUE. I WOULD HAVE GIVEN MY LIFE FOR HER. GOOD-BYE, CHELSEA
Genene then turned to 19-year-old Lydia Evans, who was sitting in the waiting room with her 5-month-old son Jacob. She had scheduled an appointment earlier for Dr. Holland to have a look at her baby, who had been cranky and irritable all week. The appointment was cancelled when Dr. Holland left on the emergency run to San Antonio with Chelsea, but when she died and Holland was scheduled to return to the clinic, the receptionist phoned Lydia and told her the appointment was “uncancelled.” She could come in if she still wanted to. Dr. Holland would be arriving shortly, she was told.
Lydia said she arrived at the clinic with her mother, father, and Jacob between 3:15 and 3:30 p.m. She testified that the receptionist told her Dr. Holland still had not returned, but the clinic nurse would see them for now.
Lydia testified, “Ms. Jones came out from the back of the office then and introduced herself, and said that we could go ahead and do the preliminary work on Jacob. Dr. Holland was due back any moment.”
The examination appeared to be routine, with Genene weighing and measuring the baby and asking Lydia about the infant’s history. Except for one thing, recalled Lydia, in her courtroom testimony
I remember that she kept coming back to his eyes—looking into his eyes—and feeling his head, she did that a lot. She seemed concerned and mentioned something about his left eye not responding to light properly, that the pupil was sluggish, or something like that, though the right eye, she said, seemed to been all right. I’d never noticed any problems with Jacob’s eyes, and I really didn’t see any problem then either—but I wasn’t really “double-checking” her.
Genene told Lydia and her mother that she detected a type of eye movement that was symptomatic of seizurelike activity and that she thought it would be best to transfer Jacob to the hospital in Kerrville to run some tests. She left the room for a few minutes and then returned and told the family that Dr. Holland had authorized her to take some blood samples and put Jacob on an IV line in preparation for the transfer.
As soon as Lydia heard that Jacob was going to be put on an IV she became concerned: Why? Is this serious?
Genene assured her it was routine, but “with the kinds of tests they’ll be running, you can’t always be sure how a baby will react.”
Lydia began to have second thoughts about the “tests”—maybe they should wait and think about it. Genene reassured her that Jacob would be fine and began ushering both Lydia and her mother out of the examining room, saying, “Now, ladies, I need to get him ready for the hospital. I’m a mother, too, and I know how it is to watch your child when he’s unhappy. I think it’d be better if you waited out in the lobby.”
Lydia’s mother spoke up and said that Lydia could leave but she’d be glad to stay and help with Jacob. Genene was insistent that it was against the rules to have a relative in the room when performing a “delicate procedure.”
As Lydia and her parents sat in the waiting room, they heard Jacob screaming in a way they had never heard before. “It was not the normal crying of a baby,” his grandmother would testify. “It was a scream. It was a terrified cry. He screamed several times, and then, in mid-scream—as though it were just cut off—there was nothing, just dead silence.”
Kathleen Holland was at Sid Peterson doing paperwork connected with Chelsea’s death when she heard from her secretary that Lydia Evans would be coming in to the clinic. Exhausted and drained by Chelsea’s death, she told her to tell Genene to immediately send the family to the hospital—she would examine the infant there. She completed the paperwork and was preparing for the presumed arrival of Lydia with her infant son, when the hospital operator stopped her and told her there was an emergency at her clinic—she was needed there immediately.
By the time Holland arrived at her office, an ambulance was parked at the door and Jacob had already been loaded in. The doctor next-door had performed emergency procedures on the child, who had had respiratory arrest. Holland got into the ambulance with Genene and asked her what had happened.
Genene explained, “He had a seizure. I had to call the doctor and nurse from next-door. He ordered 180 milligrams of Dilantin.” Genene then coughed and rolled her eyes, according to Holland, and said, “I knew that was too much, so I only gave him 80.”
Jacob was stabilized at the hospital and after six days of examinations, they still could not determine what caused the respiratory arrest.
“You’ve Got a Baby Killer on Your Hands.”
Unlike the San Antonio hospitals, Sid Peterson was a small facility in which everybody knew each other and everything that went on in the town of Kerrville. Five emergency seizures in a month at the newly opened clinic did not go unnoticed. One of the doctors commented, “There was just too much smoke. I’ve been in practice forty-three years and never had one. To the best of my knowledge, we’ve never had one in Kerrville. Something had to be wrong.”
Disturbing also was the fact that the patients would recover within an hour or so after their crisis—unless Genene accompanied them for transfer to San Antonio, where inevitably on the way there they would have another seizure.
On Wednesday, September 22, the medical management team at the hospital decided to schedule an interview with Dr. Holland for the next day to discuss the issue. It was decided also that the next time there was an emergency case brought in from Holland’s clinic, the hospital doctors would attend and observe carefully what was going on. They did not have long to wait.
The next day, Thursday, September 23, Clarabelle Ruff brought in her 5-month-old baby girl, Rolinda, to the clinic, suffering from diarrhea and dehydration. After examining the child, Dr. Holland told her she wanted to check her into the hospital for observation. She ran the IV line herself, but asked Genene to prepare the medicine she was going to inject into the line. When she was ready, she asked Genene to hand her the syringe and injected its contents into the IV line. Soon the baby went into respiratory arrest and an ambulance was called to take her over to Sid Peterson.
When the word got out that yet another Code Blue patient was on the way from Kathleen Holland’s clinic, almost the entire staff of doctors from the hospital crowded into the room to observe.
As before, the child appeared to be recovering from the respiratory arrest. As the baby convulsed and fought the incubation tube being forced down her breathing passage, one of the doctors, an anesthesiologist immediately recognized what was happening: The child was recovering from the effects of a particular type of anesthetic. Anectine—succinylcholine, or “succs” in medical slang—was a synthetic curare used as a muscle relaxant in delicate surgery. While not affecting consciousness, it paralyzes every muscle in the body, including the diaphragm, and if given in a larger dose, the heart.
The day was not over yet. When Ruff had brought in her girl to the clinic, another mother was in the waiting room with her child—Mary Ann Parker, whose baby boy Chris three weeks earlier had been the other infant on the medevac helicopter and had escaped Genene’s attention during that flight. Chris, who had since returned home from the hospital, was now suffering from diarrhea and an ear infection and Parker brought her son back to the clinic. As Holland and Genene rushed off to the hospital with the Ruff child, Genene told Parker to take her child to the hospital emergency room and that Dr. Holland would see her there. Less than an hour later, Genene Jones entered the hospital waiting room and took Mary Parker’s son away to an emergency examining room. She placed the child on a bed that was being prepared for an emergency cardiac patient coming in by ambulance. When an emergency room nurse asked that Genene move the child, who was there for a routine examination to free the bed for the incoming emergency, Genene snapped at her, “Well, I hope to hell this baby doesn’t go into cardiac arrest.”
A few minutes later, Genene called a Code Blue for Chris Parker, who had stopped breathing. The ER doctors quickly responded, stabilizing the child, and soon Kathleen Holland arrived. Remarkably, Holland found a half-filled syringe lying in Chris Parker’s bed. Asking Genene and the nurses what it was, nobody knew. According to court testimony, Holland squirted the syringe empty onto the floor and told the nurses to get rid of it.
At the end of the day, as the exhausted Kathleen Holland and Genene walked out of the hospital’s intensive care unit and paused before the commemorative plaque at the entrance, Genene wistfully said, “Maybe someday this will be the Chelsea Ann McClellan Memorial Pediatric Intensive Care Unit.”
That same day the hospital doctors were meeting to discuss what they had observed in the emergency room and the suspicions the anesthesiologist had about the presence of succinylcholine. The medical community is a tight one and the doctors decided to call their various colleagues at Bexar County Hospital in San Antonio to find out all they could about Dr. Kathleen Holland, the recently graduated pediatrics resident. One of the doctors talking with a resident he knew at Bexar County was told by him that indeed there was a problem in the PICU in San Antonio—an unusually high death rate that nobody could explain and that the common denominator was a PICU nurse. The resident could not remember her name.
Was it Genene Jones?
The resident said he would check and call back shortly.
Five minutes later the phone rang. The resident said, “You’ve got a baby killer on your hands.”
On Friday, September 24, Kathleen Holland was called into a meeting at the hospital. There were eleven doctors seated at a board table, one of them a psychiatrist. They began to quietly pose questions to Holland, carefully listening to her responses and observing her body language. A lot of children seemed to be getting sick in her clinic. Why did she think this was happening?
Kathleen explained that every child was a separate medical situation with its own explanation. She had reviewed each case. She appeared to the doctors to be tense but professional and sincere. They asked her a battery of questions about her methods, techniques, instruments, medications, and her approach to pediatrics.
At one point they asked if she used succinylcholine at the clinic. Kathleen told her she had some but had never used it.
They questioned her about Genene Jones. According to their testimony, Kathleen defended her, saying that Genene had actually taught her a thing or two about resuscitating children. She had been an LVN in the PICU in San Antonio, but was moved out after the unit upgraded the nursing staff to RNs. All had been offered jobs elsewhere in the hospital and she had been graded “eligible for re-employment.”
The meeting ended when Kathleen’s beeper went off. Jimmy Pearson, the boy who arrested on the MAST flight to San Antonio and who had been returned to Sid Peterson, was arresting and Code Blue was called. It was not a good omen.
After Holland left, the doctors decided to call the Texas Board of Vocational Nurses and explained their concerns to an investigator there, Ferris Aldridge. After hearing out the doctors, Aldridge told them this was not a board matter, but that he would put the proper authorities onto the problem. This was how the Texas Rangers at the Department of Public Safety got involved, the first time in two years of death and suspicion that anybody got law enforcement authorities involved. This was the beginning of the end of Genene Jones’s killing career.
When Kathleen Holland returned to the clinic she told Genene about the meeting and what had been asked. She mentioned that they had asked if they had used succinylcholine on any of the patients in the clinic. She also told Genene that they expressed their concern over her aggressiveness and asked her if she had trusted her clinic staff.
“At that point, she became upset,” Holland later testified. “She said, ‘Somebody’s starting rumors,’ or something to that effect.”
Over the weekend, Kathleen Holland went away, but returned to the house she shared with Genene on Sunday evening. During idle conversation, just before retiring for the night, Genene suddenly said to her, in an offhanded manner, “Oh, by the way, I found that missing vial of succs.”
This was news to Holland: “What missing succs?”
Genene went on to remind her of the day she had told her about the missing vial of succinylcholine. The only problem was that Kathleen could not remember having any such conversation with her.
“So where was it found?” Holland asked.
“In the lower drawer of the crash room’s table, under the paper lining,” replied Genene.
Holland became uneasy. Strange that the very medication that was brought up in the meeting on Friday was now the one that apparently Genene was claiming was lost at the clinic. Holland recalled that Genene suddenly began to volunteer other information. As she spoke, Genene could not look at her but kept staring down at the table.
“There is one problem,” Genene continued, “the cap has been popped.”
Holland’s heart froze.
Genene could not explain how that had happened, other than to say they had a lot of people in and out of the office. That did not satisfy Holland. She remembered once hearing that when people begin to volunteer all sorts of unsolicited information, it usually means something.
The next thing to come out of Genene’s mouth, was “Oh, yeah, I checked, and there are no holes in the stopper. I checked it against the replacement vial and all 10 cc’s are there. If somebody wants to draw it up, they can draw it up. It’s all there.”
Kathleen had a hard time sleeping that night. She could hear Genene moving about in her part of the house. The next morning, after doing her rounds at the hospital, she returned to her clinic about the time Genene was going out to lunch. Dr. Holland went straight to the refrigerator where the drugs were kept. She pulled out the two vials of succinylcholine and held them up to the light. She immediately noticed that there was a very slight, subtle difference in the meniscus—the dip in the fluid—in one of the vials. She tipped the vials and looked at their tops. One was still sealed with a cap, but the other vial was missing its cap, and Kathleen could distinctly make out two needle puncture holes in its red rubber stopper.
When Genene returned from lunch she was in good spirits and told Dr. Holland that she had just visited Chelsea. Petti would later testify that she saw Genene that day at her daughter’s graveside, rocking back and forth and sobbing, calling out Chelsea’s name over and over.
Kathleen called the office staff together and attempted to find out how the two puncture marks could have occurred in the succinylcholine vial stopper. Nobody could come up with a satisfactory answer. Genene kept saying that there were a lot of people coming into the clinic.
After the meeting, with only Genene remaining, as Kathleen put the vials into the fridge, she said, “How am I going to explain those holes, Genene?”
To her surprise, Genene replied, in what Holland later characterized as a coolly defensive tone, “I don’t think you should explain them at all. I think you should just throw it out. Tell them we lost it. We won’t be lying if we say we lost it. We did lose it. I know we found it again, but they don’t have to know we found it. Just throw it away.”
Holland was horrified. She told Genene that she could not do that ethically or legally. The conversation was interrupted by the arrival of a mother and her child for an appointment.
About an hour later, Genene walked up to Holland and said, “I did a stupid thing at lunch. I took a bunch of doxepin.”
Doxepin was a powerful anti-anxiety drug. Looking for the first time that day into Genene’s face, Holland saw that her eyes were glazed and her eyelids were drooping. After checking among Genene’s belongings, she found an empty bottle of the drug. The label showed it contained as many as thirty pills.
Dr. Holland rushed over to the doctor next-door and told him that her nurse had just overdosed on doxepin and that, “Number one, I am not an adult doctor, and number two, I wash my hands of this woman.”
While an ambulance took Genene away to the hospital, Holland called the chairman of the committee at the hospital and told him that she had just fired Genene Jones because she had attempted to commit suicide at the clinic. She asked him to come over. When he arrived with some of his colleagues, Holland told them everything she had learned and turned over the vials of succinylcholine to them. Together, while going through the drug requisition forms, they also discovered that, in fact, three vials had been ordered, not two, and one was still missing. Two of the deliveries were signed for by Genene.
Trial
On October 12, 1982, a grand jury in Kerr County began looking into the death of Chelsea McClellan and the eight other cardiac or pulmonary arrests that children suffered at the clinic and hospital. Chelsea’s body was exhumed and the presence of succinylcholine was confirmed. But it was not going to be easy. Nobody had seen Genene actually inject the child with the drug.
In the meantime, in San Antonio, a grand jury there began investigating an extraordinary total of forty-seven suspicious deaths linked to Genene Jones’s four-year employment at the three hospitals in that city.
Genene first went on trial on January 15, 1984, for the murder of Chelsea McClellan and injury to the other children. On February 15, 1984, Jones was convicted of murder after the jury deliberated for only three hours. She was given the maximum sentence of ninety-nine years. Later that year, in October, she went on trial in San Antonio and was found guilty on one count of injuring a patient there by an injection of heparin. The two sentences totaled 159 years, but with the possibility of parole.
Although Genene Jones was suspected in the deaths of forty-seven other children, the New York Times reported that the administration of Bexar County Medical Center and University of Texas Medical School shredded nine thousand pounds of pharmaceutical records from the period when Jones was employed there, thus destroying potential evidence that was under the grand jury’s subpoena. Despite the hospital’s protestations that the destruction was “routine” and “a coincidence,” the district attorney, acting on a tip from an informant, intervened on the eve of a further attempt to destroy an additional fifty thousand pounds of hospital documents, salvaging forty boxes of material that could have been relevant. The dean of the medical school at Bexar was cited for contempt of court when it was discovered that versions of the hospital’s reports from the investigation of Genene Jones while she was employed there were withheld from the grand jury.187
Jones became eligible for parole after serving ten years, but Chelsea’s family recently lobbied to keep Jones in prison. She comes up for her next hearing in 2009.
MUNCHAUSEN SYNDROME BY PROXY (MSP OR MSBP)
What was going on in Genene Jones’s head? Just about the time Genene was committing her acts, her condition was being given its name: Munchausen syndrome by proxy (MSP or MSBP).
Karl Friedrich Hieronymous von Münchhausen was an eighteenth-century German baron and mercenary officer in the Russian cavalry. On his return from the Russo-Turkish wars, the baron entertained friends and neighbors with stories of his many exploits. Over time, his stories grew more and more expansive, and finally quite outlandish. Münchhausen became somewhat famous after a collection of his tales was published.
Almost a century later, an unusual behavior pattern among young men gained recognition in the writings of nineteenth-century pioneering neurologist Jean Martin Charcot. In 1877, he described adults who, through self-inflicted injuries or bogus medical documents, attempted to gain hospitalization and treatment. Charcot called this condition mania operativa passiva.
Seventy-four years later, in 1951, psychiatrist Richard Asher described a similar pattern of self-abuse, where individuals fabricated histories of illness. These fabrications invariably led to complex medical investigations, hospitalizations, and at times, needless surgery. Remembering Baron von Münchhausen and his apocryphal tales, Asher named this condition Munchausen syndrome.189
The term Munchausen syndrome by proxy was coined by British pediatrician Roy Meadow in 1977, just around the time that Genene was graduating from nursing school. Meadow described the mothers of two children in his practice who were engaging in deception that put their children in the role of patients of their own illnesses; they were using the children as proxies.190 Subsequently, Meadow collected data on a number of similar cases, noting that often doctors responding to the mothers’ convincing complaints harmed the child as a result of unnecessary tests and treatments.
Originally, Meadow identified the mother as a perpetrator and the child as a simple victim, arguing in 1982 that only children up to age six were used as proxies because a child older than that would likely reveal the deception.191 After two more years of study, however, he discovered cases where an older child could act as an accomplice in its own victimization, feigning the requisite symptoms, with the two involved in a sort of folie à deux.192 Meadow warned that this was a pattern that might be perpetuated even after the child reached adulthood. He described the case of a 22-year-old victim confined to a wheelchair because he was brought up to believe he had spinal bifida and could not walk, despite the fact that medical examinations showed his back and legs to be completely normal.
Meadow found that often the mothers appeared normal on psychological tests, with no disorder apparent to the psychiatrist. He added that the psychiatrists frequently reported that they did not believe the mother could have been practicing the kinds of deception that had been discovered. It is often difficult for professionals to reconcile the incongruity between how caring the MSP mother appears to be and what she is really doing: for example, scratching the child’s skin to induce a rash, overdosing the child on medications, or suffocating the child to induce seizures, etc.
Kathryn A. Hanon, an investigator with the Orlando Police Department and a specialist in Munchausen syndrome by proxy abuse cases, writes: “[MSP] offenders are uncharacteristically calm in view of the victims’ baffling medical symptoms, and they welcome medical tests that are painful to the children. They also maintain a high degree of involvement in the care of their children during treatment and will excessively praise the medical staff. They seem very knowledgeable of the victims’ illnesses, which may indicate some medical study or training. They may also have a history of the same illnesses being exhibited by their victims.”193
The motivations for MSP appear to be varied. Meadow identified various individual “reinforcers,” such as increased social status, improved family relationships, and direct or indirect financial benefit. Another study focused on the acting out of sadistic impulses in MSP, while another motivation frequently found is the attention and sympathy the adult caretaker gains by presenting their child in the “victim” role. Additionally, the adult’s dependency needs may be met through the symbiotic bond with the child that is reinforced by the production of fictitious symptoms.194
Frequently, the mother blurs the boundary between her and the child by “donating” her own symptoms to the child. The mother may borrow from her own medical history and insist that her child has the same condition. The mother may even reenact her symptoms through the child. A case was reported where a bulimic mother induced vomiting and failure to thrive in her infant through illicit doses of ipecac, apparently administered to make the child conform to her ideals of thinness.195
In cases of MSP the mother is inevitably in an enmeshed, symbiotic, mutually anxious, and overprotective relationship with her victimized child. The mother relies on the child to meet her needs, and typical of the role reversal noted in other forms of child abuse, the child serves the purpose for the parent to deal with their own psychological or medical obsessions. A case is described where a mother was so depressed by her deteriorating marriage that she needed to express her sense of being “sick” by making her child sick. Her own depression lifted as a result.196
MSP is not necessarily confined to mothers. Everyone has heard of firefighters who committed arson and heroically responded to the fire long before the term MSP came into being. It is not a new story. Nurses like Genene Jones can be susceptible to the same complex.
Prosecutors argued that Genene Jones suffered from a hero complex, basking in the acclaim she received every time she successfully predicted a child was going to have a crisis or every time she brought a child back to life. Or it might have been a simple matter of excitement, being the center of attention—getting the doctor’s attention by making her patients sick: classic Munchausen syndrome by proxy symptoms. There might have been some kind of symbiotic transfer of Genene’s own fears for her health to that of her patients. Genene was constantly going to clinics and emergency wards with a litany of apparently imagined complaints that were never successfully diagnosed.
But as always with female serial killers, motive is never clear-cut. Genene Jones might simply have been punishing those doctors and nurses she did not like. Doctors who did not follow Genene’s advice often found that their patients would code. When the nurse in Kerrville told Genene to move her patient from a bed being prepared for an incoming cardiac patient, the nurse shortly found herself dealing with an arrested child—just as Genene had warned: “Well, I hope to hell this baby doesn’t go into cardiac arrest.”
Marybeth Tinning—the Killer Mom
In an extreme case of MSP, Marybeth Tinning, a housewife and former school bus driver in Schenectady, New York, is believed to have murdered nine of her own children, including one adopted child, one by one in a period between 1972 and 1985.
Marybeth Roe was born in the small town of Duanesburg, New York, just outside of Schenectady on September 11, 1942. Very little is known about her childhood. In the early years of her life, her father was away fighting in World War Two while her mother was working. Marybeth was shunted around to her relatives, one of whom tactlessly told her that she was an unplanned baby. When her baby brother later became old enough to understand, Marybeth used to tell him, “You were the one they wanted, not me.”
Marybeth was said to have had a tendency to throw tantrums. Her father would chase her up to her room with a flyswatter or a ruler and order her to remain there until she got over her “crying spell.” Is this abuse? Marybeth refuted it, saying that he had to use a flyswatter because his hands were becoming arthritic, and was, overall, defensive about her father during her trial. Again, the disciplinary culture of the times makes it hard to judge precisely the degree of physical abuse Marybeth experienced as a child.
Her former schoolmates remember her as a lonely, tiresome child, constantly clamoring for attention. Once, when she was appointed school bus monitor, she handled the authority very poorly, screaming abusively at the little children and attempting to boss around those much older than she. She alienated every child on the bus.
As a teenager, almost nobody can remember her. One former schoolteacher said after her arrest, “I cannot recall anything good or bad about her. So far as I am concerned, she was almost a nonentity.”197
She was remembered as a plain girl who dressed plainly. A member of no clique who caused no trouble. Not despised and not popular. Ignored. A few students recalled that she was moody and tended to lie and tell exaggerated stories to make herself look more important. She was an average student who graduated high school in 1961 with only one comment next to her name: “Temper.”
She had wanted to go to college, but her marks were too mediocre. She ended up doing a series of menial jobs, ending up working as a nurse’s aide in a hospital in Schenectady. She married Joe Tinning, a worker in the General Electric plant in Schenectady, just like her father.
In the first five years of her marriage, the couple had two children, Barbara and Joseph. Witnesses recalled that they lived in a duplex house near the plant and that while they struggled to make ends meet, they appeared to be a happy family. Despite the fact that she was described as inexplicably “strange” by her friends and neighbors, most felt that Marybeth “cherished” the children. They were always clean and well-dressed and appeared to have the content demeanor of children who felt loved and secure.
In 1971, Marybeth was expecting her third child. When she was in her seventh month, her father died of a sudden heart attack while at work in the GE plant. Marybeth took the death of her father very badly, weeping uncontrollably at the funeral. Ten weeks later, her third child was born, on December 26, a daughter the couple named Jennifer. The child died a week later from meningitis. Nurses recall Marybeth’s reaction as “bizarre.” Still in bed, Marybeth cradled the child while pulling a sheet over the two of them. Her entire demeanor was passive. Although the nurses noted that she was behaving in a highly disturbed way, no therapy was routinely given in those times as it would have been today. At the funeral, Marybeth looked dazed and did not cry.
It is believed that the outpouring of sympathy and support for Marybeth was so addicting to her that she then began to kill off her other children. Fifteen days after the baby’s death, Marybeth Tinning brought her 2-year-old son, Joseph, to a hospital, stating that he had stopped breathing during a “seizure” of some sort. Suspecting a viral infection, the hospital kept the boy for ten days before sending him home. The same day he went home, Tinning rushed back to the hospital with the boy, claiming she had found him tangled in his sheets, his body blue. This time he was dead. Death was certified as “cause unknown,” but cardio-respiratory arrest was suspected.
In March 1973, Tinning took her 4-year-old daughter to the hospital, claiming that she was having convulsions. The doctors wanted to keep the child overnight, but Tinning insisted on taking her home. She returned several hours later with the child, who was unconscious. Her daughter died several hours later. Death was believed to have been from sudden infant death syndrome (SIDS), although the doctors could not definitively certify it as such.
Despite the fact that three of her children had died in a very short span of time, in November 1973, Tinning gave birth to a fourth child, a baby boy. Three weeks later he was returned to the hospital dead. Marybeth claimed she had found him lifeless in his crib. The doctors could not find anything wrong with the child and certified the death as SIDS.
In March 1975, Tinning gave birth to a baby boy, her fifth child, who three weeks later was brought into the hospital by Marybeth, with breathing difficulties and severe bleeding from the mouth and nose. Pneumonia was diagnosed, and a month later the infant was returned to the Tinnings. On September 2, Marybeth showed up in the emergency ward with the lifeless child in her arms. She said she had been driving with the child in the front seat when she noticed he had stopped breathing. The cause of death was declared acute pulmonary edema.
By then the emergency room hospital staff was divided. Half of them deeply sympathized with Marybeth and grieved for her extraordinary, tragic loss of five children in so short a span of time; the other half hated her and dreaded her every appearance at the hospital. Why didn’t she just stop having children, for God’s sake?
Marybeth began theorizing, some say bragging, that there was a genetic defect that was causing the death of her children. In her latest pregnancies, her fellow workers began to grumble, “Marybeth’s pregnant, and she’s going to kill another baby!”
The Tinnings applied to an adoption agency, which sympathized with Marybeth’s “genetic” history and hurried through an adoption of a baby boy—Michael—whom they received in August 1978. But by then Marybeth had already been pregnant for seven months.
In October 1978, a girl was born. They named her Mary Frances, and in January 1979 she survived her first “medical emergency.” A month later, on February 20, Marybeth went into the hospital with the dead infant cradled in her arms, claiming she had found her unresponsive in her crib. Cause of death was declared as SIDS.
Marybeth lost no time getting pregnant again. On November 19, 1979, she gave birth to a boy, Jonathan. In March 1980, she brought him into the hospital because he had “breathing problems.” The doctors could not find anything wrong with him and sent him home. A few days later, she brought the child back, this time unconscious. The child was found to have no brain function and died on March 24.
Marybeth responded to all these deaths with a round of dramatic funeral announcements and a gathering of all her friends and relatives. Both her birth and death announcements put her in the center of attention. One relative said, “Every funeral was a party for her, with hardly a tear shed.”
On March 2, 1981, Marybeth showed up at her pediatrician’s office with her adopted son, Michael, wrapped in a blanket. He was dead. Marybeth explained that she had found him unconscious that morning. The death of the adopted child broke the “genetic” explanation and began to make people think the unthinkable: Could this mother actually be murdering her own children?
In August of 1985, Marybeth, at the age of 42, gave birth to another girl, her ninth child, Tami Lynne. On the morning of December 20, the girl was found dead in her crib. Again, SIDS was certified as cause of death.
A neighbor visited the Tinning home the next morning to see if she could be of any comfort to Marybeth, who she assumed would be grieving over the death of her newborn daughter. When she entered the house, she found Joe and Marybeth in the kitchen, nonchalantly eating breakfast as if nothing had happened
Later, after Tami Lynne’s funeral, Marybeth had people over her house for a brunch. Her demeanor had changed noticeably. “She was smiling. She was eating, conversing with everyone there,” the neighbor testified, “and didn’t appear to be upset.”
Sandy Roe, Marybeth’s sister-in-law, testified that when she met with Marybeth after Tami Lynne’s death, she did not seem upset. “We spoke about Christmas,” Roe stated, “She never really talked about the death of the baby. It didn’t seem to bother her.”
Nine deaths were now too many and authorities ordered an autopsy. It revealed that the child had been suffocated.
Marybeth Tinning confessed to the murder of the infant and to the death of two other children, but not the others. She also confessed that she was attempting to poison her husband. In 1987, Tinning was sentenced to twenty years to life and is up for a parole hearing in March 2007.
Christine Falling—the Killer Babysitter
The case of Christine Falling is another extreme example of Munchausen syndrome by proxy. Christine Laverne Slaughter Falling was born in abject poverty in northern Florida. Even though Christine’s mother was 16 years old, Christine was already her second child. Her father was 65 years old. Christine was shuffled around to various relatives and foster parents and grew up to be a grossly obese, dull-witted child suffering with epilepsy. Her friends remember her killing cats to “see if they really have nine lives.” Despite this, Christine professed a great love for cats.
Christine was adopted into a religious family, but after several years she became so uncontrollable that at the age of nine she was sent away to a juvenile center. There she was reported to be a compulsive liar and thief. When Christine was old enough to go to high school, she went into a special program of half-days, allowing her to work the other half.
When Christine was 14 she married a man in his early twenties. The marriage lasted six weeks, during which Christine launched a twenty-pound stereo at her husband in an outburst of bad temper. In the two years following the breakup of her marriage, Christine made at least fifty visits to the local hospital emergency room, complaining of troubles such as snakebites, red spots, bleeding tonsils, dislocated bones, falls, burns from hot grease, and vaginal bleeding.
Around the time Christine was 16, she was living with her mother. She was too dull to find work as a store clerk and could only earn a living babysitting for others in her poverty-stricken, tar-paper shack neighborhood.
On February 25, 1980, while babysitting 2-year-old Muffin Johnson, Christine says the girl stopped breathing. Falling rushed the child to the hospital, where her death was declared a result of encephalitis. The hospital emergency staff praised Christine for how well she had handled the emergency, wrapping the child up in a blanket and attempting mouth-to-mouth resuscitation on the way to the hospital.
A year later, Christine was babysitting 4-year-old Jeffrey Davis, a distant relative. After Jeffrey was found dead, Christine stated that she had laid him down for his nap and had not noticed that he had ceased breathing. Death was certified as myocarditis—heart inflammation.
Three days later, Christine was babysitting her 2-year-old cousin, Joseph, while his parents were at Jeffrey’s funeral. Joseph also failed to wake up from his nap. Again, death was diagnosed as myocarditis as a result of a virus.
There was some speculation that Christine might carry some type of virus deadly to children, like Coxsackie A8, which is passed from person to person through contact with fecal matter. Doctors found no traces of any virus.
When suspicions were voiced that Christine might be murdering the infants, her relatives and neighbors quickly came to her defense, stating how much Christine liked children and how gentle and caring she was with her charges. Journalists pointed out that infant death was not unusual among Florida’s poor, where bad hygienic conditions were common.
Christine Falling next found a job as a housekeeper for 77-year-old William Swindle, who lived in a small cottage. The first day she arrived at work, Swindle was found dead on the floor of his kitchen. Death was presumed to be of natural causes.
Christine stated in an interview, “The way I look at it, there’s some reason God is letting me go through this. If God hadn’t wanted me to go through this, He wouldn’t have let it happen.” Christine went back into the babysitting business.
On July 14, 1981, Christine was helping her stepsister take care of her 8-month-old daughter, Jennifer. The two women drove to a government health center where the baby was given an immunization injection. The baby was crying when Christine carried her out of the health center. The two women then drove to a supermarket, where the mother went inside to buy some diapers. Christine was left alone in the car with the crying infant. When the mother returned to the car, the infant was silent. As they were driving home, Christine suddenly told her stepsister that Jennifer was not breathing. They rushed to a hospital, where the infant was pronounced dead.
At the baby’s funeral, Christine fainted when the organist played “Precious Memories.” Later, she told people that the child had died of “a ‘yemonia’ sickness.”
A year later, on July 2, 1982, a 17-year-old mother dropped her 10-week-old baby off with Christine to babysit for a day and a night. Christine stated that at 4:00 a.m. she had fed the child his formula and that he was well. In the morning, however, she found the baby dead in the crib.
Christine was again submitted to a battery of tests. Thinking that perhaps somehow her epilepsy medicine might have gotten into the food of the infant, a careful autopsy was performed. What it revealed was that the child had been smothered. Christine was charged with three counts of murder.
She confessed, “I love young ’uns. I don’t know why I done what I done…The way I done it, I seen it done on TV shows. I had my own way though. Simple and easy. No one would hear them scream. I did like, you know, simple, but it weren’t simple. I pulled a blanket over the face. Pulled it back. Then again I did the blanket pulling over the face…just the right amount for the little one. A voice would say to me, ‘Kill the baby,’ over and over…very slow, and then I would come to and realize what happened.”
Christine Falling is serving a life sentence, but she became eligible for parole in December 2006.