The Good Nurse: A True Story of Medicine, Madness, and Murder by Charles Graeber is a true crime biography of the life of Charles Cullen, one of the most prolific serial killers in US history. Graeber is an American journalist who spent time as a medical student before moving on to journalism, writing for many prolific news outlets. His joint history in medicine and writing provides him with the necessary expertise to explain the intimacies of the Cullen case. First published in April 2013, the book was adapted into a Netflix movie of the same name in 2022. Cullen’s story is fraught with trauma, neglect, and the failure of institutions to choose lives over profit, reinforcing the role of the institutions that enabled Charlie’s crimes.

This guide uses the paperback first trade edition of the text.

Content Warning: This text contains depictions of domestic abuse, medical violence, alcoholism, attempted death by suicide, and medical conditions such as severe burns, which may be disturbing to some readers. Additionally, the text mentions instances of sexual abuse, though not in detail.

Summary

The biography is split into two parts: the first focusing on Charles (“Charlie”) Cullen and his perspective, and the second on the investigation into his crimes. Charlie is an unusual, unhappy man often described as a loner by his colleagues. Following a childhood of severe poverty and trauma, he joins the Navy, where he succumbs to alcoholism and attempts to die by suicide several times. He then joins a nursing college and works part-time jobs to cover tuition, drawing positive attention from his peers. He meets and marries Adrianne, but soon after their marriage, their seemingly perfect relationship falls apart.

Charlie begins nursing at St. Barnabas’s burn unit. He’s seen as an exceptional nurse but begins mixing drugs and mis-administering them to patients. He’s let go from this position but quickly finds new employment. Adrianne serves Charlie with divorce papers but begins to reconcile with him until an unspecified act of domestic violence leads her to call the police and leave with her children. At his new workplace, Warren Hospital, Charlie bonds with Michelle, but the intensity of their relationship repels her. When he breaks into her home, she calls the police, after which he attempts to die by suicide and is placed in a psychiatric hospital.

Following a series of personal struggles, he overdoses a patient on digoxin and then again attempts to die by suicide after he’s questioned about her death and his position is terminated. A similar chain of events subsequently occurs at hospitals in New Jersey and Pennsylvania. Charlie is repeatedly hired, found to be mis-administering drugs, questioned about patient deaths, and then terminated. After more than 10 years of this behavior, he accepts a position at Somerset Medical Center, where he befriends fellow nurse Amy Loughren.

At Somerset, administrators notice Charlie’s behavior and the increase in patient codes associated with his presence. They begin an investigation and ultimately terminate his contract but hesitate in calling the police or similar authorities for several months.

Part 2 introduces Tim Braun and Danny Baldwin, detectives in Somerset County. They receive a call to observe an autopsy and then are pulled into a meeting with hospital administrators, who are vague but imply that the hospital has experienced several deaths that aren’t explained by natural causes. Tim and Danny struggle with the medical details of the investigation, meeting with Poison Control and discovering that the hospital knew about the overdosing issue for at least five months. When they start to investigate Charlie, they find a note attached to his criminal record and discover that the hospital lied to them about what data of Charlie’s was accessible. The detectives begin interviewing nurses. They discover Amy and are drawn to her candid nature. When they present her with Charlie’s drug order records, she’s shocked.

At her home, the detectives convince Amy to help them with the case. She provides medical insight, knowledge about the hospital’s workings, and access to Charlie. They record her phone calls, hoping to catch Charlie saying something incriminating. After one of Charlie’s victims is exhumed and confirmed a murder victim, they question Charlie and search his belongings. However, both their interview and their search turn up nothing.

Charlie calls Amy to tell her that he has found new employment. Tim reaches out to his new workplace privately and recommends that Charlie be fired, but in doing so alerts the press. They have Amy meet Charlie while wearing a wire to try to get a confession out of him, but she’s only partially successful. Charlie is arrested, and after a day of interrogation, Amy is brought in. Her presence leads him to confess; in his testimony, he admits to having killed or attempted to kill 40 people.

In the postscript, Charlie is asked to donate his kidney to his ex-girlfriend’s brother. Although he wants to do this, some people believe that he’s doing it as a form of manipulation. After an additional hearing and a prison transport, Charlie is taken away at night to donate his kidney using a false name. Tim retires, Danny transfers to a different district, and Amy ends her nursing career and becomes a therapist.