When People Desperately Want To Die (But Aren’t Allowed To)

When my Uncle Larry was dying of cancer, he became too sick and needed constant care. He was transferred from my parents’ house to a nearby hospice, a squeaky-clean facility with a caring, attentive staff. But he didn’t want to be there. He didn’t want to be anywhere anymore. He knew it was over. He was in brutal pain and he wanted to die.

I remember the last day I spent with him. The healthy man I once knew as my uncle was a fraction of himself. I felt nervous hugging him, scared I may crumble his small bones. My father and I watched football with him while he dozed in and out of his morphine haze. He didn’t have much strength for attention. During my previous visit, we had been out in the yard together. I pushed him around in his wheelchair and asked him questions about his days as a bush pilot up north.

When my Uncle Larry was dying, euthanasia was still illegal in Canada. (They changed the law in its favor, as well as assisted suicide, in June of 2016.) However, Larry had an honorable doctor who listened to his request: “I want it to be over. I want to die.” When my uncle had said his goodbyes to each of us, his doctor gave him a slight overdose of morphine to let him pass away peacefully. It was right for him to break the law to end my uncle’s suffering. Uncle Larry made it very clear to all of us that he wanted to die with some dignity instead of being forced to endure a slow, miserable wait.

My husband and I have agreed: no living like vegetables. If either of us becomes so sick that our quality of life has been compromised, the plug should be pulled. The government has no business telling me when and if I can end my own life. If I am terminally ill and dying in a hospital, I want that conversation to be between my husband, myself, and my physician. Like Canada, California laws changed last June to legalize assisted suicide and euthanasia. Out of fifty states, only four others—Vermont, Oregon, Washington, and Montana—accepted this new legislation.

Euthanasia will always be a contentious debate, if only for the fact that the life-ending medicine is not self-administered. With assisted suicide, your doctor prescribes you a lethal dose of medicine which you take yourself. The patient has full control of his or her death. But a physician or nurse could potentially provide euthanasia without the patient’s consent and pass it off as a natural death. One of America’s most prolific serial killers got away with it, hiding in plain sight, as a kind, helpful member of hospital staff.

No one but Charles Cullen knows exactly how many people he killed. He probably doesn’t even remember. Maybe he kept a ledger? Maybe he ticked them off like a grocery list? The 57-year-old former New Jersey nurse is currently serving 127 years in prison for the murder of 40 people, though it’s estimated that he killed more than 400. If this is true, it would make him the most prolific serial killer in American history.

Cullen was unstable from childhood. He claims that he has been suicidal most of his life, first attempting suicide by drinking the contents of a chemistry set when he was a small child. Cullen blames most of his psychopathy on his terrible upbringing. His father died when he was seven months old, and his mother passed away in a car crash years later. Even though he was surrounded by eight siblings, Cullen was the baby of the family and a loner. He was destroyed when his mother died. He dropped out of high school and joined the U.S. Navy.

Suffering from suicidal tendencies, he obviously wasn’t fit to serve, so they shuffled him off to hospitality. When he started to show signs of severe mental illness, he was honorably discharged. Cullen did learn one thing in the Navy: He liked playing nurse.

Before enrolling in nursing school, Cullen allegedly attempted suicide seven more times. His first nursing job was in the burn unit at St. Barnabas Medical Center in New Jersey. “There was a lot of pain,” he told 60 Minutes in a 2013 interview from jail. “There was a lot of suffering. I didn’t cope with that as well as I thought I would.”

Cullen’s known victims ranged from ages 21 to 91. According to 60 Minutes, some patients were critically ill when Cullen gave them a lethal injection, while others were on the up and ready to be discharged from the hospital.

Cullen’s weapons varied. Sometimes he would inject saline bags with insulin; others were killed with a lethal injection of Digoxin. Digoxin or “Dige” would replace insulin as his go-to. Not only was it powerful, but it was unlikely to be detected. Cullen used a big ol’ dose to slow down a patient’s heart rate to nothing.

The craziest part is that Dige wasn’t even hard to access in the critical care unit where Cullen worked. These facilities used an automatic drug dispensary system called “Pyxis.” Nurses would type in a name of the drug the patient needed, but they could grab whatever pill they wanted because Tylenol 3 and Dige would be in the same drawer. You could access morphine with the same button you’d push to get an aspirin.

According to his former wife, Cullen was an alcoholic and an abusive spouse. When she divorced him in 1993, reports detailed that Cullen was an angry, terrifying drunk who “stuffed pets into bowling bags and trash cans, poured lighter fluid into other people’s drinks, and made prank calls to funeral homes.” His ex-wife reported that Cullen would abuse their Yorkshire Terriers daily. After the divorce and losing custody of his two daughters, Cullen moved into a basement apartment in Phillipsburg, NJ.

He soon became obsessed with a female coworker, asking her out on a daily basis and calling her at all hours. He followed her around the hospital and even proposed to her with an engagement ring. In March of 1993, Cullen broke into her house and was busted for misdemeanor trespassing. He told police that he fantasized about being her boyfriend. Embarrassed after being caught, he made another failed attempt at suicide.

When Cullen wasn’t trying to kill patients, he was trying to kill himself, either slowly with alcohol, or with more drastic, melodramatic escapades, like in early 2000 when he lit a charcoal grill in his bathtub in the hopes of suffocating himself with carbon monoxide. Throughout his 16-year career, Cullen went from being a patient himself at the psych ward to nursing people back to health. According to his biographer Charles Graeber, he even took a call for shift work at the hospital from a psych ward as he was being discharged.

“He sees himself as a victim,” said Graeber, “and as a victim he is entitled to lash out in any way that he wants to make things right. If that means killing patients, then anything will justify his victimhood.”

His victimhood helped him out and left him undetected. No one was going to shun a man for getting psychiatric help. None of his poor records followed him around as he bounced from one New Jersey hospital to another hospital with suspicion following him the entire way. The state was desperate for nurses. One hospital even settled with him to avoid a liability lawsuit, despite the fact that they suspected he was overdosing patients.

“People wouldn’t be suffering anymore,” Cullen told 60 Minutes. “So, I thought I was helping.”

Maybe he saved the lives of some patients who were in pain, but many were recovering.

“I felt overwhelmed at the time,” claimed Cullen. “It more or less felt like I needed to do something.”

In December of 2003, one of Cullen’s coworkers at his hospital in Somerville, NJ became suspicious about his activity in the Pyxis system. Amy Loughren began to work with police as a confidential informant, keeping a tight watch on Cullen’s patients and his nosing into the electronic charts. She wore a wire, befriended Cullen, and grew close to him, hoping to coax out a confession. It worked. Cullen was arrested in 2003 and gave into police interrogation after only six hours and a lot of hand-holding from Loughren. Amy told the Daily Mail that Cullen said he would confess if he could be promised the death penalty. After his long-awaited trial, Essex County Chief Assistant Prosecutor Norman Menza said, “There is evil in this world and sometimes there is no explanation for this evil. In the many hours I have spent with Mr. Cullen, I have gotten no explanation. There is a deeper evil involved.” Cullen stood hunched over during his sentencing with his sunken face toward the floor. He could barely look up when the court announced that he would be eligible for parole in 397 years.

Cullen is still in prison. His final suicide plea was a total failure.