‘I didn’t really meet the murderer; I didn’t know this person that could kill people. It was very hard for me, betraying him, betraying a friend in that way’ … Eddie Redmayne and Jessica Chastain in The Good Nurse Photograph: JoJo Whilden/Courtesy of Netflix
The actual nurse who assisted in the arrest of a coworker who was thought to be America’s most prolific murderer discusses the truth behind the Netflix drama
It was his shyness that struck her first. “He was so soft-spoken that immediately I felt like I needed to protect him and my protective nature kicked in right away,” Amy Loughren recalls of Charles Cullen. “I knew that he was brilliant. His knowledge of medications, his knowledge of critical care was outstanding, and I’m drawn to people that are smarter than me. And he laughed at all my jokes. So we were fast friends.”
Loughren was unaware that Cullen, a fellow night nurse, was surreptitiously overdosing patients with drugs in order to kill them. But later, she would assist investigators in apprehending her friend and colleague and locking him up. He is still regarded as the most active serial murderer in American history, according to some estimations.
The Good Nurse, a Netflix movie starring Oscar winners Jessica Chastain and Eddie Redmayne and directed by Tobias Lindholm, centers on the platonic connection between Loughren and Cullen. It is a critique of the American healthcare system that prioritized profits even when warning signs were raised, as well as a study of the ultimately unknown reasons of mass murderers.
Loughren, a mother by herself, had a bad encounter with the system. The travel nurse at Somerset Medical Center in Somerville, New Jersey, hid the fact that she had cardiomyopathy, a condition that affects the heart muscle, because she knew that if she missed more than six days of work, she would lose her job and her health insurance, making it difficult for her to care for her family or pay for her medical treatment.
However, she found a supporter in Cullen who, after entering the ICU, helped her split the job and hide her condition. Speaking via Zoom from Florida, Loughren explains: “He was one of the only people that knew about it and he really did understand what it meant for me if it got out that I was too sick to be working. He certainly helped me on those nights when I wasn’t physically capable of being there completely.”
The two became close after being put in a trying position together. “When you work in a setting where life and death are involved, you get extremely close, and since nurses put in such long hours, sometimes they spend more time together than they do with their own families, whether this is healthy or not. Because we just want to sleep at home, night nurses in particular tend to simply not have a lot of a social life. As a result, we often rely on our coworkers and colleagues as our social network.
“Did I notice a dark side? I noticed that perhaps he was depressed, maybe that he was kind of like me and suffering from childhood trauma.” (Cullen’s mother was murdered in a vehicle accident while he was a teenager; his father, a bus driver, passed away before Cullen became one year old.)
But they were never even close to being romantically involved. Loughren, 57, comments: “Charlie knew his limitations. One of the reasons that we did have such a deep friendship was because there wasn’t any of that. We were so close because I was never concerned about that and there was never any boy-girl stuff going on ever.”
Loughren was unaware of the situation until news spread that the facility had caught the attention of police authorities. If any medications had been stolen, she questioned. Her first reaction after being questioned by a detective was to protect her pal. “I was saying, ‘You’re full of shit. There’s absolutely no way that my friend Charlie – if you’re asking questions about him, I’m not cooperating.’ He was like, ‘Yeah, that’s our job.’”
Loughren realized it could only have been for malicious purposes once the investigator provided proof of the precise pills Cullen had withdrawn; there was no other explanation. The reality had at last become apparent. She was aware of what her buddy had been doing to the patients who were in his care, which had a terrible impact on their families.
She says now: “That’s where all of my guilt comes in. 20/20 hindsight. I was unaware of anything until the police presented me the proof, and I had no reason to suspect anything. When I did see the proof, I was able to take a look back. Then, things started coming to light, and I began to recall specific instances when I felt he definitely done something, but I wasn’t challenging him in that manner.
Charles Cullen. Photograph: Kathy Johnson/AP
“You don’t question another nurse when they make a specific decision when you know that they’re a very skilled nurse or they’re very seasoned. You might think, ‘That may not be the same decision I would make; however, they’re a good nurse, they have their reasons.’
“Yes, there were a couple of head tilts when we were in code together or when I would walk in on him and a code had already started and he would have given a certain medication that I thought, ‘That’s odd, we don’t use that medication any more in our protocols, why is he using that medicine?’ He was so good at what he did, I never thought, ‘Oh, he’s trying to harm someone.’ Why would anyone think that?”
Loughren was afraid for her career and sad for the victims. She gave her cooperation to the investigators’ efforts to apprehend Cullen. Investigators listened in on several “tough” phone conversations with him. In the end, she encountered him in a restaurant while wearing a wire. The wire picked up the sound of her heartbeat, and she could feel her pulse quickening, which may be dangerous given her heart condition. The wire broke down, but there was still enough information to make an arrest once she approached Cullen and obtained a partial confession.
Did she have conflicted feelings given their strong friendship? “Absolutely. I never really met the killer; I had no acquaintance with this murderer. I found it quite difficult to turn on him and betray a buddy in that manner.
“My integrity is pretty damn intact. It’s very hard for me to fake any emotions. When I went in to talk to him, those emotions were real. I genuinely cared for him and I know the only reason that we were able to actually get him to confess was because he did feel comfortable and he did care about me. At least I thought so. I would like to think so. I would like to think that person was real and they were two different people.”
Amy Loughren and Jessica Chastain. Photograph: Anthony Harvey/Rex/Shutterstock
2003 saw the arrest of Cullen. He was given 11 life sentences after confessing to the murder of up to 40 victims. Investigators think that up to 400 victims may have been killed by him when he was moving between nine hospitals in New Jersey and Pennsylvania during a 16-year period. For instance, in the first hospital where he worked, he confessed to poisoning three to five IV bags every week that were distributed at random to patients. He did this by injecting lethal medications into the bags.
When Loughren visited him in jail, she did not receive the responses she was looking for. All communication between them ended once he learned about her involvement in his capture.
She muses, “It’s been over 20 years, and the killer is still in jail; that’s where he belongs. The only way any of us, including the families of the victims, can go on is by holding him responsible for all he did. He deserves to be imprisoned. He may have also been suffering from untreated mental illness since, despite his repeated cries for assistance, our healthcare system failed to respond to them.
The Good Nurse makes a strong case that Cullen was able to hide his deadly poisoning of patients with overdoses of drugs like digoxin and insulin owing to for-profit institutions avoiding accountability as he went from hospital to hospital. This is in light of the infamously lax US healthcare system, which results in an estimated 68,000 deaths annually from patients who cannot afford the necessary treatment.
In addition, Loughren, a retired nurse who assisted Chastain in getting ready for her role as her in the film, says that once we began profiting off people’s misery, we lost our soul and those patients ceased to be human. These patients turned into a money symbol. They were diagnosed as such patients. These patients developed become a source of profit. Now because they are so far removed from the patient’s bedside, the decision-makers don’t care. It is unquestionably a sign of our healthcare system’s dark capitalism.
Eddie Redmayne in The Good Nurse. Photograph: JoJo Whilden/Netflix
Journalist Charles Graeber’s 2013 book, The Good Nurse: A True Story of Medicine, Madness, and Murder, which served as a major source for the movie and was based on meticulous research and interviews with Cullen (“a sad Mr Rogers type, both drippy and depressed”) and Loughren, explores the dangers of managing hospitals like businesses. When questioned about his intentions, Cullen played by Redmayne responds, “They didn’t stop me.”
In his interactions with Cullen, Graeber recalled getting the impression that hospitals had failed in their duty to care for and safeguard patients who were weak. He believed that the hospitals were aware of what he was doing, and that some of them had a good idea of what he was up to. However, instead of trying to understand him or determine the best course of action, they would only give him positive or neutral references and move on to dealing with someone else’s problems.
He believed that his bosses’ negligence of duty showed a hypocrisy that he himself had emphasized, nearly to the point of criticizing the institution. Although he would never put it like this, he felt somewhat justified.
The 53-year-old author continues over the phone from Nantucket, Massachusetts: “I wanted to stress the challenging job nurses perform, the wonderful work that good nurses do constantly, and how thin they are pushed in a for-profit system. For those who can afford it, the healthcare system does very well for itself and provides some of the best treatment in the world.
“However, it appears that its corporate identity and for-profit interests cloud the judgment of some of those who are designed to run or protect those institutions, and it fails ultimately patients and treats many frontline healthcare workers as interchangeable parts. This is in terms of serving the entire country, the entire population who need it. That is highlighted in Charlie’s tale. Ironically, he is really right in one regard: Although what he did was wrong, I can’t think of a more potent criticism.
Capturing the Killer Nurse, a documentary, will be streaming on Netflix on November 11 in addition to The Good Nurse, which is now available.