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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Dr. Kathleen Holland slumped into the last chair left in her pediatric clinic one afternoon in April of this year, looked around at the vacant office, and cried. It had been such a wonderful place to begin her career: the Fine Medical Center, a busy complex of doctors’ offices less than a mile from downtown Kerrville and Sid Peterson Hospital. She had signed a five-year lease and spent hours selecting wood stains for the cabinets and soothing colors for the walls. Now, at the age of 36, she was moving out, a step ahead of the sheriff and a few steps short of bankruptcy. The patients had stopped coming when the publicity hit, but the bills hadn’t, and there just wasn’t’ enough money to pay the landlord. Even now, he was hovering outside, watching Dr. Holland and a handful of friends pack up her things.
Already the parents of three children she had treated had filed lawsuits against her and Genene Jones. Holland and Charleigh Appling, who had gotten married on April 17, 1982, had divorced on December 30, in hopes of saving Charleigh’s assets from the creditors. The grand jury had not yet cleared her. And Sid Peterson Hospital had refused to restore her hospital privileges. She had been naïve to trust Genene, Holland told her friends-naïve and stupid. Now she was paying for it.
Dr. Holland opened her new pediatric clinic on August 23, 1982. She had originally planned to start at the end of the month, but Bill Schick, her business manager, suggested that starting up a week early might bring in a bit of business from preschool physicals. Genene Jones, after leaving the Medical Center Hospital, had worked for Medox, a San Antonio nursing agency near the hospital, and spent a few months at the Santa Rosa Medical Center, a large nonprofit private hospital in downtown San Antonio; On August 3 Genene’s nursing license expired. The Texas Board of Vocational Nurse Examiners did not receive the fees to renew it until November 29, 1982; during the entire time that Genene worked for Dr. Holland in Kerrville, she was practicing nursing without the valid license required by state law. In late summer she began looking for a place to live in Kerrville, and when she had trouble finding a landlord willing to accept a tenant with both children and animals, Holland decided to buy a small house next to her and rent it to her. The real estate agent found a $45,000 place on Nixon Lane, in an isolated subdivision in the hills seven miles outside of town. Holland bought it, and Genene rented a U-Haul and moved in.
Kathy Holland planned to live outside the hamlet of Center Point, on a rugged sixteen-acre tract fifteen miles south of the clinic. Charleigh had bought the land in May 1980 with the help of a Veterans Land Board loan, and they’d been dreaming of living there ever since. They would have peace and quiet, beautiful countryside, and room for two horses that Kathy was boarding at a stable. They would live in an underground home that Charleigh would build into the side of a hill as soon as the pediatric practice was flourishing; in the interim, he would build a smaller house on the property. As August 1982 arrived, the first house was little more than a wooden frame. Charleigh often spent nights at the site in a sleeping bag to keep an eye on things. There was no bathroom there, and Dr. Holland found it difficult to dress for work without a shower or hot water. So she arranged to stay on Nixon Lane for a while.
Debbie Sultenfuss, like Genene, had worked at Medox for a time. Then in May 1982 she moved to Kerrville and began working in the intensive care unit at Sid Peterson Hospital. Debbie moved her trailer to Kerrville, but she said the utility company was slow hooking up the electricity. She, too, spent many nights at the house on Nixon Lane.
In August Dr. Holland hired a secretary-receptionist, a tiny 33-year-old woman named Gwen Grantner, who had bounced from job to job in Kerrville. She was less than five feet tall and weighed about 85 pounds-and she talked nonstop. She was born in Chicago, and though she had never been to England, she spoke with a strong Cockney accent. Gwen told Holland she’d been married to a Briton, found his manner of speech appealing, and decided to affect it herself. The new doctor was intrigued. “She had this neat accent,” says Holland. “She was very honest about things, and I liked honesty. She’d said she had a lot of different jobs, but that was because of disagreements.” Holland asked Gwen Grantner to join her fledgling medical office. The staff was complete and the office ready to open.
THE DREAM GIRL
Like many parents in and around Kerrville, Petti and Reid McClellan were pleased when they heard that a new pediatrician was coming to town. Here was a chance to take their kids to a real expert, a young woman fresh from training in the most modern medical techniques. “Everybody was real excited about it,” says Petti. “I just had this thing about specialists.” The McClellans, both 28, had met in Llano, where Reid owned the Hi-Line Fishing Lodge on Buchanan Lake (he has since sold it and become an electric line repairman) and Petti spent time at her mother’s weekend home. They were married on May 10, 1980, in an outdoor ceremony. They made an attractive couple: Reid, solidly built with thick black hair and a shaggy moustache; Petti, slender and a bit frail, with a sweet face and a girlish smile. Each already had one child-Reid a son named Shay and Petti a son named Cameron. Now both wanted another child, and both wanted a girl. “From the minute I found out I was pregnant, I started calling it she,” says Petti. “If someone bought me a baby gift for a boy, I’d take it back.”
Chelsea Ann was born at 12:01 p.m. on June 16, 1981. She was about four weeks premature, and the delivery was difficult; the placenta tore early, and Petti bled heavily before she arrived at Sid Peterson Hospital. Shortly after birth, Chelsea showed evidence of hyaline membrane disease, a respiratory problem caused by underdeveloped lungs, usually found in premature children. A helicopter ambulance took her to the Santa Rosa Medical Center in San Antonio, and she was put on a respirator in the neonatal ICU.
At Santa Rosa, Chelsea improved steadily. On July 5, after 21 days in the hospital, she was eating well and breathing on her own, and her weight had climbed to four pounds, six ounces. Her parents took her home. With Chelsea out of the hospital, Petti went to her gynecologist and had herself sterilized by tubal ligation.
On May 6, 1982, Petti brought Chelsea back to the Santa Rosa emergency room. She was feverish and on the previous night had experienced what Petti described to hospital personnel as two “breath-holding” spells. Petti says one occurred when one of Chelsea’s brothers knocked her down; she briefly stopped breathing and turned blue. After dinner, Chelsea began vomiting and lost her breath a second time, Petti says, until she blew air into her daughter’s mouth. Chelsea, then ten months old, remained at Santa Rosa until May 11. She was treated for pneumonia, but an assortment of tests turned up no evidence of seizures or a breathing disorder. “I would just caution the parents to observe her closely,” wrote one doctor who examined her there. “Her growth and development have been amazingly fine for her age, and I don’t think there is any reason to suspect she is going to be slow in the future.”
The McClellans took Chelsea back to their mobile home in Ingram, six miles west of Kerrville, where they had moved by that time, and lavished attention on her. She developed a spoiled child’s temper, but she was attentive and curious. She followed the large world around her closely with her blue eyes, and when someone caught her staring, she would laugh and break into a wide, coy smile. “She was a beautiful kid,” says Genene. “God, she was beautiful.”
CHELSEA McCLELLAN: THE BEGINNING
Tuesday, August 24, 1982
Dr. Holland had opened her office on Monday, and Chelsea McClellan was her second patient. Petti says she called in the morning to make an appointment and spoke to Gwen Grantner. Holland says Gwen told her Petti was worried about Chelsea’s “erratic breathing” and that when Chelsea arrived in the waiting room, she had a bluish tint around her mouth. But the McClellans say they never described any breathing problems to Holland, Genene Jones, or Gwen Gartner—then or later. “There wasn’t a damn blue thing about Chelsea,” says Petti, “except her eyes.” She took her daughter to the doctor, she says, because Chelsea had the sniffles. On the patient information form she filled out in Dr. Holland’s waiting room that day, Petti listed the reason for the visit as “bad cold.”
Petti and Chelsea arrived at the clinic about 1 p.m., and Dr. Holland led mother and child to her private office, in the back of the suite. As Holland began to ask Petti about Chelsea’s medical history, the little girl started pulling things off Holland’s desk. “Why don’t you let me take Chelsea and play with her so you can talk?” Genene suggested. She picked the child up and took her out of the office.
The summons came five minutes later: “Dr. Holland, would you come here?” Holland excused herself, closing the door behind her, and walked back to the treatment room to find Chelsea limp on the examining table and Genene fitting an oxygen mask over her face. Genene later said that she had been playing ball with Chelsea in the receptionist’s area and the child had suddenly slumped over. But now there was no time to ask questions: Chelsea wasn’t breathing. Genene began pumping oxygen into her lungs with a respiratory bag, and she and Holland started an IV in her scalp. Chelsea began seizing; Holland ordered 80 milligrams of Dilantin, an anticonvulsant drug. They called the Kerr County Emergency Medical Service (EMS). Chelsea’s mother had no idea what had happened until Holland returned to her private office to tell her. “Your daughter’s just had a seizure,” she said. Holland told Petti to stay put, but she followed the doctor into the hall and looked inside the treatment room as Holland went back in. Chelsea was sprawled on the examining table, Genene hovering over her. “I could see her little legs,” says Petti. “She was laying there, real limp.”
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