The Angel of Death: Kristen Gilbert, The Serial Killer Nurse

Henry Hudon’s Final Days

Henry Hudon was nineteen years old when he joined the United States Air Force. His father had been in the airforce for twenty-three years, fighting against Rommel in WWII. Henry wanted to serve his country and follow in his father’s footsteps.

He went to basic, then technical training, before qualifying as an assistant physical therapist and eventually being posted to RAF Lakenheath, north of London. It’s here that, at a pizza place, Henry was asked by a nearby officer to de-escalate a fight which had just broken out. We don’t know the exact circumstances, but young Henry did as he was asked and, for his pains, was bottled across the back of the head, falling face first into the concrete floor.

He suffered a detached retina and traumatic injury to his frontal lobes and was invalided back home. As a veteran, he was entitled to financial assistance and medical care and, somewhat surprisingly, seems to have actually received it. He was returned to his hometown in Massachusetts, where he eventually rented a small apartment, being cared for by his mother and his sister as needed.

Henry’s sister, Christine, described her brother as high energy, boisterous, and likeable before the brain injury. Afterwards, though, she said, “I was talking to a different person”. He was morose, quiet, and sometimes violent and aggressive. He heard voices and was constantly terrified.

Henry was diagnosed with paranoid schizophrenia and sent to a Veterans’ Affairs Medical Centre—most folks just call it “the VA”—in order to get his medications adjusted, an in-patient treatment process which could take weeks or months. This would happen every eight or nine months, and Henry would frequently skip out on his in-patient time. So his sister Christine or their mother Julia would have to find him and bring him back.

It’s December 7, 1995, and Henry’s skipped out on an in-patient stretch at the Leeds VA in Northampton, Massachusetts. He’s quite ill with the flu, however, and starting to regret his decisions. He calls both his mother Julia and his sister Christine asking them to bring him back the next day.

It’s Julia who goes. She tells her son to say he’d been drinking and taking pills—flu was ravaging the small town and she was worried he’d not be able to get in for treatment. Henry duly complies, and so instead of the psych ward, the doctor assigns Henry to Ward C, a twenty-six-bed acute care facility.

Henry suddenly loses his mind, frantically resisting and citing staff and patient claims that people in Ward C are being killed for no reason. This fits common delusional frameworks for Henry’s type of mental illness, so Julia doesn’t think anything of it. They put Henry’s effects into a bag, which she makes them put a nametag on so he doesn’t lose anything.

They call an orderly Henry’s known for years—a kind man called Rich—who succeeds in calming him down. Staff say Julia should just leave, and they’ll take care of her son. As she goes, Henry, weeping, says to his mother, “Mom, I don’t wanna die.

Please don’t leave me here.”

Late that same night, Julia Hudon gets a call from a doctor at the VA saying that her son is gone. Exasperated, she offers to go back out to his apartment and try to persuade him to return. “No, you don’t understand, Mrs Hudon,” the doctor says.

“He’s gone as in he’s dead. D E A D.” They inform Julia that Henry has died of a series of cardiac arrests.

Christine says her mother did nothing else for the rest of the night but cry. Christine goes out to the hospital to identify her brother’s body. While they’re talking, Christine suddenly demands an autopsy, surprising everyone including herself.

“I just heard myself saying it,” she told a TV documentary team. The hospital is unwilling, saying there’s no requirement. Christine insists, arguing that multiple cardiac arrests are not a typical symptom of influenza, and that she has a right to know the cause of death.

Her brother’s fears were probably in her mind as well, but when the autopsy results come through, there’s no conclusive evidence of foul play or malpractice. What is found, though, is that his last attack was so severe that part of his heart had exploded throughout his chest cavity. This is strange for a strong and healthy thirty-five-year-old male, but not necessarily unprecedented.

So the Hudon family grieve and make funeral arrangements, and the world, serenely indifferent, spins ever onward.

The Hospital

The Leeds VA is a complex of redbrick colonial buildings at the top of Bear Hill in Northampton, in western Massachusetts. Their mission statement, printed on a sign out front, is: “To Care for Those Who Shall Have Borne Battle”. Back in the 19th Century it was a stagecoach tavern, and by 1924, after President Harding ordered the land to be cleared, it became the Department of Veterans’ Affairs’ first ever psychiatric facility. Primarily focused on mental health care to this day, the hospital would also take overflow patients from other facilities and had a variety of intensive care and other facilities we’d associate with an ordinary hospital.

For those who don’t have direct contact with the VA system, it’s worth saying a little bit about them. They are primarily, in most cases, tranquil places. Many of their patients are aged and seriously ill, and staff tend to have strong relationships with their regulars, typically knowing them well and providing the best standard of care they can.

The flip side of this, of course, is money. Public health in the US in general has been chronically underfunded for decades, and veteran care is a recurrent national scandal. VAs in the US tend to be understaffed, unevenly equipped, and heavily reliant on private philanthropy.

This is important for what follows. The reality of the way in which these systems are run—held together by staff routinely going above and beyond, and private organisations and citizens reaching into their pockets or volunteering or both—means that we have to cut the good people running these places a bit of slack.

Anyway, the Leeds VA was just such a place, and situated in the kind of idyllic surroundings only Massachusetts seems able to produce, with an added layer of serenity baked into the design of its generous grounds owing to its function as a psychiatric hospital. In July of 1995, Stanley Jagadowski, a truck driver and Korean War vet, was admitted to the ICU at Ward C for post operative bowel obstructions. He’d had his operation at another facility which didn’t have the aftercare beds at the time, so off to Leeds VA he went.

He was recovering well, though, and the doctor had recommended he be shifted to a nursing home the following day. The shift changed at four pm, so the single duty nurse changed out as well. By 8:43, two licensed practical nurses (LPN) had paid him a visit and confirmed the doctor’s prognosis—Stanley was on the mend.

LPNs, by the way, are degree qualified nurses who provide basic medical care. Registered Nurses (RN), who provide more dynamic care, frequently supervise them.

One of the LPNs saw the duty nurse, an RN, go into Stanley’s room with a syringe and swabs, ostensibly to flush his IV line with saline to remove a blockage. This might have struck them as strange, as all his prescribed medications were oral tablets, or it might not, as they wouldn’t necessarily have known everything he was prescribed. A little while later, the other nurse heard Stanley yell, “Ow! It hurts!

You’re killing me!”, which made her turn towards the door, where she saw the duty nurse leaving. Within minutes, the hospital was calling a Code Blue—critical life threatening emergency—and shortly after that, Stanley Jagodowski was dead of a cardiac arrest.

This sequence of events looks pretty damning, and it’s worth wondering why those two LPNs didn’t go straight to someone in authority and call out the duty nurse as a murderer, but there’s a few factors militating against this. Firstly, there’s authority. These two LPNs might not have been across every aspect of Stanley’s treatment, and they’d have little reason to question what the RN was doing.

There was also the fact that Stanley had a history of heart troubles, so his dying of a cardiac arrest after an operation wasn’t that suspicious. On top of all that, this is a VA hospital. In a primarily psychiatric hospital with seriously injured, ageing, and unwell veterans, hearing patients yell out weird or disturbing stuff isn’t actually that remarkable.

Another thing about VA hospitals is that people die in them. Lots of people. Mainly owing to the patient profile.

And in any case, the nurse in question was Kristen Gilbert, described in every available source including court documents as “pretty and popular”, and well known throughout the hospital as being one of its very best operators—a highly intelligent, well-liked, and highly motivated staff member on whom they would frequently rely in times of trouble.

This isn’t to say the hospital was lethargic or negligent in its duty. Nurse Kathy Rix, a long-time staff member and a similarly popular and well-respected medical professional, had been noticing some disturbing trends over the past few years. Firstly, there were the issues with epinephrine. Epinephrine, also commonly referred to as adrenaline, is produced either artificially, or as a hormone by the body’s adrenal glands, situated at the top of the kidneys.

When artificially synthesised, it’s a colourless, odourless liquid. Epinephrine’s used to treat a variety of heart problems and muscle spasms, as well as asthma. Given that its primary side effect is radical increase in heart rate, it’s a carefully controlled substance, as giving it to a healthy patient could cause death.

Kathy Rix was concerned about rising death rates on her ward, especially from cardiac arrest, and started doing an audit of various aspects of operations on her own time. She discovered some disturbing stuff, not least of which was that out of 135 doses of epinephrine administered, 88 couldn’t be accounted for. Usually, when a drug’s administered, you’d expect there to be a matching prescription.

Now normally you’d expect small discrepancies, especially in busy ICUs, with drugs administered or checked out in the heat of the moment and possibly not properly recorded owing to the natural flow of adrenaline in the staff involved. But the sheer scale of the epinephrine stock anomalies combined with the alarming increase in deaths from cardiac arrest had her antennae up.

Mortality rates in hospitals do trend up and down, so Kathy wasn’t that worried initially. But as the expected downward trend didn’t seem to be surfacing for an improbably long time, Kathy eventually took two of her colleagues, John Walt, and Renee Walsh into her confidence, and they all began quietly investigating the anomalies together. From the very outset, their intention was to take anything concrete they found to the authorities.

These three, as well as the VA hospital itself, have come in for some criticism for being slow to do this, but from the research available this doesn’t seem warranted. They blew the whistle in a timely and effective manner. As chill as a VA hospital might be for the patients, it’s still a fraught environment for the staff, and their deliberate, careful approach is understandable—if they jumped at every misgiving they had they’d basically have to camp at the cop station every night.

And yes, it is life and death we’re talking about here, but this is a hospital. Pretty well all their major decisions are life and death. Life and death is the very essence of their everyday existence which, while this doesn’t make these issues less urgent, it sure seems like it would make them stand out less.

The Life and Crimes of Kristen Gilbert

Unlike many other cases of this type, sources for this story have been refreshingly simple to find. The Boston Globe, who famously blew the lid off Boston and the world’s Catholic Church child abuse scandal, did fantastic investigative work after the story broke, and were also able to secure the cooperation of many of the key witnesses and investigators. Special acknowledgment needs to go to Thomas Farragher of The Globe, whose archived packages on this story were invaluable. Also, Radford University’s Department of Psychology compiled a painstaking profile and timeline, which were extremely useful in untangling the frankly lazy and chaotic minor sources out there in internet land.

Kristen Gilbert was born Kristin Heather Strickland on 13 November 1967, in Fall River, Massachusetts. At first glance, her childhood seems unremarkable, but there are indications of the adult she would grow up to be. In the early eighties, the family moved to Groton Massachusetts, about ninety minutes’ drive away. Kristin’s father was an electronics engineer and her mother a homemaker and part-time teacher.

They lived in a nice house in the suburbs, across from their friends, the Moore family, whose kids Kristen used to babysit. Kristen was in the math club, went to prom with the brightest kid in school, breezed through her honours class and graduated high school two years early in 1984 at the age of sixteen. Basically, she was a high performer.

When the Globe talked to her old neighbours, the Moores, they described a neighbourhood spat of some kind, which they wouldn’t elaborate on. Shortly after this, the Strickland family moved house. What the dispute was about remains unknown. Alberta Moore would tell the Globe that Kristen lied a lot, saying she had a “blank look in her eyes like she was making stuff up as she went along”. She apparently went around telling people she was related to Lizzie Borden, an infamous 19th Century figure accused, but not convicted, of the axe murders of her father and stepmother. One of Kristen’s friends described how she had stolen one of her tops and then worn it in front of her, claiming she just happened to own the same one. The same friend recalled Kristen’s favourite character from General Hospital, a soap they all loved to watch, was basically one of the villains—a cruel and conniving destroyer. Whether these early memories genuinely explain how she went on to murder a bunch of people is debatable, and the benefits of hindsight must be considered. But what comes later does stitch together quite neatly with this admittedly thin collection of character assassination anecdotes.

After high school, Kristen enrolled in Bridgewater State College and majored in pre-med. It seems that during this time she developed a pattern of emotional and physical abuse inflicted on a series of boyfriends. Boyfriends from this period report being spat at, attacked with car keys and fingernails, and having their cars vandalised.

One man in particular says Kristen attempted to manipulate him by falsely claiming she’d attempted suicide by eating glass. Her mistake seems to have been making this claim in writing, which led Bridgewater to order her to undergo psychiatric treatment, which she appears to have avoided by transferring. She also, according to her father, developed a habit of telling people that her mother was an abusive alcoholic who beat her, which she wasn’t.

It seems she was always interested in developing a fantasy persona of herself—a sort of personal origin myth which would simultaneously set her apart from, and gain her entry to, groups of peers. This is pretty common amongst a bunch of different types of people, normal and abnormal, but it seems Kristen did it to a pathological extent.

In the summer of 1986, she met a man named Glenn Gilbert on Hampton Beach and began a relationship with him. The next year, aged twenty, she transferred to Wachusett Community College, and then Greenfield Community College, in order to be closer to Glenn. Presumably this significant life change was made more convenient by the transfer away from a college that wanted to put her mental health status in the spotlight—a definite hazard to any future career in medicine.

Around this time—1987, to be precise—we get the first of the more serious clues (apart from domestic abuse) that something might be wrong with young Kristen. In this year she took a job as a ‘home health aide’ with the Visiting Nurses Association of Franklin County. Home health aides basically visit homes and provide basic care to disabled or other vulnerable folks, and it seems that she took a dislike to one of her charges, a mentally disabled boy, and deliberately scalded over sixty percent of his body with hot water.

She claimed he’d been burnt by a hot bath, but apparently the nature of his injuries was inconsistent with this. Details are sketchy, as charges were never laid, but the story is well attested by several credible sources.

The next year, Kristen eloped with Glenn Gilbert. They bounced around a couple of homes before buying a ranch house together in a nice part of Northampton. Kristen had graduated, at the age of twenty-one, with a diploma of nursing at the end of 1988, and by March of 1989, she was employed as a nurse at the Leeds VA, where she was to work for seven years, eventually earning $40k a year as a senior RN. This combined with her husband’s income from his work at an optical lens firm, meant that the couple were pretty comfortably off.

By 1991 they’d given birth to their first son and then, in 1993, on Kristen’s birthday, the couple’s second son was born. Things, as they say, were looking up.

The Talented Kristen Gilbert

Kristen Gilbert established herself as ‘one of the good ones’ very quickly in her nursing career. She was noted for her ability to take charge of a situation, for the air of calm she was able to bring to her duties, patients, and the hospital, and for her quick intelligence and high competence. Code Blue situations, or “codes”, happened reasonably frequently in a hospital like this, and she was always one of the preferred nurses to be on hand for the emergency response teams.

She didn’t neglect the social aspects of hospital life either. Nursing is often termed one of the ‘generous professions’, in that it requires a lot from its practitioners, both personally and professionally. The uniqueness of the experience creates a kind of camaraderie of the cognoscenti—basically, if you’re a nurse, only others in your same profession really understand completely what your life is like, the way your job changes the way you see the world, and the way the world both sees and fails to see the reality of you. This means some effort is required to create cohesive and tight-knit teams, as much for mutual survival as for support, so those hollow office rituals like Secret Santa or monthly social club can actually take on a greatly enhanced meaning in a job like nursing.

In Kristen’s case, she jumped in with both feet. She was instrumental in organising the Secret Santa, as well as starting a Sunshine Club—this being a club which would ensure flowers got sent to families in case of births, deaths, birthdays, and so on. She frequently organised gift drives around Christmas time to send presents to needy families and was a fixture at post-shift drinks at the nearby VFW. A VFW stands for Veterans of Foreign Wars and is a sort of social hub for veterans and their families, whose most visible public manifestation is the bar/restaurant type venues they run.

There’s a strange incident somewhere in this period between 1991 and 1993, which not too many of the sources seem to have picked up on. It seems that some time after the birth of her first child, Kristen claimed to have received a bomb threat. The ward was evacuated and searched by police, who came up empty. After the cops had finished searching, Kristen claims to have found a strange looking box.

Nothing beyond these basic facts has been determined, but it’s worth remembering this for later. That single incident aside, at this early stage in her career, it seems staff and patients alike all thought of Kristen in glowing terms. The other thing everyone comments on is that Kristen was very attractive—James Perrault, a Persian Gulf War veteran and newly hired hospital policeman, certainly thought so.

Just after the birth of her second child, Kristen’s marriage to Glenn hit a troubled patch. It was about the same time that James Perrault joined the eleven-member hospital police force. These hospital police aren’t actual sworn police officers, but they perform many of the same functions within the hospital precinct—they’re sort of somewhere between a security guard and a cop. Perrault was a veteran of the 1991 Persian Gulf War, and had previously worked as a department store security guard.

The hospital police job was better paid and was also the next stage on his way to becoming a fully-fledged police officer.

When Kristen first started work at the hospital, she was on the overnight shift, but by 1990 had moved to the evening, working from four to midnight. Perrault’s shifts were from three to eleven, so their shifts overlapped quite a bit. Pretty soon, Perrault started flirting with Kristen, apparently receiving encouragement as well as hints that Kristen’s marriage was in trouble.

Whether it was in trouble because Kristen had found a new prospect, or because of the normal wear and tear on relationships, we’ll never know. In any case, they started meeting up at the VFW after work, along with their other colleagues, and pretty soon progressed from highly personal email exchanges to a full-blown extra-marital affair. Other colleagues noticed this blossoming relationship, and Kristen would badmouth her husband publicly at work, presumably as a way of justifying herself in their eyes.

It’s around this time that her husband, Glenn, reports that his food started tasting funny. He started telling his friends that his wife wanted him out of the house by Thanksgiving—some reporters say “dead” instead of “out of the house”. He was eventually hospitalised in November of 1995, at Cooley Dickinson, the nearest civilian hospital, and diagnosed with low potassium and glucose levels.

This, combined with the funny tasting food, led some to suspect Kristen had been spiking his food with diuretics. A week after his release, Kristen approached her husband claiming she wasn’t happy with the standard of care he’d received at the hospital—she wanted to take some blood, but before that, she needed to flush the vein with saline. Anyone who knows anything about medicine knows that this makes no sense at all.

Kristen injected a clear liquid into Glenn’s arm, which immediately began to feel cold and painful. He yelled out for her to stop, but she pinned him to the wall with her hip. After this, he lost consciousness.

When he came to, he saw his wife, apparently flustered, packing up her kit and saying he’d simply passed out from the sight of the needle—nothing to worry about, happens all the time. The state police suspect that Kristen tried to kill him with an injection of potassium. It’s important to say at this point, however, that we only have Glenn’s word for most of this, that low potassium and glucose levels can just happen through diet, and that neither the police nor the DoJ were inclined to charge Kristen with this attempted murder, so none of it’s proven.

With all that said, though, it does seem consistent with the rest of her behaviour.

By 1995, the year Stanley Jagodowski and Henry Hudon died, Perrault had moved to an apartment in Easthampton to be closer to Kristen. She began making claims of domestic abuse at Glenn’s hands, so Perrault gave her an ultimatum, saying she either needed to leave her husband or he’d leave her. During this conversation, which they’d been having at the Mt Holyoke Mall, Kristen got up and walked to a public phone and called her husband, ending the marriage then and there.

Perrault later told investigators he was standing close enough to her to hear her side of the conversation. Kristen moved to an apartment complex near Perrault’s place, enlisting Perrault’s help to pack and move her things. She did not take her children with her.

A few weeks later, she filed for divorce five days before Christmas. She would later engage in a bitter custody battle, which she would lose, but at this point she seems to have been more concerned with ensuring that James Perrault had a key to her new place.

The Investigation

It’s difficult to pinpoint an exact time when the investigation into Kristen Gilbert really began. We know that it formally began on the 17th of February 1996, when the DVA Inspector General’s Office got involved, but the reality is that Kathy Rix and her friends had been investigating her for some time before this, and even before Kathy went to Walsh and Walt, she’d been picking over the inventories and death rates by herself, in the knowledge that something, she knew not what, was wrong.

For the sake of telling a coherent story, we need to periodise the career of Kristen Gilbert. There’s phase one, where she’s working a day shift in the Main Medical Unit, for about a year. Then there’s phase two, where she moves first to the overnight shift and then, in early 91, the evening shift in Ward C. And finally there’s phase three, her “post-escalation” period, after she began her affair with James Perrault.

In phase two, around 1990-1993, when she was swapping shifts in Ward C, the death rate for her shift tripled. After a year, when she moved to the evening shift, overnight shift deaths dropped back to their pre-Kristen levels, while the evening shift death rate tripled. This was noticed at the time, and she was given the nickname “The Angel of Death”.

It’s worth pointing out here that this isn’t that unusual. There are facilities all over the world, especially nursing homes, where there are unlucky staff members who bear this moniker. There’s a big overlap between many VA hospitals and nursing homes, the Leeds VA being one of these. Deaths can switch from clumped to distributed and then back again for no reason at all.

Some types of death are more likely to occur at certain points in the circadian rhythm, and therefore at certain times of day. Sometimes an excess of competence can lead to a nurse or doctor being present at more deaths simply because they’re the ones you call when the chips are down.

There’s a big difference between an anecdotally observed tendency and the abstract reality of statistics. So it was years before the climbing death rate, combined with other strange occurrences, turned the vigilant Kathy Rix onto Kristen Gilbert. We have to remember that at this time, Kristen was an A++ nurse, highly popular with her colleagues, possessed of glowing proficiency reports and, apparently, ridiculously good looking to boot.

By the time we reach phase three of her career—her post-Perrault escalation—cracks are beginning to appear. We already know about the deaths of poor Stan Jagodowski and Henry Hudon, but one thing that hasn’t been mentioned was an item of hospital policy. Whenever there was a cardiac emergency, the on-duty hospital police officer was required to attend and attempt CPR.

Which means that whenever there was a code on one of Kristen’s shifts, Perrault would be the officer in attendance. It’s around this time—1995—that staff begin chattering about the sharp increase in cardiac emergencies and deaths on the ward. It’s also around this time they start noticing strange dynamics between Gilbert and Perrault.

They’ll frequently be the last to leave after their post-shift drinking sessions at the VFW, as if they’re waiting to be alone. Some staff report the two of them exchanging flirtatious looks and smiles as they work to save the lives of patients who are coding. One nurse reports seeing Gilbert and Perrault literally playing footsies while Perrault administers CPR to a patient.

The eighty-eight unaccounted for doses of epinephrine are discovered around this time, and the hospital authorities change their procedures around the handling of drugs and send out a circular to other VA hospitals suggesting they do the same. In the meantime, Kathy Rix and her colleagues are starting to put two and two together, and what they’re coming up with is appalling. Given all the available facts, the best theory is that Kristen Gilbert is deliberately overdosing patients on epinephrine and seems to be doing so in order to show off in front of her new boyfriend.

That she’s using the drug to instigate codes, which will bring him running to her, so she can impress him with her efforts to save the patient. Think about that in the context of your own workplace. How willing would you be to believe that something like this was actually happening?

And let’s further say your prime suspect is one of the most popular people in the office, and personally known to you as someone who goes out of their way to perform good offices and acts of kindness. What would you need before you went to the police and told them that someone you’d been working with for years might be killing people for insane reasons and by invisible means?

A few months after filing for divorce from husband Glenn, Kristen Gilbert was on duty in the Ward C ICU, which housed only one patient—Kenneth Cutting, a forty-one-year-old Army veteran who was blind and immobilised by Multiple Sclerosis. Ken Cutting, amiable and chatty with the staff despite his condition, was a popular patient. Early in her shift, Gilbert went to her supervising doctor saying that Ken “Wasn’t doing too well” and asking if she might be able to go home early if he died.

This might strike us as an unusual conversation, but it’s actually pretty commonplace and wouldn’t have raised any alarm bells. Thirty-five minutes after this grim little professional chat, a code blue was called and Kenneth Cutting died of a massive heart attack. Two hours after this, Kristen Gilbert checked out of work to meet James Perrault for a date.

Two weeks after this, Edward Skwira was admitted to the Ward C ICU. Mr Skwira was a sixty-nine-year-old WWII Army veteran who was in and out of hospitals for chronic alcoholism. He was a very ill man, and to a large extent it seems that his care was palliative in nature.

Nurse Kathy Rix was on duty when Mr Skwira first came in, but Kristen Gilbert was the only nurse in attendance when he eventually coded and died of a massive heart attack. This death wouldn’t have been that remarkable if suspicions hadn’t already been aroused—Mr Skwira was already suffering from severe cardiac issues when he was admitted. But Kathy Rix, already disturbed by the unexplained deaths on Gilbert’s watch, and by their alarming increase in frequency, had taken a careful drug inventory of all the medicine cabinets including the Ward C ICU.

Before Mr Skwira’s death, three ampoules of epinephrine had been present in the ICU medicine cabinet. After the code, they were missing. Kathy Rix then went to the sharps or needle disposal bin in the ICU and found the three broken ampoules in there.

This is a serious no-no. When drugs are administered, the packages need to be preserved until they can be recorded and accounted for—it’s really very negligent indeed to simply toss them in a bin, and highly suspicious to put them in a bin no sane person would put their hand into.

Enough was enough, and Kathy Rix, John Walt, and Renee Walsh went through their chain of command to report their findings. The case was assigned to a Special Agent with the Office of the Inspector General for Veterans’ Affairs, a trim, square-jawed man with a blonde flat top and moustache called Steven Plante. Agent Plante, who by his own account was used to investigating contract fraud and negligence—the crimes most typical in the VA—began his investigation based on the very reluctant and hesitant testimony of these three nurses.

They themselves say the whole thing was unthinkable, and that they were hoping the investigation would reveal some sort of series of mistakes, accidents, or misunderstandings. They suspected murder but hoped like hell it wasn’t.

Despite his lack of experience in homicides, Agent Plante conducted a thorough and stellar investigation. He began, as he should have, with an open mind and with every single staff member and process in the hospital as a target. This very quickly narrowed into an investigation of one target, Kristen Gilbert.

At this point, he called the US State Attorney, William Welch II and told him they had a potential serial murderer on their hands. Welch responded with extreme scepticism, but he knew of Agent Plante, and somewhat refreshingly for law enforcement, he also knew his job. He assigned a team of state police to the investigation, with Massachusetts State Trooper Kevin Murphy in the lead, chosen for his experience in homicide investigations.

Together they began poring over hospital records, going back over the original findings of Plante’s inquiry and following the pathways they led to. Trooper Murphy recalls this phase of the investigation fondly. In interviews, he would say that it wasn’t like any ordinary murder investigation, but was more like a white-collar crime inquiry, with an emphasis on technical forensics, records, and documentation.

Which might explain why Agent Plante did such a good job.

By this time, Kristen Gilbert became aware of the investigation, tipped off, investigators believe, by Perrault. She claimed a mentally disturbed patient twisted her arm and injured her shoulder and applied for sick leave. The investigators, increasingly convinced she was their perpetrator, saw this as a great outcome as it removed her patients from harm’s way, and recommended management let her go on leave.

In the meantime, Agent Plante interviewed her, and her guarded, defensive manner deepened his suspicions even further. Investigators had also zeroed in on Perrault, having found out about their relationship, and found him to be mostly cooperative, but guarded when it came to questions about Kristen, as if he were interested in protecting her.

By June of 1996, however, Kristen Gilbert was falling apart. She was deliberately overdosing on drugs and getting checked into mental institutions, and on one occasion she called Perrault and told him, “You wanna know, fine. I killed all those guys.”

Perrault, who’d been trying to withdraw from his relationship with her during the investigation, had already seen the obsessive side of Kristen by this time. She’d harassed, stalked, and manipulated him, and by the time she made this call, he already had a restraining order on her. After this phone call, Perrault went straight to the cops who told him that he had to pick a side, and that if he chose hers, he would no longer have a job, much less any hope of becoming a cop.

Perrault finally threw in one hundred percent with the investigation and agreed to go before a grand jury and testify. Hearing about this, Gilbert blocked him in his driveway and pleaded with him not to go. When she couldn’t persuade him, she followed him there and deflated his tyres.

On future occasions when he testified, Perrault would come back to find his car had been keyed, or his windscreen spraypainted.

Bombs, Damn Lies, and Statistics

While all this was happening, the Daily Hampshire Gazette broke the story about the inquiry into the VA deaths, without naming the suspect. A few weeks later, the DoJ confirmed that a grand jury had been convened. Glenn Gilbert, who’d been musing on the serious misgivings he had about his now ex-wife, asked Murphy and Plante to search his house, especially a cabinet which had belonged to Kristen and which she’d left behind. In it, they found The Handbook of Poisons, not by itself suspicious in possession of a nurse, but it had been dog-eared at pages about epinephrine.

In the meantime, Gilbert’s behaviour became increasingly off the chain. She’d retained her own private investigators, and when her friends and colleagues refused to cooperate with them as they did with the police, she lashed out at them furiously. She repeatedly harassed Glenn Gilbert, threatening him, telling him he didn’t have to cooperate with authorities, and at one stage rocking up to his house and attempting to attack him with a set of car keys.

By September of that year, with the walls closing in and, incidentally, the death of Kristen’s grandmother, Kristen Gilbert went to a toy store and bought a device called a Talkgirl Jr at Toys R Us, and packets of Energiser batteries at a Thrifty Drug Store, both with her personal credit card. The Talkgirl Jr is a toy which changes the playback speed of voice recordings, making a woman’s voice sound like a man’s and vice versa. Gilbert called her husband, using *67 to disguise her number, and the toy to disguise her voice, and left a message on his answering machine saying, “I just wanted to say goodbye for the last time.

Goodbye.” Later the same day, September 27 at 1711 hours to be precise, she called the security desk at the VA hospital, where James Perrault was on duty, and phoned in a bomb threat with the stated motive of justice for the veterans of the Persian Gulf War who’d been exposed to chemical weapons. She said there were three devices and that they had two hours to evacuate the veterans.

She called multiple times over the next two hours. The ward was evacuated and searched, but no devices were found.

This whole thing is nuts, as reading the transcripts it seems she’s simultaneously abusing him and trying to curry favour by advocating a cause which she knew Perrault, a Gulf War veteran himself, would be sympathetic to. All while talking in a disguised voice, so in theory Perrault wouldn’t even know it was her. Not to mention the fact that she somehow thought she’d be able to derail the investigation this way, and that she’d apparently faked a bomb threat in the past.

Over the next few days she made threatening calls to Glenn Gilbert, the VA front desk, and Perrault, once at the VFW at a time when only someone who knew him would know he’d be there, and once where she attempted to add a Southern accent to the voice alteration. In the meantime, she’d also bought a Talkboy Jr to go with her Talkgirl, presumably in some cockamamie attempt to cover her tracks. She told the store assistant the toys were for her nephews. As flatly stated in the casefile, “Gilbert does not have any nephews”.

Also, the calls to the security desk only happened when Perrault was on shift.

So Perrault met with investigators and agreed to call Kristen from the desk to tell her he’d be on duty from five to seven that evening. They then put Kristen under surveillance which meant, as this isn’t the movies, that Trooper Kevin Murphy himself had to stake out her apartment. Shortly after, Kristen Gilbert was observed making a call from a public phone booth near the Tasty Top ice cream parlour, and her index fingerprint was lifted from the handset.

Perrault confirmed that this was the call he received—an anonymous threatening caller with a disguised voice. These were sufficient grounds to search Kristen’s apartment, where they found the Talkboy Jr among other things, and Kristen Gilbert was indicted for the felony charge of falsely phoning a bomb threat to a federal institution. Gilbert was admitted to a mental hospital, then released into the custody of her parents in Setauket, NY, before standing trial and being imprisoned for fifteen months.

In the meantime, the homicide investigation continued, with the bodies of Edward Skwira and Stanley Jagodowski being exhumed.

Investigators were also interviewing victims’ families, and poor Christine Duquette and Julia Hudon—Henry Hudon’s sister and mother—had their wounds reopened by the discovery that their Henry had likely been murdered, and they’d likely need to testify both before a grand jury and at trial. Along with the wealth of circumstantial evidence, investigators discovered that eye tissue samples could be used to determine high epinephrine levels. There is a valve in the eye which spasms after death, trapping fluid in the eyeball, and thus preserving substances present in the body.

On top of this, Edward Skwira’s body contained completely inexplicable traces of Ketamine. US Attorney Welch decided it was time to call another grand jury.

For those who aren’t aware, a grand jury is a panel of citizens assembled by a prosecutor to decide if there’s sufficient evidence to proceed with an indictment. They’re not required to determine innocence or guilt, but rather weigh evidence to see if there’s grounds to lay charges. Assistant United States Attorney William Welch, having been convinced by the findings of Murphy and Plante, had convened a grand jury, but was faced with the problem of a distinct lack of smoking gun.

All the evidence against Kristen Gilbert was circumstantial. This presents a two-fold problem, the first being that in jury trials, the only real slam dunks are eyewitness and forensic evidence. Nobody had ever seen Gilbert actually administer fatal overdoses, and there was no real hope of finding convincing forensic evidence, as the substance used to kill occurs naturally in the body and metabolises really quickly—at the time there was no forensically conclusive way to determine epinephrine toxicity postmortem, eyeball vitreous fluid notwithstanding.

The other problem is that circumstantial evidence is much easier to knock out of consideration in a trial by motions to strike or exclude, so Welch was faced with the probability that a significant portion of the evidence gathered might be of no use to him at trial.

Welch’s strategy to overcome this was to create what he called “a compelling wall of guilt”—basically he wanted to overwhelm the court with incriminating facts, testimonies, and statistics. But to even get there in the first place, he needed to convince the grand jury there was a case to answer. For this, Welch turned to Dr Stephen Gehlbach of the University of Massachusetts-Amherst. And now we get to the intensely thrilling discussion of conditional probability.

A great many online sources talk about this case as an example of math catching a serial killer, and this is both misleading and disrespectful to the people who actually did catch her, namely, Kathy Rix, Stephen Walt, and Renee Walsh, in combination with Trooper Murphy and Agent Plante. It wasn’t math, it was people—people who took very seriously their duty to preserve life, and other people who took equally seriously their duty to investigate wrongdoing. The role of statistics and hypothesis testing here was a part of a complex structure of evidence designed to convince a grand jury to indict.

Firstly, Dr Gehlbach presented a graph of deaths on the ward from 1988 through 97 inclusive. The death stats were divided across shifts, being night, day, and evening. The data from 1988 shows a normal distribution of deaths, but by 89 it starts spiking. In 1990, the night shift showed far more deaths than the others, and then for 91 through 95, the evening shift was consistently the most fatal, year in year out, by a long way.

Kristen Gilbert was on the night shift in 1990, and then the evening shift every year after that until she went on leave in 1996.

Now that the correlation between Gilbert and elevated death levels had been shown, Gehlbach went on to talk about p-values, which is just fancy pants talk for probability. First we begin with a hypothesis, namely that if we flip a coin, there’s a fifty-fifty chance of coming up heads. So let’s say we flip the coin ten times and come up with six heads.

We compute this against our hypothesis and come up with the answer that six heads in ten flips has a p-value of 0.38, as opposed to the 0.5 in our hypothesis. The next question is, what number of heads would lead us to question our hypothesis? Or to put that another way, how many times would it have to come up heads for us to begin thinking there’s something wrong with the coin, or that something other than chance is affecting the result?

Turns out that for a p value to be sufficiently low to constitute what’s called “a scientific surprise”, you’d need to get nine heads from ten flips.

From here Gehlbach went on to do a focused study of deaths in the eighteen months leading up to Kristen Gilbert going on leave. Over these 547 days, there were 1641 shifts. 74 of these shifts had at least one death. A simple calculation of 74/1641 gives us a value of 4.5%. So over this sample, we’d expect four and a half shifts out of every hundred to have a death, which is our hypothesis.

What we need to do next is calculate conditional probability. The condition here is that Gilbert was on shift, so the statement would be the probability of a death given that Gilbert is on shift. Gilbert worked 257 shifts in that period, of which 40 had at least one death, which gives us 40/257, or 15.5%. Once this has been established, we need to perform an independence test, to determine whether the probability of death is related to Gilbert being on shift.

So, if we say probability is P, death is D, and Gilbert being on shift is G, we get some statements like this: P(D) = 0.045, meaning that the overall probability of death is 4.5%. And P(D|G) = 0.155, meaning that the probability of death, given that Gilbert is on shift, (the bar means “given that”) is 15.5%. The variance between these two p-values is high enough that Gilbert being on shift must obviously be related to the increase in death rate, and the p-value for this relationship as tested against the hypothesis, works out at one in one-hundred-million. Which means there’s only a 1 in 100,000,000 probability the relationship between Gilbert being on shift and the higher death rate is pure chance.

It’s very important to point out that this does not prove Kristen Gilbert’s guilt. What it did do at the time was contribute to a range of evidence which convinced the grand jury that there was sufficient cause to indict her for murder, as among other things, the increased death rate could not just be pure coincidence. This statistical evidence was not admitted at the actual trial, as George Cobb, of Mount Holyoke College, successfully argued that it was likely to be radically misinterpreted by the jury, owing to something called “the prosecutor’s fallacy”.

Basically, it is perfectly valid to state that the smallness of the p-value means that it is impossible that the increased death rate is owing to pure chance. It is also valid to state that it is impossible that the increase in death rate is unrelated to Kristen Gilbert. But what it is not valid to state is that this p-value makes it impossible that Kristen Gilbert is innocent.

This just isn’t true with reference to the evidence at hand, as chance is the only factor among a range of possible factors which has been ruled out. So it’s not valid to state that in this case, “math caught a serial killer”. What’s probably the real valid statement is that in this case, ‘math helped bring a serial killer to trial’.

Trial and Wrap-Up

The trial went from the 23rd of November 2000 to the 20th of January 2001. It contained over seventy witnesses and in excess of two hundred pieces of evidence, in accordance with Welch’s strategy of presenting a “compelling wall of guilt”. Prosecutors sought the death penalty in this case as, while Massachusetts hasn’t had a death penalty for quite some time, the VA is a federal jurisdiction.

Thus, the federal prosecution and the application for a federal death penalty. Quite a bit of evidence was excluded from the trial, including prejudicial stuff around the unproven allegations of her attempted murder of her ex-husband, and some stuff related to the bomb threats.

Glenn Gilbert and James Perrault both testified that she’d confessed to the murders, but Gilbert’s lawyers argued that this was all part of a pattern of stress-induced disturbed behaviour which had been brought on by the investigation, her shoulder injury, and her grandmother’s death—basically the same defence she used for the bomb threat trial. Judge Ponsor, aware of the complexity of the trial, advised all the participants that this would be a marathon, not a sprint, and told counsel for both sides they should take regular exercise and generally look after themselves.

There was a huge amount of technical evidence, with both sides producing experts testifying on the effects of epinephrine. Doctors testified about the victims, especially those who had been physically healthy leading up to their sudden deaths, or who had conditions which wouldn’t typically lead to a heart attack. Nurses testified to Kristen Gilbert’s suspicious and increasingly erratic behaviour.

One nurse testified that Gilbert had offered her an ampoule of epinephrine from her pocket when she’d complained of asthma. Unfortunately for the prosecution, the tissue samples they’d so painstakingly and innovatively collected turned out to be inconclusive and were stricken. The whole issue of epinephrine became contentious throughout the trial, especially as some of the victims had actually been prescribed the drug as part of unsuccessful attempts to revive them.

At one point, Dr Michael Baden, forensic pathologist, misspoke and corrected himself saying he’d had a “senile moment”, rather than a “senior moment”. The defence tried to use this to have his testimony stricken.

Apart from the technical and circumstantial evidence, the prosecution made heavy use of pathos. They showed pictures of the victims, made emotional statements about fallen heroes of the USA, and closed with a photo montage of the victims with their families and in their uniforms. But what they stressed the most apart from the circumstantial evidence was Kristen Gilbert’s character. The prosecution led with the theory that Gilbert was killing these patients for the sole purpose of impressing her boyfriend with her nursing skills, as she put on an act of attempting to save them.

The prosecutor argued that this was a ploy to bind her new boyfriend, who was three years younger than her, more tightly to her. This sounds preposterous in isolation, but to a group of twelve ordinary decent people, this must have seemed insane. It certainly did to her colleagues.

On the other side, Gilbert’s defence argued that she was the target of malicious professional jealousy. That the evidence against her had either been fabricated or blown out of all proportion by her colleagues. They argued that the only reason Gilbert had been present at so many deaths was because she was acknowledged as one of the most able nurses in the hospital, and that she’d naturally be called to more than her fair share of code blues.

All this is to say that the trial was hard fought, and at the end the judge took the extraordinary step of telling the jury they could, if they chose, also deliver verdicts of second-degree murder if they thought this more appropriate. This indicates that, as solid as the circumstantial evidence might seem, in a courtroom and against a good defence team, it was far from a slam dunk. And from a certain point of view, it could be argued that intent to murder wasn’t satisfactorily proven by the prosecution in each case.

The jury took twelve days to deliberate, after which they found Kristen Gilbert guilty of three counts of first-degree murder, one count of second-degree murder, and two counts of attempted murder. Twelve days is an unusually long time for a guilty verdict, and this was a majority of ten, not a unanimous one. Presented as an unbroken and logical narrative, the evidence accumulates nicely, and it seems obvious that Kristen Gilbert is guilty.

But in a trial format, with nothing but circumstantial evidence and the counterarguments of the defence, doubt can creep in. Ultimately the jury agreed on her guilt, but there’s still testament to the power of solid forensic or eyewitness evidence in the length of their deliberation.

Kristen Gilbert was sentenced to four consecutive life sentences without the possibility of parole plus twenty years for the murders of Stanley Jagodowski, Henry Hudon, Kenneth Cutting, and Edward Skwira. She is currently serving her sentence in federal prison in Fort Worth, Texas. Investigators chose these four murders as they had the most impressive documentation attached to them, but they believe she may have hurt and killed many more. As to how many people Kristen Gilbert actually killed, estimates vary from thirty to eighty, with thirty-odd being the more plausible figure.

Aftermath and Appendices

In sentencing, the jury had the option to recommend the death penalty. The prosecution argued her bomb threats and past behaviours were aggravating factors, as were the profile of her victims. The defence cited mitigating factors, focusing on the welfare of her two children. Gilbert’s father also personally begged the jury not to sentence her to death.

After two days of deliberation, they opted to recommend life imprisonment. If they had decided on the death penalty, Gilbert would ironically have been executed by lethal injection.

Gilbert appealed, applying for a new trial, almost immediately after the verdict. She dropped this appeal in 2003 when a Supreme Court decision made it possible that a new trial would once again expose her to the death penalty.

Gilbert was eventually diagnosed with borderline personality disorder, which resolves the problem of how such a clearly intelligent and competent person could have behaved so stupidly. The compulsions caused by her mental illness might explain some of her whackier behaviour, especially once the investigation started.

As for the voice disguise, when investigators recorded the calls and played them back at different speeds, they basically got Gilbert’s voice en clair. The Talkboy Jr and Talkgirl Jr proved to be remarkably ineffective tools for covering her tracks.

Key Takeaways

• Kristen Gilbert, a respected VA nurse, murdered patients by injecting them with epinephrine to induce cardiac emergencies and impress her boyfriend.
• Nurse Kathy Rix discovered 88 unaccounted epinephrine doses and rising death rates, leading her and colleagues to investigate and report Gilbert.
• Statistical analysis showed a 1 in 100 million probability that Gilbert’s presence on shift was unrelated to the elevated death rate, helping secure indictment.
• Gilbert was convicted of three first-degree murders, one second-degree murder, and two attempted murders, receiving four consecutive life sentences without parole.
• The case relied entirely on circumstantial evidence, with no direct witnesses or conclusive forensic proof of epinephrine poisoning at trial.

Frequently Asked Questions

Who was Henry Hudon and what happened to him at the Leeds VA hospital?

Henry Hudon was a 35-year-old U.S. Air Force veteran who suffered a traumatic brain injury and was diagnosed with paranoid schizophrenia. On December 7, 1995, he was admitted to Ward C at the Leeds VA in Northampton, Massachusetts for flu treatment after his mother Julia brought him in. He frantically resisted being placed in Ward C, claiming people were being killed there.

That same night, he died of a series of cardiac arrests. His sister Christine demanded an autopsy, which found no conclusive evidence of foul play but revealed that part of his heart had exploded throughout his chest cavity, which was unusual for a healthy young man.

What was Kristen Gilbert’s background before she became a nurse at the Leeds VA?

Kristen Gilbert was born Kristin Heather Strickland on November 13, 1967, in Fall River, Massachusetts. She moved to Groton, Massachusetts in the early 1980s. She was a high performer in high school, graduating two years early in 1984 at age 16. She enrolled in Bridgewater State College as a pre-med major, where she developed a pattern of abusing boyfriends.

In 1986 she met Glenn Gilbert, and in 1987 transferred to community colleges to be closer to him. That same year, she worked as a home health aide and allegedly scalded a mentally disabled boy with hot water. She married Glenn Gilbert in 1988, graduated with a nursing diploma at age 21, and began working at the Leeds VA in March 1989.

How did Kathy Rix and her colleagues first become suspicious of Kristen Gilbert?

Kathy Rix, a long-time staff member at the Leeds VA, noticed disturbing trends including rising death rates on her ward, especially from cardiac arrest. She conducted her own audit and discovered that out of 135 doses of epinephrine administered, 88 couldn’t be accounted for—there were no matching prescriptions. As mortality rates failed to show expected downward trends, she eventually took colleagues John Walt and Renee Walsh into her confidence, and they began quietly investigating together. Their suspicions intensified after the death of Edward Skwira, when Rix found three missing epinephrine ampoules in the sharps disposal bin rather than properly preserved for recording.

What was the statistical evidence used to help indict Kristen Gilbert?

Dr. Stephen Gehlbach of the University of Massachusetts-Amherst analyzed death statistics from the ward. He found that from 1988-1997, deaths spiked on whichever shift Gilbert worked: the night shift in 1990, then the evening shift from 1991-1995. For the 18 months before Gilbert went on leave, there were 1,641 shifts with 74 having at least one death (4.5% probability).

Gilbert worked 257 shifts, of which 40 had at least one death (15.5% probability). The conditional probability test showed a p-value of one in one-hundred-million, meaning there was only a 1 in 100,000,000 probability that the relationship between Gilbert being on shift and the higher death rate was pure chance. This statistical evidence helped convince the grand jury to indict but was not admitted at the actual trial due to concerns about the ‘prosecutor’s fallacy.‘

What was the prosecution’s theory about why Kristen Gilbert killed her patients?

The prosecution’s theory was that Kristen Gilbert was deliberately overdosing patients with epinephrine to instigate cardiac emergencies (Code Blues), which would bring her boyfriend James Perrault—who was required to attend all cardiac emergencies for CPR—to the scene. She would then impress him with her efforts to save the patients. This was described as a ploy to bind Perrault, who was three years younger than her, more tightly to her. Evidence supporting this included staff observations of them exchanging flirtatious looks during codes, playing footsies while Perrault administered CPR, and the fact that codes on Gilbert’s shifts increased dramatically after her affair with Perrault began.

What was the outcome of Kristen Gilbert’s trial?

Kristen Gilbert’s trial ran from November 23, 2000 to January 20, 2001. The jury took twelve days to deliberate and returned a majority verdict (ten, not unanimous) finding her guilty of three counts of first-degree murder, one count of second-degree murder, and two counts of attempted murder. The victims were Stanley Jagodowski, Henry Hudon, Kenneth Cutting, and Edward Skwira.

She was sentenced to four consecutive life sentences without the possibility of parole plus twenty years. The jury had the option to recommend the death penalty but chose life imprisonment after two days of deliberation, with mitigating factors including the welfare of her two children and her father’s personal plea. She is currently serving her sentence in federal prison in Fort Worth, Texas.

What other crimes did Kristen Gilbert commit besides the murders?

Besides the murders, Kristen Gilbert was involved in several other crimes. She allegedly attempted to murder her husband Glenn by injecting him with what was suspected to be potassium after he was hospitalized with low potassium and glucose levels. She also allegedly poisoned his food with diuretics.

During the investigation, she made bomb threats to the VA hospital using a Talkgirl Jr voice-changing toy, claiming there were three bombs and demanding evacuation in the name of Gulf War veterans exposed to chemical weapons. She made threatening calls to Glenn Gilbert, the VA front desk, and James Perrault. She also harassed and stalked Perrault after he tried to end their relationship, including blocking him in his driveway, deflating his tires, keying his car, and spray-painting his windshield.

She was indicted and imprisoned for 15 months for the bomb threat before the murder trial.

How did James Perrault contribute to the investigation against Kristen Gilbert?

James Perrault, a Persian Gulf War veteran and hospital policeman, had an affair with Kristen Gilbert from approximately 1995. Initially he was guarded when questioned about her, appearing to want to protect her. However, after Gilbert called him and confessed, saying ‘You wanna know, fine.

I killed all those guys,’ and after investigators told him he had to choose sides or lose his job and career hopes, Perrault fully cooperated with the investigation. He agreed to testify before the grand jury and at trial, confirming Gilbert’s confession. He also participated in a sting operation where investigators had him tell Gilbert he’d be on duty from 5-7 PM, allowing them to surveil her and catch her making a threatening call from a public phone booth, where her fingerprint was found on the handset.

What was unusual about the deaths of patients under Kristen Gilbert’s care?

Several aspects of deaths under Gilbert’s care were unusual. The death rate on her shifts tripled compared to other shifts, and this pattern moved with her when she changed from night to evening shift. Patients who were recovering well or physically healthy suddenly died of cardiac arrests. Stanley Jagodowski yelled ‘Ow!

It hurts! You’re killing me!’ after Gilbert entered his room with a syringe to ‘flush his IV line,’ despite all his medications being oral tablets. Henry Hudon, a strong healthy 35-year-old, had part of his heart explode throughout his chest cavity.

Large numbers of epinephrine doses—88 out of 135—could not be accounted for. Three epinephrine ampoules were found discarded in a sharps bin after Edward Skwira’s death, against proper protocol.

What mental health diagnosis was Kristen Gilbert eventually given?

Kristen Gilbert was eventually diagnosed with borderline personality disorder. The article suggests this diagnosis helps explain how such an intelligent and competent person could have behaved so stupidly, particularly her increasingly erratic behavior once the investigation began. The author compares this to how compulsions can cause people to take risks they otherwise wouldn’t, noting that her mental illness may explain some of her ‘whackier behaviour’ during the investigation period.

Sources

• Original Casual Criminalist video: The Angel of Death: Kristen Gilbert, The Serial Killer Nurse
• Hero image source by CommsLTHT / openverse, by-sa.

Related Coverage