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Back in 1992, toward the end of August, a young doctor at the Columbia VA hospital named Gordon Christensen was getting ready to take a trip with his kids. They were going to the lake of the Ozarks to explore a cave. It was supposed to be a much needed break from the high stakes, high stress world of the VA hospital for Gordon. But before heading out of town, Gordon was approached by an administrator at the hospital who urgently wanted to meet with him. Gordon was an epidemiologist, an expert on the spread of disease. If any unusual trends came up at the hospital, Gordon was the person to talk to. The administrator who requested the meeting was named Linda McGarry. She headed up a department called quality improvement, or Qi. Linda had some data she really wanted Gordon to see. She was quite worked up about it.

She told me that the subject we were going to talk about could ruin my career, which was alarming. But I had just gotten tenure. Yeah, I felt pretty secure, but I had no idea what she was going to ask me about.

Linda came down to Gordon's office on August 27. That was a Thursday.

She sat down. I had a couch underneath a picture frame, and she told me that there were rumors on the floors that there was an angel of death in the hospital.

An angel of death, as in someone was suspected of killing patients in order to relieve them of their suffering. A mercy killer. Gordon noticed a yellow pad of paper clutched in Linda's hand, the supposed evidence behind this wild theory. She didn't hand him the papers, but he could see that they were full of the names of patients and the dates they had triggered a code blue and died. Linda asked Gordon if he could design a study that would cross check her team's work to see if they were right in their fears. If a nurse was suspected of being a serial killer, as an epidemiologist, he could help identify patterns that might otherwise go undetected.

This is what I was supposed to do. This was my responsibility, so I was willing to do it.

Suddenly, the burden of the investigation had fallen upon this young doctor. He was in a race to find out what or who was killing the patients before another cold blue rang through the ward. From campsite media and Sony music Entertainment, you're listening to witnessed night shift. This is episode two. Nurse H, I'm Jake Adelstein.

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The wireless customer you are calling is not available. Please try again later. We're sorry, you have reached a number that has been disconnected or is no longer. If you feel you have reached this recording in error, please check the number and try your call again. God damn, Robert Long before I started digging into the deaths at the Columbia VA hospital, they were just a mundane thing happening in my dad's job. And if you think mundane sounds a little callous to describe a series of suspicious deaths, you have to remember death was a regular thing in my dad's life. He was a pathologist. Death was literally his business. Sometimes he'd look at a tissue sample and determine whether it was cancer or not and save a life. But a majority of his patients were corpses. I spent a good deal of my teenage years hanging around the VA hospital, doing homework, hitching a ride back home with my dad. Even now, more than 30 years later, dad still has the same office in the same place, right past the police post near the south elevators. He was also the chief medical examiner in our county. And while we were reporting this, he was still a medical examiner at the age of 87.

When somebody dies under suspicious circumstances in Boone county, dad is the man to call. There's no way dad could have been in the death business this long without finding a way to deal with it.

Every death I know, there's a ripple effect through an entire community to an entire family. And if I took every death personally, I would be lying in the corner in the fetal position crying. So what you see is that I'm mostly focused on, am I finding out the cause of death? So you might judge me an insensitive lout, but I'm not. I just said, you can't. I mean, you can't. You can't. You can't grieve every death because you simply couldn't function in this world. So that's how I deal with death.

That helps explain why my dad was so casual when his boss wandered into his office and mentioned there might be a nurse killing people. But as the suspicious deaths continued, my dad became more involved. And as he and his colleagues looked more deeply into this mystery on four east, it became an all consuming part of his life. These events in 1992 would go on to change the way my dad viewed his work, his colleagues, and his mission at the hospital. Honestly, it kind of changed his view of everything. And as a result, it made its way into my life, too. I've spent decades covering crime abroad, and one day about a year ago, my dad said to me, you know, you should really look into what happened here in your own hometown at the VA.

And they just kind of want to forget about it. They don't really want to deal with it. I don't know what they're going to do when you put out the podcast. They're not going to be happy. You know, there's really nothing they can do to me.

The VA might want to forget, but my father cannot and will not, because it was actually my dad who started this investigation. He was the one who told Linda that the way to find out what was causing these deaths was to ask doctor Gordon Christensen to study the data. Gordon, the epidemiologist. From the top of the episode, he'd been hired by my dad, and he thought very highly of him.

Gordon Christensen, the guy who I pointed to head up research, who is an extraordinarily conscientious, competent physician.

If you put my dad and Gordon side by side back then, you'd see some differences immediately. My dad was in his mid fifties, older than Gordon, who was 43. Dad showed up to work every day wearing a sweater that looked like it was pulled out of a dog bede. If he did wear a shirt, well, he never quite managed to tuck it in all the way. Gordon, on the other hand, wore a wider than white lab coat and had his hair neatly combed to one side, like howdy Doody. He was reportedly one of the first doctors on earth to recognize the threat of staph infections in hospitals. He'd been at the VA for about four years at this point, and his career was on the upswing, but he remained humble and polite.

At that time, my role was to be the director of infectious diseases, which is a fancy title for me. That's one person, me, who is in charge who does the infectious diseases. But I was the center point if anything came up.

We were unable to interview Gordon ourselves because, sadly, he died in 2020. But we caught a lucky break. His daughter was curious about this period in her dad's life and did a series of interviews with him a few months before he died. She was kind enough to let us use the tape. That's mostly what you'll be hearing on this podcast when you hear Gordon's voice. Anyway, just as my dad had this incredible rumor about a nurse killing patients sort of casually tossed his way by the chief of staff, my dad inadvertently did the same thing to his friend Gordon by sending Linda his way with this very unusual problem. If Linda was right and there was a mercy killer in the hospital, Gordon had to move quickly. Even if there wasn't homicide, something was happening to the people on that ward. The sooner he figured it out, the more lives he might be able to save. Gordon gave Linda instructions for all the data her team needed to gather. He requested data going back three years, which would include death rates from all the hospital wards. He wanted to see if there were any unusual patterns or clusters of deaths associated with a certain nurse.

Gordon didn't know the real names of the nurses, and in order to do an unbiased analysis, he didn't want to know. Each staff person was assigned a letter. Nurse A, nurse B, nurse C. You get the idea. Once all the information was gathered, Linda gave Gordon the raw data compiled in a big spreadsheet.

And I went through and made the calculations. And there was one person who stood way out beyond everybody else.

One nurse was way off the map. They were present in the room when the code blues were called in nearly every suspicious case. Gordon took his findings to Linda right away.

So I told her that the study had confirmed there was someone who was associated with these deaths. And she asked me who it was, and I said it was nurse H. And she asked, well, nurse H was the one they were suspecting.

Nurse H. Gordon was used to tracking the movement of viruses. But this time, the virus appeared to be a person, and ward four east was ground zero. The following union view is being videotaped.

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Gordon Christensen had been very careful to hide the names from himself to eliminate any chance of bias. But Linda McGarry knew who Nurse H was because she had helped prepare the data. And Nurse H was the same nurse that the nurses in Qi had been suspecting back when the rumors first sprung up. A young male nurse named Richard Williams. Gordon found that the death rates for this guy, labeled nurse h in the blind study, were ten times higher than anyone else, so apparent that anyone could see it like a skyscraper on the prairie. According to Gordon's analysis, there was almost no chance in the universe that Nurse H wasn't involved somehow. His data suggested that a single nurse could have been the cause of dozens and dozens of patient deaths. Gordon had identified 40 mysterious deaths in all. In other words, the Columbia VA hospital might have a serial killer walking the halls. Gordon was horrified by the findings as he saw it, he wasn't a scientist crunching a dataset anymore. He was the first person to realize that if something wasn't done, more people would surely die. Gordon had worked fast, analyzing numbers all day and through the night.

But he traced the spike in deaths all the way back to May. It was now August. It felt like the supposed killer had a head start. So Gordon was extremely agitated when he tracked down my dad at the hospital the next morning. He pulled no punches.

He came to me and said, this guy is murdering people. And I said, I wouldn't use the word murder yet. I said, maybe. Maybe he's just the best nurse. Maybe he's taking care of the sickest people.

My dad was able to calm Gordon down for the moment, and Gordon decided to take one more run through the numbers, just to be sure.

So they went back and did it again. And the people that died weren't the sickest people. They were people getting ready to go home.

In other words, these patients were not expected to die. My father and Gordon understandably freaked out when pop first heard the rumor he'd pulled Richard Williams off patient care on ward four east just as a precaution. Maybe at first there was a part of dad that wanted to believe there had been some sort of mistake. But now he saw the numbers and understood the problem was very real. The most basic analysis told you that patients were ten times more likely to die if Williams was their nurse. And if he was your night shift nurse, you could be looking at goodnight forever. The numbers seemed to be saying to them, you've got a nurse killing patients. And this just might be the tip of the iceberg. As far as they were concerned, ward four east was now a crime scene, and they knew they had to alert the hospital administration and call on the cavalry, the FBI. Meanwhile, Richard Williams was making his presence felt on his new assignment. After my dad pulled Williams off patient care on ward four east, the nurse was sent over to the ICU to do some training. But the nurses on the ICU had heard the mercy killer rumor and did not trust Williams.

They were threatening to walk off the job. The head nurse of the ICU didn't want this person anywhere near their patients either. It was a mess. But then another problem reared up and quickly became a crisis. One young doctor had dared to say the one thing that was apparently on nearly everyone's mind. This encounter had actually happened about a week before. Linda went to see Gordon to ask him to do a study. But it didn't immediately come to light. It was kind of like a match dropped into the underbrush. Earlier that summer, a new crop of intern doctors had come to work at the VA. The interns were newly graduated medical students. They were baby doctors with limited privileges. Among them was doctor Mohanad al Kalani. He was assigned to work the night shift on four east.

Doctor Al Kalani was in early weeks of his training here. His internship would have started July 1.

That's doctor Jan Swaney again. She's the one in the last episode who was present for the death of Melvin Carver. You may remember Melvin, who got stranded at the VA overnight and was mysteriously dead by the next day. Here's what happened with Doctor Al Khilani. Less than two months into his training, he was on a shift when he got a page from nurse Richard Williams. Williams reported that the blood pressure of one of their patients, Leo Yamry, was low. The doctor needed to come immediately. As soon as he got there, the doctor could see that Leo's breathing was shallow. He needed an iv, and the nurse ran to fetch one. A cold blue was called, but the team could not revive Leo. At 02:08 a.m. he died. He was 75 years old. Shortly after the doctor found Williams at the nurses station, he was washing his hands.

There was some. Something about the situation that made Doctor Al Kalani uncomfortable. Right? And he said to this nurse, Richard, why are you killing my patients? I was. When I heard this, I thought, you are kidding me. Who in their right mind would ever know that this would really be happening in the hospital right here?

Here is one of the strangest things about this story. It was Richard Williams, the nurse himself, who reported that accusation to his superiors. Williams claimed he'd been wrongly accused and he wanted the hospital to do something about it. There was no precedent at the Columbia VA for how to handle something like this. It was a very serious allegation and had simply never come up before. The encounter with Williams had actually come about a week and a half before Gordon completed his analysis of the data. Now that data was in the hands of hospital officials, who promised to investigate further using the full might of the VA bureaucracy. But Williams complaint twisted the entire thing and sort of rerouted the investigation. The VA administration had Gordon's data linking one nurse to more than 40 suspicious deaths. You would think that they would immediately notify the cops about potential killings going on in their hospital, but instead they came up with another solution. They put together an ad hoc internal board. So instead of investigating the enormous crisis unfolding on Ward Four east, the investigation became a sort of HR matter. The board's job was to investigate whether Al Khalney said anything inappropriate to Williams during their fleeting encounter.

Exactly one week after Gordon heard about the alleged angel of death, doctor Swaney got a call from Gary Baker, an administrator. Gary told her the director of the VA wanted her to serve on the board.

I was late to the party, right? I'm busy doing other things, doing my work, and I think this whole thing had been brewing for a couple of months or longer before I was brought in on it. So, you know, this is bizarre, but my goodness, let's. Yeah, I'll serve on this. We need to get to the bottom of it.

The ad hoc board was small, just three people. The administrator, Gary Baker, a doctorate. That was Jan Swaney, and Lee Miller, the nurse she met in episode one.

I have always been an advocate of the VA. When I was there, in spite of the bureaucracy, I think the VA has always done an outstanding job taking care of patients. The patients who go there, they didn't used to pay for care. You just showed up. If you qualified, you got care.

Lee retired from nursing to teach sign language, and it's clear that he's a good communicator. During our conversation, he came prepared and asked a lot of questions. Despite the respect he had for the Columbia VA, Lee's memories of this investigation stirred something up in him.

When I was reading that 99 page document last night, I had lots of mixed feelings. Sort of like, ugh. And I'm glad to talk to you about it, but at the same time, it's a little hard. Reading the report was hard in some ways.

The first week of September, Lee and the other two members of the ad hoc team sat up in your typical corporate meeting room in the hospital, quiet, with nice furniture and a long conference table with big chairs. There was a tape recorder in the middle of the table. They called the nurse into the room. Lee knew Richard Williams.

I knew him clearly when he came in to be interviewed. It's like, hi, Richard.

You know, Lee was a nurse manager, so he was used to overseeing new nursing graduates. Usually they were highly motivated and curious. They wanted to get involved in everything, try everything, ask questions.

I would not characterize Richard that way. I would characterize him as doing what he's told. I would characterize him as bland and a little bit passive, pleasant, and non assertive. I mean, he was fine. I think he just came to work and did his job.

Richard Williams was an RN. He'd worked at a different hospital in Springfield before coming to the VA in 1989. Three years earlier, he was only 26.

And yet he appeared older than his stated age. That's how he would say it in medicine.

This wasn't the first time Jan was coming face to face with Williams either.

He has sort of a soft voice, very pale skin, wearing a white uniform, little spectacle, wire rim type glasses. Hair was thinning, and his. He had sort of brown salt and pepper hair with a white streak that came off of his temple area. He was somebody who didn't call attention to himself. He didn't have this big presence. He was sort of there and quiet.

This is something we would hear from other people, too, that Richard Williams was very unmemorable. He faded easily into the background, almost like a ghost. But in that conference room with William sitting across from her, Doctor Sweeney remembered one encounter in particular. He was the same nurse who had attended the code blue for Melvin Carver. She couldn't shake that weird moment when she had made the call to stop the code blue to allow Melvin Carver to die. And Williams had said, thank you, Doctor Sweeney. Now those words felt entirely different, like a killer's incantation marking an unnatural death. But doctor Swaney wasn't here to litigate her own peculiar interaction with Williams. She was here to serve on a bureaucratic board with a narrow scope. They were investigating two things, the circumstances of Leo Yamry's unexpected death and the doctor's comment to nurse Williams. Directly after the doctor had asked him, why are you killing my patients? And sitting in the conference room, Williams insisted he'd done everything according to protocol. Nobody seems to know where the tapes of these interviews are, but luckily we were able to get the transcripts which show that the night shift started normally enough.

Williams had given the patient an orange to eat and closed the curtains for the night. He'd responded when the patient complained of a severe headache. He'd taken his vitals, seen the blood pressure was low, and paged the doctor. He'd given him rescue breaths, done CPR. The man didn't live, but he'd done all he could do to help save him. As for what happened next, we don't have the audio of what Williams told the board, but we do have a transcript of Williams telling a reporter about this very incident in his own words. We had a voice actor read it.

Right behind the nurses station, right behind me, and tapped me on the shoulder and said, richard, why are you killing my patients? And I looked up at him and I said, you're kidding. He said, no, I'm serious. I want to know why you are killing my patient. Do you not like me?

The thing that sticks out to me was that Williams wasn't most upset about the accusation itself, that he had killed a patient intentionally. What seemed to upset him was the impact on his reputation. He was offended, and he wanted the record set straight.

I didn't become a nurse to mercy kill or to determine when someone would die. I've been a nurse for seven years. I have never had anything like this happen. This has been a blow to my ego. I just can't believe that people think that I am killing people.

I believe he was really upset about the encounter, and he wanted to clear his name. So I would say, yeah, anger was part of his emotional response and being defensive.

Lee Miller saw something slightly different when he reviewed the transcript. A pleasant and agreeable person simply answering questions.

I don't recall him being extremely nervous. I think I would remember that if he'd been upset or nervous. I think if I had been him, I would have been upset and nervous. Frankly, I thought about that, too. I might have been yelling at the investigation board and not just pleasantly answering questions. So I think there's something interesting there.

This question of how a wrongly accused person should act was something my reporting partner Shoko and I disagreed about.

I don't think that you can assume that everyone would react by yelling and screaming. If I were to put myself in William's shoes, then regardless of whether I was innocent or not, I think that I would want to come across as calm and pleasant.

Even if you were guilty? Yes. If I were wrongly accused of something this horrible, of killing people, I would be furious, I would be angry, and I would be yelling. And I think that is a normal person's reaction. You don't just be like, hey, you're accusing me of murder. That's fine with me. Let me pleasantly answer your questions. Mm hmm.

That makes sense. But another thing that I find bizarre is that Williams instigated this committee, in a sense.

Right.

It almost seems like he wanted this whole thing to be investigated and taken to the top, because if he hadn't told anyone about the al Kalani incident, no one would have known about it.

But I also think that that's a smart move because he must have known by then that he was getting this reputation as the angel of death and that people would investigate. And by going forward and bringing it up, it looks, I am an innocent guy. I'm so innocent that I'm going to bring this up before someone else does.

Mm hmm.

Yeah, absolutely. This is just a thought experiment, to be clear. But what exactly Williams was hoping to get out of complaining to the higher ups and painting himself as the victim is one of the mysteries of the early investigation. We'll get into an even bigger one after the break. The board interviewed Richard Williams, but of course, they also wanted to hear from doctor Al Kalani. The doctor came in to be interviewed on a Friday in September. He sat down, and one of the board members started the tape recorder. They began the interview by asking softball questions to warm him up. But what they really wanted to know was, why did he accuse nurse Williams of killing his patients? His answer surprised them.

He said, no, it was just in jest. It was just a joke. I never really meant to accuse Richard Williams of killing my patients.

After giving all indications to Williams that he was serious in the moment, he was now backing down.

When he said he was joking, I pretty clearly remember saying to him, were you really joking?

Doctor al Khalani insisted that, yes, he really had meant the accusation in jest, and he now told the story differently from Williams in his version of events. When he realized that the nurse was upset by his comment, he apologized. He said, I'm sorry. I didn't mean it. The board tried to get Al Kalani to say more, but he had shut down. It was clear he just wanted to get it over with and move on. The board had hoped that they could finally hear why he had made the accusation, that he might help them escalate the matter further. But if the accusation at the center of their whole investigation was just a joke, they had basically convened for nothing. We really wanted to get the doctor's side of the story. He's never spoken to reporters and now works at a clinic in another Missouri town. My reporting partner Shoko tried to reach out to him there. Doctor Apple on his office. This is Courtney.

Hi. This is Shoko Plumbeck.

Speaking.

I was wondering if I could speak with Doctor Al Kalani.

But when she called and explained what we were doing with this show, his receptionist gave her a forceful no and hung up. We didn't understand why at first, but then doctor Jan Swaney told us her theory.

The thing that I felt is that Doctor al Kalani had come from a country that was not a democracy.

According to staff from the hospital at the time, doctor al Khalani was from Jordan and had just gotten a new visa to practice medicine in the United States. He was vulnerable. A resident doctor is basically someone who's invested many years of their life in medical training, but has yet to see any of the payoff. Maybe doctor Al Kalani was suspicious of this board and its intentions, or maybe he was afraid.

And I feel that doctor al Kalani suddenly found himself called before an investigative board, talking into a tape recorder, giving sworn testimony, and he realized he was into something that he never intended to get involved in, and he wanted to back out of it.

I'm guessing this whole thing was pretty traumatic for him. And even if he felt sure Williams was killing his patients, he probably realized that he couldn't actually prove it. And it would be a very serious thing to accuse someone of with so little proof. I have to say, I still found a few moments in the transcript that to me show that Alkalani harbored real concern. The first was that he had been on ward four east for less than two months and four patients had died. All four patients had been under the care of Richard Williams. The second was that the death of the veteran they were investigating followed another death that had occurred only a few days prior. As the doctor told the board, quote, if you have two patients die within 24 or 48 hours, you get somewhat concerned. Still, whatever concerns he may have legitimately had when it went down in the official record, was doctor Al Khalani's insistence that he was only joking. Lee Miller wasn't buying it. He still doesn't.

I made a note on my pad about that. I said, clinical people don't joke about killing patients, and that's absolutely true. And I think he was just afraid to make an assertion. I believe, and this is just what I believe, it's not what I know. I believe he was absolutely serious.

And while nurse Lee Miller and doctor Jan Swaney began to question the purpose and limitations of their investigation, Richard Williams was still working away, politely, quietly, shift after shift after shift, often under the COVID of night. Next time on witnessed night shift, I.

Think his goal was to keep the investigation reined in.

None of us were trained to do this kind of investigation. Why are we pretending that we can investigate this situation?

The tab was out of the bag. Richard Williams knew that he was exposed.

Don't want to wait for that next episode. You don't have to unlock all episodes of witnessed night Shift ad free right now by subscribing to the Binge podcast channel. Just click subscribe at the top of witness show page on Apple Podcasts or visit getthebinge.com to get access wherever you get your podcasts. As a subscriber, youll get binge access to new stories on the first of every month. Check out the Binge Channel page on Apple Podcasts or getthebinge.com to learn more. Night Shift is a production of campsite Media and Sony Music Entertainment. The show was hosted by Jake Adelstein. It was written and reported by Jake Adelstein and me, Shoko Plumbeck. Amy Planbeck is the producer, Elizabeth Van Brocklin is the managing producer. Michael Canyon Meyer is our story editor. Fact checking by Abukar Adan voice talent for this episode provided by Harrison stagner Josh Dean is our executive producer. Sound design mix and original scoring by Erika Wong. Additional music from Mike Harmon and APM. A special thanks to Eddie Adelstein and Benny Adelstein. Thanks also to our operations team, Doug Slayin, Ashley Warren, Sabina, Marae, Destiny Dingle and David Eichler. Campsite Media's executive producers are Josh Dean, Vanessa Gregoriatis, Adam Hoff and Matt Scherr.

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