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One Friday afternoon in the spring of 1992, an ambulance pulled up to a hospital in Columbia, Missouri. The doors of the ambulance opened, and an elderly man got out. The man's name was Melvin Carver, and he was 85. Melvin was a veteran of World War II. When he needed doctor, he went to the Veterans Affairs Hospital in Columbia, the VA. It was a government building built in the early '70s, boxy and plain, tan-brown brick. Inside, the walls were painted Pale Blue. The place smelled of disinfectant. The ambulance had brought Melvin from a rural nursing home several hours away. But Melvin's problem wasn't an emergency. He simply had an ulcer on his toe, a complication of diabetes. And the ambulance was just the best way to give Melvin and his bad toe a ride. By the time a surgeon at the hospital had patched up Melvin's toe, it was getting late.

So the patient was left at the VA hospital late on a Friday afternoon with no place to stay. The ambulance had gone home. He had nothing.

This is Jan Sweeney. She was a doctor at the hospital back then.

So he got admitted to the hospital that late afternoon because he needed a bed to stay in overnight. We had a slang term for that called a social admission. Not that he was ill enough to require a hospital bed, but he needed a hospital bed like he needed a room. He needed a bed and a room and three meals and all that.

This wasn't totally out of the ordinary. This sometimes happened. The VA is government-funded health care. It may not be the fanciest, but they provide good, solid care. Melvin's doctor got him a bed on the fourth floor on the East Wing. It was a ward for patients who were not in critical condition. He was in a standard patient bed, and he wasn't being monitored on any machines. In other words, he was stable.

The patient had advanced Alzheimer's disease and was nonverbal. Yet we had a medical record on him, so we knew a bit about the patient's history, and we knew what he needed overnight.

Within a day or two, the ambulance would return and give Melvin a ride back to the nursing home. He spent the night in the hospital. First thing the next morning, Dr. Sweeni arrived on the floor to do rounds. She was the attending physician for the ward where Melvin was staying. A room on the fourth floor, East Side. East, also known as Ward 4 East. She and a team of residents and interns began their rounds, the morning routine of visiting each patient, checking in on them, and checking their vitals. They headed to Melvin's room.

We went in to see the patient, and I remember him being in no distress. He made eye contact with me. He was not verbal, but he was cooperative. All his vitals normal. His labs had been drawn the night before. Everything was normal.

The plan of care for Melvin was basically just wait till his ride showed up. He didn't need anything else. Dr. Sweeni left Melvin, continued down the hall to check up on her other patients.

We're still rounding. We're just down the hall doing rounds, seeing a few other patients. So we were probably only 30 or 40 feet away because rounds proceed slowly, right? When about an hour later, the code blue is called.

Suddenly, Dr. Sweeni got a page on her paper. It was Melvin's room. Dr. Sweeni sprinted back down the hall.

So we're just back in the room and he's blue and pulseless and he's not breathing and he's pulseless. So he's dead.

But there There was still hope. It's a code blue. It's a chance to bring the person back to life. During code blues, a lot of things happen very quickly all at once. There's a lot of commotion, but there's also a protocol. Someone grabs the crash cart, and the AAD is pulled out to jumpstart the heart. There might be CPR.

The nurse had started the code blue process, of course, and was at that point, I think, bagging the patient to get air into the lungs. I had to decide right away whether we were going to proceed with the code or stop it.

Dr. Swayne knew the efforts to bring someone back to life can be hard on a body, especially one that is old and frail.

He had an advanced state of Alzheimer's disease, and in my determination, I thought that death was a natural death and that we wouldn't be doing him any favors to try to extend his life a short period of time. So I called off the code.

At Dr. Sweeni's signal, the team stopped what they were doing. She pronounced the patient officially dead.

The patient is extremely memorable to me. It's such an improbable death that it has stuck with me all these years. I had just seen him an hour before, and he was seemingly at a baseline state.

Usually right after a patient died, there wasn't much of a talking mood in the room.

The nurse would be going about his or her business, and I would go about my business, and there would be no interaction.

But after Melvin died, something was different. The nurse who'd been caring for Melvin, a pale, balding young man and all white, said something to the doctor.

I remember Viv Sadly, the nurse saying to me, Thank you, Dr. Sweeney, when I called off the code.

What did the nurse mean by thank you? Was he thanking Dr. Sweeney for trying to save the patient, for making the tough call not to proceed, or for something else? There's a reason that small moment still haunt Dr. Sweeni. She didn't know it at the time, but the polite young nurse would become the center of a vast conspiracy, one involving dozens of people mysteriously dying on Ward 4 east. They might have just been sick old men ready for their final breath, or it might have been something darker and much more unnatural. It was here at the Harry S. Truman Veterans Hospital in Columbia, Missouri, that an unusual number of patients had died on Ward 4 East. The FBI concluded many of the deaths were suspicious. This is a case from a very, very beginning that has been botched by everybody, not just the FBI, but everybody. From Campside Media and Sony Music Entertainment, you're listening to Witness Nightshift. This is episode one. Code Blue.

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My name is Jake Edelstein. For the last 30 years, I've worked as a foreign correspondent in Tokyo. I mostly cover crime, and I've written a few books. My first book, Tokyo Vice, got turned into a TV show. If you've watched it, you might have heard the name pronounced Adelstein, but the correct German pronunciation is Adelstein, as far as I know. In Japan, it's pronounced three other ways. It's all the same to me by now. You might hear it pronounced a bunch of different ways in this podcast. Anyways, I've built a life in Japan, and I never really felt compelled to cover anything back home in America, with one exception. Over 30 years ago, something mysterious had happened back in my hometown of Columbia, Missouri, back in 1992, the same summer that Melvin died. I was 23 years old then, just starting out as a journalist abroad. But it wasn't just that this story was happening in my home town. I had a personal connection to the VA hospital where the deaths were occurring. My dad worked there as a doctor, and I still remember how the hospital looked, how it smelled like soap and cigarettes.

I grew up there. I had a great respect for this place, this hospital, whose whole mission was to care for aging warriors, now sick and vulnerable, all without charging a dime. So it alarmed me when I started to hear stories about mysterious deaths at the hospital. It was like a violation of this part of my childhood. It stuck with me. I know it haunted a lot of other people in my hometown, too, including my father, the doctor. So without much to go on at first, I flew back home to Missouri and started to scare up some ghosts. My first lead was a man named Otis Leslie. He was a World War II vet, a family man, and exactly the guy the VA is supposed to help. I to visit his daughter, Cathy Robbins, with my producer, Amy, and reporting partner, Shoko. Cathy lived in a cozy apartment in Blue Springs, just outside of Kansas City. We sat down in the kitchen, which looked like it was used often. There were handwritten dessert recipes and the faint smell of chicken stock mixed with pulpry. She had pictures of Otis laid out on the table. Some were in frames and others were in black and white and slightly frayed.

That's his unit. He's the one circled. You can see it.

Oh, yeah. Oh, yeah. He has that swashbuckler look to him.

His daddy was born in Oklahoma, and they lived in Texas, in Oklahoma. Then, of course, he went into the service.

In World War II, Otis flew planes and served as a military police officer, an MP.

They went through hell. He was infantry.

He never tell you about what the fighting was like or any of that?

Not really. It was war.

Otis was from a generation of soldiers where nobody talked about post-traumatic stress disorder. They were war heroes, not wounded warriors. There was no counseling because no one was around to treat the wounds you couldn't see.

He said the only time he ever felt really, really bad was they had gone into a village. I don't know if it was Germany or where. It had to be Germany. And there was civilians there. And I guess this one little girl, she just kept screaming and carrying on, and he kicked her. And he felt horrible afterwards. But it just really bothered him the rest of his life that he kicked that little girl.

After the war, he met Kathy's mother. He got married. He gave up drinking, but he never gave up smoking. The military had handed out cigarettes freely to soldiers. Uncle Sam got a lot of people hooked, and then ended up paying to treat a lot of disease at the VA. Do you remember that he had a particular brand or whatever?

Harrington's. I've got the last pack.

You kept his last pack?

Yes, I did.

Kathy carefully opened a black lacered box and lifted out a red and white cigarette pack, flattened, but other than that, almost perfectly preserved. 20 Class A cigarettes made in Redsville, North Carolina. North Carolina. The American Tobacco Company.

Yeah. I've always kept it.

Kathy's dad had nicknamed her Pete, and little Pete idolized her father, always wanted to copy him. By the time she was a teenager, she'd started smoking, too.

He always discouraged it, but I did it anyhow. But he was always telling me, Pete, you need to get off those dad-dang things. He didn't cuss.

He never cuss.

No, I never heard him cuss. I never heard him cuss.

He was a.

He was a dag-dang. Dag-dang, Dagnabbit, Dad Burn.

He had a good reason for wanting her to quit. He didn't want her to end up like him.

He coughed a lot. He had emphysema. He was on oxygen, and it didn't take a lot for his throat to bleed.

Otis' emphysema was chronic, and it would flare up from time to time. In late June of 1992, he had another episode.

He was throwing up blood, but what it ended up being was it was a cookie. You know the peanut cookies? Yeah. The hard peanut cookies? He scratched his throat.

An ambulance drove him to the Columbia VA hospital.

And they thought, Oh, well, maybe he's got TB. Maybe he's got this. They just kept him in there and kept running these tests. I guess they thought his oxygen was too low. They intubated him, and he was never happy about that. The VA is part of the promise the United States makes to those who fight wars on its behalf.

It's one of two federally-funded health care providers in the US, the other being the Indian Health Care Service. The VA is tailored to the unique needs of veterans. It exists for them, and the Columbia VA was well guarded in central Missouri. Veterans like Otis came from far away to be treated there. The VA was well-equipped to deal with most things, even patients like Otis, who sometimes raised a little hell.

He was on a ventilator, and he hated the later. He wanted it out, and if we weren't with him, he had to be restrained. When I was with him, I had untied his hands, and he was being good. I informed the nurse. I said, I'm going back to the waiting room. Can you go back and tie his hands up? She goes, Yeah, I will. Well, she didn't. In just that little bit of time, he ripped that thing out of his throat. But when he did, he brought the feeding tube up which aspirated into his lungs. Then about that time, he coded. I'm standing back against the wall and all these people are coming in, flipping him upside down. Thank God they got him back, but he was close. That's so scary.

Did you hear them saying, like, I'll have to be cold blue?

Oh, yeah. I mean, they were coming in from all over the place. Alarms were going off. Scared the shit out of me.

The doctor stabilized Otis and got him hooked back up to all the right machines.

I said, Oh, Daddy, what did you do? He goes, I took the dead ding thing out. I said, Well, I can see that. But he was smiling until he got it. He was very pleased with his self for ripping that thing out.

Otis was a hellraiser, and probably in some ways, he was amused by the chaos he had caused. But there was something else, a sixth sense he had.

He was not comfortable being in there. He was ready to check himself out. He He told me, he said, If I don't get out of here, Pete, I'm going to die in here.

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Otis Leslie survived that self-inflicted scare, the Code Blue. He stabilized quickly, and Before long, he was well enough to move to a different part of the hospital.

He had finally gotten out of ICU and had been put in a regular room. Of course, it was down the hall, the same floor, just down the hall. It was a private room.

The new room was on 4 east, the same ward where that other elderly man, Melvin, had also been hospitalized. Otis really wanted to go home. And before his wife left for the night, Otis asked her to gather all his their longings and put them in the car. She said goodbye, and Otis said, I'll see you in the morning.

My dad was supposed to go home the next day.

He was finally getting out of that dagnab place. But then, Kathy got an unexpected call from her mother.

My mother called me, yeah, and she told me that Daddy had died. And I got a hold to my sister and picked her up on the way and just drove to Columbia.

It was the middle of the night when Kathy and her family got to Otis's room. Her father, the guy who'd seemed so vibrant the day before, was gone.

It was a bad night. He was... He was laying there and his mouth was open and his tongue was blue.

The timing seemed like a cosmic joke. Otis had been sick for so long, and then right when things were looking up, when he was on the verge of going home, he'd crashed.

I mean, it was a shock. But it wasn't something that we weren't thinking could happen. It was just... It was very quick.

Kathy and her sister stood next to her father's bed, trying to comprehend that their father was no longer there.

We're over here by Daddy's bed, and we're trying to have a conversation, and he's just standing there staring at us.

Standing between them and the door was a young man. He had pale skin, and he was silent. He was Otis' nurse.

And he wouldn't leave the room and give us a minute to say goodbye. And it was my mom, my sister, and I, and he just stood there and watched us.

It was awkward, upsetting the delicate emotional balance of the room.

And it made me really uncomfortable. I mean, I don't know why he wouldn't leave. He just stood there and watched as we were trying to say our goodbyes. Oh, I swore I wasn't going to do this.

It's okay.

I'm fine. No, it's fine. I'll be fine. But he wouldn't leave the room. And it's like he was just enjoying watching us.Full apart?Yeah.

Kathy She didn't get that man's name at the time, this quiet young nurse working the night shift on Ward 4 East. He was only meant to be a background character in her life. A footnote to the overwhelming grief of losing her dad. But he wasn't comforting and he wasn't offering condolences. He was just there, looking around. Lee Miller worked as a clinical nurse at the VA in the '80s and '90s. He remembers the night shift well.

It's quiet. There's a person who likes working the night shift because they like the quietness. There's no therapy. There are no physical therapists around, no occupational therapists, no psychologists, no dietitians. There's no meal service. So all you have is patients and nursing staff, basically.

A time to relish the piece when both the staff and the patients appreciate not having many people around to look over their shoulder. On these shifts, Lee would come in at midnight and go patient to patient evaluating each one. He'd take people's vital signs, give medications, check people's IVs. He'd help people go to the bathroom or turn over in bed. On the night shift, there was even a little time to chill out.

I remember working with people who maybe brought knitting to work, and they would watch the call light system and knit for a few minutes, but they were there ready to respond. If somebody needed something, they were there.

Every once in a while, he'd hear a code blue over the intercom.

Code blues are resuscitation attempts when somebody's heart stops beating and they stop breathing. Typically, I would say in a hospital, a nurse makes rounds, walks into a room, finds somebody not breathing, and calls a code. Essentially, you can say in that moment, they're clinically dead, they're not breathing, and their heart's not beating. So essentially, the goal is to restore life.

That's a harrowing scene and a favorite of primetime medical traumas, but not something that should ever be routine.

I would say it was not It was not unusual at all to go for a week, and there wasn't one, maybe even a couple of weeks, and there were no cold blues. So they are infrequent.

Eventually, Lee became a manager overseeing other nurses. He did that for more than a decade. And over all those years, it was the same story. Cold blues were infrequent. When they did happen, they happened in random places.

So they might be in the operating room, they might be in the ICU, they might be in the parking lot. I don't ever remember a series of cold blues from the same location.

But then, in the summer of 1992, something changed. There seemed to be more cold blues blaring through the hospital and they were all coming from one place.

These codes are happening on Four East.

Dr. Jan Swaney figured that the first once to notice something was off would have been those on the code blue team, the staff who responded to the emergencies. Like the respiratory therapist.

If you're the respiratory therapist who goes to work at night and you're running codes through the night, you're the first to know there's a pattern here.

And also the residents.

They're running the codes. And they're on call at night, and they're the ones who are realizing there's something bad. There's some bad karma on Four East, right? So I believe that's where the rumors began.

It was all so strange, but at the same time, almost metaphysical, not quite real. Hard to pin down. But by the end of the summer, everyone was talking about it. And in late August, the strange happenings on Four East had been going on long enough that news about them filtered to the very top of the hospital's leadership, all the way up to the chief of staff, a guy named Dr. Earl Dick. He oversaw all the medical employees. If the VA is a ship, this guy, Dr. Dick, was the captain, but he was on his way out of town, so he turned to the chief of pathology. And here's the chief of pathology. It was probably a Friday that he said he was leaving town, and when he left town, he would make me the acting chief of staff. Dr. Dick asked the pathologist to cover for him as captain while he was away. Okay, sure, the pathologist thought. It'd probably be a normal, quiet week. But on his way out, this guy, Dr. Dick, gave the pathologist a truly bizarre homework assignment. And so he said to me, he was going out of town. He said, There's some rumor that there's some nurse killing people.

Would you look into this? You know, just your typical water-cooler conversation about an alleged killer on the loose in your workplace. And I said, Sure. I really didn't think much about it. The pathologist was skeptical. People died in hospitals all the time. He saw a lot of death. And he autopsied enough VA patients to know they weren't the healthiest demographic in America. They have heart disease, they have brain disease. When they were in the military, they were in courage to smoke cigarettes. They were given free cigarettes. Really, all the patients are sick. I mean, this was a hospital after all, and that's what sick people often do. They die. The idea of someone going around killing patients seemed so far fetched to the pathologist. It just seemed highly unlikely that any medical professional someone hired to help people would be killing patients. He thought that this sensational rumor would be resolved in no time and just blow over. But it didn't exactly go the way he thought it would. Not even close. More patients would die on the night shift. The deaths would spark rumors, accusations, and fear. I know all about this because I know the pathologist quite well, in fact.

He's my dad. For the next decade, my dad, Eddie Adelstein, found himself wrapped up in this case. He would face the Herculean task of figuring out why patients were dying in droves on Ward 4 East. Maybe it wasn't a virus or a cancer or Uncle Sam's damn cigarettes. Maybe the unthinkable was happening, and there was a serial killer wearing a staff badge, hiding in plain sight. There's really weird shit here. No, I know. I mean, like I said, somehow at a very high level, the thing was to close this case down. At a very high This season on Witnessed Night Shift. I recall it being somewhat surreal. I can't believe this guy is sitting on this couch talking to me about this. Why is that a good idea for someone who's suspected of being a serial killer.

And death followed him wherever he went, this man. It followed him.

Here's a deal. This type of stuff does not belong in any medical care anywhere. We gave them death sentences in our facility.

So they would rather see a whole bunch of innocent people killed than to do anything about it. I mean, my gosh, what do you want him to do? Clear out half the hospital?

Unlock all episodes of Witnessed Nightshift. Ad free right now by subscribing to the Binge podcast channel. Not only will you immediately unlock all episodes of this show, but you'll get binge access to an entire network of other great true crime and investigative podcasts, all ad-free. Plus, on the first of every month, subscribers get a binge drop of a brand new series. That's all episodes, all at once. Unlock your listening now by clicking subscribe at the top of the Witness Show page on Apple Podcasts, or visit getthebing. Com to get access wherever you get your podcast. Witnessed: Nightshift is a production of Campside Media and Sony Music Entertainment. The show was hosted by Jake Adelstein. It was written and reported by Jake Adelstein and me, Shoko Planteck. Amy Planteck is the producer. Elizabeth Van Brokeland is the managing producer. Michael Canyon-Meier is our story editor. Fact-checking by Aboukar Adon. Josh is our executive producer. Sound design, mix, and original scoring by Erica Wong. Additional music from Mike Harmon and APM. A special thanks to Eddie Edelstein and Benny Edelstein. Thanks also to our operations team, Doug Slawin, Ashley Warren, Sabina Mahra, Destiny Dingle, and David Eichler.

Campside Media's executive producers are Josh Dean, Vanessa Gregoriades, Adam Hoff, and Matt Sher. If you enjoyed Witness: Night Shift, please rate and review the show wherever you get your podcast.