The Death Shift
When nurse Genene Jones was on duty in a San Antonio hospital, babies had mysterious emergencies and sometimes died. Then she moved to a Kerrville clinic, and the awful pattern began again.
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Bradley confided his opinion to Dr. Adams, who called Dr. Packard over. Packard went up to see Tony Hall. The two quickly agreed to hold an emergency meeting of the medical staff’s executive committee that afternoon. But first there was the matter of Hall’s appointment with Holland, which went off as scheduled at about noon. Hall told the doctor her office nurse, Genene Jones, had irritated the hospital staff by giving orders and making notations on charts. Holland apologized. Genene might be a bit too aggressive, she conceded; she would speak to her.
About 2 p.m., after his afternoon rounds, Duan Packard sat in the doctors’ seventh-floor lounge, sipping coffee and puzzling over the problem. Dr. Joe Vinas, a young surgeon, sat down beside him and asked what was wrong. Packard explained. Vinas was not surprised at the doctor’s suspicions. “Packard’s the old man of Kerrville medicine,” Vinas says. “He smells a rat real fast.” Like the other doctors in town, Vinas believed that the number of patients who had had emergencies in Holland’s office indicated that something was very wrong. “Seizure? Respiratory arrest? Cardiac arrest? Bullshit. That doesn’t happen in Kerrville,” he says. “It never has.” Now, in the coffee room, Packard told Vinas he could help. Vinas had done his residency at Medical Center Hospital and would know people who had worked with Kathy Holland. “We need to find some things out,” Packard told him. “You have the job of tracing her background.”
Vinas went home. About 6 p.m. he made his first call, to a surgery resident still at Medical Center Hospital. Vinas told the resident what had happened in Kerrville; the resident told him there had been problems in the pediatric ICU in San Antonio, a number of deaths that no one could explain. He said there was one particular nurse who seemed to be the common denominator in all of those deaths. But the resident couldn’t remember the nurse’s name. Was it Genene Jones? Vinas Asked. The resident said he would check and call back. The phone rang five minutes later. “You’ve got a baby killer on your hands,” the resident said.
Too Much Smoke
Friday, September 24
The executive committee met again at 1 p.m., and Vinas revealed what he had learned. Then Dr. Holland was brought in. She sat at the oblong table, surrounded by eleven men. The room was quiet. A lot of children seemed to be getting sick in her office, Packard began gently. Why did she think that was happening?
Holland said she appreciated their concern and would welcome advice, but she knew of no problem. Each of the children, she explained, was a separate medical situation. Each had displayed clear symptoms that explained what had happened. Holland began to elaborate; to the other doctors she seemed tense but self-assured and professional. She had brought index cards with her, one for each of her emergency patients, and she began flipping through them, explaining each child’s symptoms and the treatment she had given.
The doctors asked about the drugs she had used. Had she ever used succinylcholine, the muscle relaxant sold under the name Anectine? Yes, during her residency. Did she have it in her office? Yes, but she had never used it. Did she trust her nurse? Yes. Genene had taught her things about resuscitating children, Holland told them. Did she know the result of the investigation in San Antonio? The LVNs had been moved out to upgrade the ICU, Holland told them, and all had been offered jobs elsewhere in the hospital. As the conversation continued, the doctors told her they wanted her to have another doctor consult on all her hospital patients’ treatment. Holland’s beeper went off, and she left the room briefly, then returned. Jimmy Pearson, back at Sid Peterson, seemed about to arrest, she said. “Would one of you care to accompany me?” Holland left the room.
The doctors sat back and talked about what they had heard. Holland had offered plausible explanations for individual cases, they agreed, but when the incidents were taken together—and Vinas’ information from San Antonio was considered—there was far too much smoke. The doctors were in agreement. They would lift Dr. Holland’s privileges to admit and treat patients at the hospital. The only remaining question as they left the conference room was when.
Packard and Hall agreed it was time to bring others into the matter. Packard called the Texas Board of Medical Examiners. Hall called the Austin office of the Board of Vocational Nurse Examiners, the group that licenses LVNs. He spoke to the nursing Board’s investigator, Ferris Aldridge, who wrote a note after the conversation and placed it in Genene’s file. “Mr. Hall advised of drastic increases respiratory and cardiac arrests in Kerrville and suspicious deaths in San Antonio, stating that a child killer was suspected,” the note reads. “Told him that this was not a matter for a board investigation, but would locate the proper authority for him.” Aldridge picked up the phone and called Texas Ranger Joe Davis in Kerrville, who said he would investigate. After more that a year of suspicions in two different counties, someone had finally notified a law enforcement agency.
Sunday, September 26
Kathy Holland returned to Nixon Lane in the afternoon, after having spent most of the weekend in Center Point with Charleigh. When she arrived, Genene approached her: did she remember that bottle or Anectine that had turned up missing a few weeks ago? She had found it, lying in a drawer of the examining table in the treatment room. And the safety cap had been removed. But Genene said there was nothing to worry about: She had gotten the other bottle of Anectine—the one they’d ordered when they’d thought the first one was lost—and checked it against the bottle she’d found in the treatment room. Both bottles were completely full, Genene said; evidently the lost (and now found) bottle had never been used.
First, the questions about Anectine from the executive committee at the hospital; now Genene’s belabored explanation of the fate of the missing bottle. Holland went to sleep wondering.
“I Did a Stupid Thing”
Monday, September 27
In the morning Holland met with Dr. Packard in his office at the hospital. “I’m concerned about your nurse,” said Packard. There was going to be an investigation, he told her. “In the meantime,” he said, “you better tell that nurse that if she cares about you, she better make sure your office runs as tight as a ship.” Holland returned to her office. After Genene left for lunch with Debbie, Holland went to her small office refrigerator to look for the Anectine. “There were two vials in the refrigerator,” she recalls. “I flipped them up to myself, and there were two huge holes in the stopper [of one]. At that point, I damn near freaked out.”
Genene returned to the office after a long lunch. Holland led her over to the refrigerator and told her to remove the two bottles of Anectine and look at the top of each. “How’d the needle holes get there?” she asked. “I don’t know,” said Genene. She mentioned Misty Reichenau’s arrest. Didn’t Holland remember? While they were having trouble getting the breathing tube down Misty’s throat, Debbie had gotten the Anectine out of the refrigerator. Holland called Debbie down to the clinic and questioned her. What had she done with the bottle? Debbie said she had put it behind the cotton-ball dispenser in the treatment room. In statements to friends and investigators, Holland gave the following account of the rest of her conversation with Genene:
“That still doesn’t explain the holes,” Holland said. “How’d the holes get there? How am I going to explain the holes in the bottle?”
“I don’t think we should explain them at all,” Genene told her. “I think we should just throw it out. We thought the bottle was lost. We should say we never found it.”
Holland left the office. What should she do? She had to tell someone, but whom? She thought of Joe Vinas; he was young and approachable, and he had trained at Medical Center Hospital. She called his office and left a message, then returned to her clinic.
About 4:15 p.m. Genene approached Dr. Holland again. She had a ribbon tied into a bow. She explained that she had been to Chelsea McClellan’s grave and had found the bow there. (Petti McClellan later said she had seen Genene at the cemetery, kneeling in front of Chelsea’s grave; she was rocking back and forth sobbing and calling out the dead child’s name: “Chelsea, Chelsea…”) Then Genene said, “I did a stupid thing over lunch. I took some Doxepin.” Genene had been taking the antidepressant drug regularly, but now she was saying she had taken an overdose. How many had she taken? Just a few, Genene told Holland; she had thrown the rest away. Genene looked woozy; she lay down on a couch in the office. Holland, frantic, told Gwen to call an ambulance, then burst into the doctor’s office next door. “My nurse has just told me she has taken an overdose of Doxepin,” she announced. “Number one, I am not an adult doctor. Number two, I wash my hands of this.” Genene’s overdose was modest—she later said she had taken four 50-milligram pills—but EMTs who arrived at Holland’s office one final time found her semiconscious and fed her oxygen on the way to Sid Peterson Hospital. She was admitted to the emergency room, and doctors pumped her stomach. She had planned to take a handful of the pills, Genene said later, but she had decided at the last minute to face her problems head-on, just as she had in San Antonio. “I figured if I could live the nightmare once, I could live it again,” says Genene.
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