Angel of Death

Just about everybody in the two-stoplight town of Nocona knew Vickie Dawn Jackson, the sweet, soft-spoken nurse who worked nights at Nocona General Hospital. Vickie had been a nurse or a nurse’s aide since she was a junior in high school. Over the years, she had bathed Nocona’s residents, fed them, inserted their catheters, given them their medications, ban­daged their wounds, and sat by their beds, holding their hands when they were aching from pain.

She owned 25 nurse’s uniforms, all of which she kept pressed on hangers in her bedroom closet at her house on the poor side of town. When she went to the local Dairy Queen, an hour or so before her shift began, she would almost always be dressed in one of her uniforms. Her hair, which she dyed herself at her kitchen sink with Lady Clairol Pale Blonde, would be neatly brushed and pulled back in a little knot on the top of her head—Vickie believed it was important that a nurse never let her hair get in the way of her work—and because she also thought that patients liked nurses who smelled good, she would be wearing a dab of Charlie on her neck, which she’d buy on sale at Wal-Mart.

“Hi, y’all,” Vickie would politely say to the teenage girls working behind the counter. She would usually order a taco basket (two tacos, onion rings, and a small salad), and as she’d walk through the main dining room, she would shyly smile at customers who had once been her patients. She would eat by herself in one of the back booths, and when she was finished, she would carefully wipe the crumbs off her table with a napkin, throw away her trash, walk outside to her beige four-door Buick, and make the four-minute drive to Nocona General, a one-story brick building on the southwest side of town.

Nocona General was one of the smallest hospitals in the state. On any given day, there would rarely be more than fifteen patients there, scattered throughout eighteen rooms on a single hallway. At the beginning of her shift, Vickie would make a point of visiting all the patients, introducing herself as Nurse Vickie and telling them that if they needed anything, anything at all, just to let her know. She’d regularly check on them throughout the night, and during her breaks, she’d often read a nursing textbook.

She was, by all accounts, a most dedicated professional. “She received compliments as a caring person,” said Barbara Perry, the hospital’s director of nursing. “She did everything that was asked of her,” added another nurse who worked with her, “and she never seemed upset about what she had to do.”

On December 11, 2000, however, Vickie, who was then 34 years old, decided to make a slight change in her work routine. She filled a syringe with mivacurium chloride, a drug that paralyzes the respiratory system, and she began walking up and down the hospital’s hallway, looking for a patient to murder.

You no doubt know all about Henry Lee Lucas, the one-eyed drifter who wandered through the state, brutally murdering women. You know about Kenneth McDuff, the small-town bully who was twice sent to death row for his vicious slayings. You probably remember Angel Resendiz, the Mexican vagrant who rode on freight trains, hopping off in various towns and cities so that he could bludgeon unsuspecting victims to death.

And now, into that pantheon of Texas monsters comes . . . Nurse Vickie. From December 11, 2000, to February 18, 2001, according to law enforcement officials, Vickie murdered ten patients at Nocona General Hospital, most likely killed another ten, and attempted to murder five more. As opposed to other nurses who have been caught doing away with patients, Vickie was not a mercy killer. She didn’t target those who were terminally ill or suffering from severe pain. Nor was she one of those emotionally disturbed nurses who are so desperate to win approval from co-workers that they put patients into medical distress so they can later be found heroically attempting to revive them. “She didn’t try to save anyone at all,” said Kevin Benton, an investigator with the Montague County district attorney’s office. “She wanted people dead. Lots of people.”

What was even more peculiar was that almost all of Vickie’s victims were townspeople she’d known, from elderly residents whom she had first cared for years ago at a nursing home and neighbors who’d lived just a few blocks away to parents of friends whom she had known since she was a teenager. One night, she injected mivacurium chloride into a slim, sexy woman her own age who frequented a country-western nightclub that Vickie also went to, and on another night, she injected mivacurium chloride into a bespectacled teenage girl who went to high school with her children.

Vickie even used mivacurium chloride to murder her own husband’s grandfather. Then, in a scene that could have been lifted straight out of one of Flannery O’Connor’s short stories about small-town Southern life, Vickie attended his funeral, bringing along a potato salad for the reception. “I’m so, so sorry,” she said to members of the family, patting their backs and shaking her head sympathetically. “Is there anything, anything at all, I can do for you in your time of need?”

For the past six and a half years, Nocona’s residents have been at a loss to explain why such a meek, mild-mannered nurse, one with no history of violent behavior, would suddenly want to wreak havoc on their town. “I swear to you, this was a nice girl who never uttered a single bad word about anyone, and that’s the God’s truth, pardon my French,” said Richard “Rat” Thomas, one of Nocona’s old-timers who drives his Sears riding lawn mower to the Dairy Queen almost every afternoon. “She looked nice, she dressed nice, and she smiled nice—I mean, real nice. Seriously, now, how could someone be so nice during the day and then do all that killing at night?”

After a nearly endless series of legal delays, Vickie’s trial was finally scheduled to begin this past October. Because of a change of venue, many Nocona residents prepared to caravan out to San Angelo, the West Texas city where the trial was to be held, hoping they would at last hear the full story about what had happened and why. But just before jury selection began, Vickie stood in front of the judge and quietly told him that she wished to plead no contest to the capital murder charges. After a brief hearing, the judge sentenced her to life in prison (prosecutors were not asking for the death penalty), Vickie was escorted away, and that seemed to be that—the mystery of the murders never to be resolved.

But a few weeks later, I received word that Vickie had agreed to see me. She had been reading the newspapers’ coverage of her case, and she wanted people to understand that although she had pleaded no contest, that didn’t mean she was guilty. So I drove to the Montague County jail, where Vickie was waiting to be transferred to state prison, stepped into one of the interview rooms in the visitors area, and saw her behind a sheet of Plexiglas. She was forty years old. She didn’t look good at all: Her hair was dull brown with a few gray streaks, and she had gained maybe thirty pounds since she had first made headlines.

Nevertheless, she gave me an almost timid smile and in a soft voice said, “Hello to you, Mr. Hollandsworth. Did you have a safe trip? I heard there had been some rain, and I was worried you might have had an accident.”

Nocona, population 3,200, is located in cattle country, just south of the Oklahoma border. People often use the word “nondescript” to describe it—“damned nondescript, if you ask my opinion,” one resident told me. Like a lot of small towns, its downtown is largely abandoned. The famous Nocona Boot Company, which was founded there in 1925, is now headquartered in El Paso. Along U.S. 82, the main street in town, there are a handful of small businesses—a grocery store, a couple of gas stations, a feed store, a saddle shop, a bank, a barbershop, and a leather-goods company that makes baseball gloves—and scattered throughout the rest of Nocona are a few churches, a high school, a rodeo arena, and a dusty public golf course right next to the hospital, where golfers on the driving range periodically knock their balls into the hospital’s back wall.

And there is, of course, the Dairy Queen. Because there is so little to do in Nocona, the restaurant regularly receives awards from the Texas Dairy Queen Operators’ Council for having the largest annual sales volume among the more than six hundred Dairy Queens in the state. As a public service, its owner, Guy Hill, has installed a large electronic sign in front that not only flashes announcements about upcoming civic events (“Little Dribblers Basketball Tournament This Weekend!”) but also displays an array of slogans encouraging Nocona residents to lead better lives (“Don’t Major in Minor Things!” “If You Can’t Be On Time, Be Early!” “Drink Upstream From the Herd!”).

“To city people, Nocona might not look like much,” Hill told me. “But it’s a fine community, a fine place to raise a family. I love it here. And until Vickie came along, I thought just about everyone else loved it here too.”

Vickie came to Nocona with her family from Indiana in the early eighties, when she was fifteen years old. They had moved so that Vickie’s younger brother, who suffered from asthma, could live in a drier climate.

They bought a dilapidated frame home on Henrietta Street, on the east side of town. Vickie’s father worked as a shade-tree mechanic; her mother worked double shifts at the Nocona Nursing Home as a cook. To help her parents make ends meet, Vickie also got a job at the nursing home, working after school in the laundry room. During her junior year, she was promoted to nurse’s aide. She dressed and undressed the patients, emptied their bedpans, gave them enemas, bathed them, and turned them in their beds so that they would not get bedsores. Some of the patients, either suffering from dementia or furious that their families had put them in the nursing home in the first place, would scratch her, bite her with their dentures, even spit at her.

“But Vickie wasn’t like other girls who were there just to get a paycheck,” said a nurse who worked with her during those years. “She was always kind to the patients. You could tell she took pride in what she was doing.”

“It always had been my life dream to become a nurse,” Vickie told me early on during our interview, her hands folded neatly in her lap. “Ever since I watched my great-grandmother die when I was a little girl, I thought, ‘I want to devote my life to helping people.’ I read a library book on Florence Nightingale, and I said, ‘That’s who I want to be.’ ”

Obviously, I wondered if Vickie had made that statement only to persuade me to write a more flattering article about her. But according to investigators, she was exactly that kind of girl. She didn’t break any laws during her teenage years, nor did she act in a way that might have suggested she was disturbed. If anything, she was the classic wallflower, a modest and unassuming young woman who dressed in secondhand clothes. “To be honest with you, she was just one of those girls you didn’t really notice when you walked down the hallway,” said Dickie Williams, a burly Nocona native whose father was murdered by Vickie.

It wasn’t that Vickie didn’t try to get noticed. Occasionally, on weekend nights, she’d come home from the nursing home, change into jeans and a tube top, and show up at the car wash next to the Dairy Queen, where the high school kids hung out. “I remember she’d sort of stand there for a while,” recalled Nicole Atteberry, who had a relative murdered by Vickie. “But I don’t really remember her getting in someone’s car and cruising the drag like everyone else did. Maybe no one asked her. I just don’t know.”

One afternoon during her junior year, a construction worker walked up to her at a Nocona game room, where the lonely Vickie sometimes went to play Ms. Pac-Man. His name was Johnny McLaughlin, and he told her she was cute. A few weeks later, she convinced her parents that she was truly in love, and she and Johnny, who was five years older, got married in front of a justice of the peace. To no one’s surprise, they were divorced within a year.

When I asked Vickie about Johnny, she said, looking a little embarrassed, “Oh, it was just a teenage thing. I guess I married him because he was one of the first boys who paid attention to me. But then he told me he was still on the rebound from another girl he loved.”

For a moment—just for a moment—Vickie’s face changed. That gentle look was suddenly gone, and I could not help but wonder what she was feeling. Hurt? Betrayal? After all these years?

“Anyway,” she said, her smile returning—well, a bit of a smile—“it was so, so long ago.”

Vickie moved back to her parents’ home, graduated from high school in May 1984, and went to work full-time at the nursing home. She wanted to save enough money to enroll at a nearby junior college so that she could become a licensed vocational nurse (LVN). But within six months, she was pregnant. Leroy Carson, a young Nocona man who was a self-employed mechanic, just like her father, had paid her some attention. “Leroy told me he loved me,” she said, summarizing their first days together, “and I believed him.”

They married in May 1985 and moved into a tiny house right across the street from her parents. After the birth of her son, Curtis, she quickly became pregnant again and in 1986 gave birth to a daughter, Jennifer. One year later, she began going to nursing school part-time.

She led a hectic life: raising two kids, cooking meals, cleaning house, going to college, and working the night shift at the nursing home. Her problems were compounded when her parents, who had been taking care of Curtis and Jennifer when she was at work, moved back to Indiana to care for her dying grandfather. “Vickie was burning the candle at both ends,” said one of her friends at the time, Nancy Burnett, whose father would also be murdered by Vickie. “She was working so hard she wasn’t getting any sleep. A lot of us told Vickie that she needed to slow down, but she wouldn’t listen. She kept saying she could get everything done.”

In 1989 Vickie became an LVN, and the Nocona Nursing Home’s administrators promoted her to night-shift nurse. She was so devoted to her job that she sometimes took her children along to give the residents “get well” Crayola drawings they had made at home. She liked to have copies of True Story on hand, the romance magazine she bought each month at the grocery store, and late at night, she’d read articles to some of her female patients about women meeting the men of their dreams and living in houses with white picket fences.

At home she tried to make her own marriage feel like something out of True Story. One day she had her hair styled at Kountry Cuts, then one of Nocona’s better beauty salons, and afterward she drove 48 miles to Wichita Falls to have her picture taken at a Glamour Shots. For the photo shoot, she wore a gold lamé jacket and large earrings covered with imitation gemstones, and a few days later, she presented the photo to Leroy.

He wasn’t impressed. In 1994 Leroy moved out, and the couple divorced two years later. According to Vickie, Leroy told her he never would have married her if she hadn’t gotten pregnant. “He told me that I had become a stupid, boring nurse and that no one cared about me,” Vickie said, that same distant look returning to her face.

Vickie, however, refused to give up on her dream of a happy marriage and a house with a picket fence. She began walking around the block, carrying dumbbells in her hands, trying to lose weight so that men wouldn’t say she was “going to fat.” On weekend nights, she got a baby-sitter and showed up with one of her friends, another single mother, at a country-music dance hall not far from Nocona called the Third Spur. She wore jeans, boots, and what she described as “short Western tops,” and she sat at one of the tables near the bar, drinking piña coladas.

But she apparently made little impression on the patrons. “I’m sorry, I don’t remember seeing her,” said Lisa Pelkey, who at the time was one of the more popular women at the Third Spur, largely because of a tight black dress she often wore with a zipper that went all the way down the front. I asked Pelkey if Vickie had looked even the slightest bit familiar back in early 2001, when Pelkey was admitted to the hospital and Vickie came into her room to inject her with mivacurium chloride. “No, I’m sorry,” she said, bursting into tears. “She didn’t.”

In May 1997, after spending an entire evening at the Third Spur talking to no one, Vickie decided that she was going to walk up to the next man who came through the door and ask him to dance. The man was Kirk Jackson. He was 31 years old, five feet three inches tall, a little round, and slightly balding. They sat together and got tipsy—Kirk drank beer, Vickie had more piña coladas—and when Vickie learned that Kirk worked as an aide at a nursing home in nearby St. Jo, she said, dreamily, “This must be fate.” They then danced to a slow Garth Brooks song, Kirk’s hand sliding down to squeeze Vickie’s bottom.

On July 4, two months after they had met, they held their wedding ceremony at a public park out by Lake Nocona. Vickie redecorated her home, buying a new water bed so Kirk wouldn’t have to sleep on the same bed Leroy had. She purchased matching recliners to put in front of the television, and she bought a Chihuahua puppy that she jokingly named Killer because he was so small.

After Kirk was hired by Nocona General Hospital to work the night shift as a nurse’s aide, Vickie also got a job there, as a night-shift LVN, so the two of them could spend more time together. She began taking courses at a community college, telling her children that her goal was to become a registered nurse so that she could have more responsibilities at the hospital, make more money, and someday buy a nicer house.

“I wish you could have seen her back then,” Jennifer, who is now twenty years old, told me recently when we met at the Dairy Queen. “She was still so full of optimism. She still really believed her life was going to work out. Every day she’d put on her nurse’s uniform, she’d do her hair and her makeup, and she’d turn to me and Curtis and use one of these phrases that she got from her self-help books. She’d say, ‘This day is going to be a good day, I promise. We’re all going to have a good day.’ ”

But it wasn’t long before the bad days returned. Kirk had never been married, and on his nights off, he liked to have his friends come over to the house to drink and play cards.

“I said, ‘Kirk, for the sake of the family, you’ve got to stop it. The kids can’t sleep,’ ” Vickie said. “I tried to talk to him about his alcohol use. I tried to talk to him about his role as a husband. And he got mad and called me a bitch. He said, ‘Oh, no, you’re not going to control my life.’ ”

“You could tell she was worried that he was going to leave her,” said Kirk’s mother, Angela, who also worked at the hospital, as a clerk at the nurses’ station. (Kirk declined to be interviewed.) “She didn’t like the way he flirted with the prettier nurses. Sometimes, she’d go stand by herself at the end of the hall, trying not to cry. She’d say to me, ‘I can tell Kirk doesn’t love me. I can tell.’ ”

In late 1999, unable to handle the escalating tension between his mom and Kirk, Curtis packed up and moved in with Leroy; a few months later Jennifer did the same. It was during this time that Vickie possibly made her one cry for help. She went to see a counselor at a public mental health center in the nearby town of Bowie.

Wearing her nurse’s uniform—she didn’t want to be late for work in case her sessions ran long—she would sit on a chair and talk. According to the counselor’s notes, Vickie admitted she was deeply depressed and felt “rejected and unloved.” She also said she was going through mood swings. “Tearfulness alternating with episodes of irritability and rage” was the way the counselor put it. “She was unable to recall what she might have liked to do for fun,” the counselor added to her notes.

The counselor no doubt had seen many women just like Vickie: worn-down, small-town wives stuck with bad husbands. Apparently, she did not find Vickie’s statements all that alarming. After a second session, in which Vickie said she was worried that Kirk was having an affair, the counselor simply recommended that Vickie read the book Adultery: The Forgivable Sin.

But Jennifer, who was then fourteen, soon realized that something else was happening to her mother. “When I’d see her on the weekends, she would be sitting on the little steps outside of our front door, staring at nothing, or she’d stand at the kitchen stove, stirring things in a pot, her mind a million miles away,” Jennifer said. “One day, when she was standing at the stove, she suddenly turned around and kicked Killer the Chihuahua, which she had never done before.”

And then came the weekend visit in which Vickie told her she had been seeing a counselor. Vickie revealed that she might be bipolar. “I asked Mom what that meant, and she said, ‘It means I could kill you and get away with it.’ ”

Jennifer, a slim young woman with short dark hair, pressed her lips together, as if to keep them from trembling. “I didn’t know what to say,” she finally said. “I mean, I don’t think she was talking directly about killing me. She was my mom. But still, I felt something, you know what I mean? I felt like something was crumbling inside her.”

She paused. “The next time I went over there for the weekend, I started sleeping with a baseball bat beside my bed.”

During my interview with Vickie, when we talked about this time in her life, I asked her, as gently as I could, if she had been feeling despondent that her third marriage was falling apart and that her children had left her. Not only that, she was having to pay for the loss: After Curtis and Jennifer had moved back in with Leroy, he had gone to court, claiming that he now deserved child support. A judge agreed, ordering Vickie to pay her ex-husband $300 a month.

Vickie immediately sensed where I was going. “Oh, I was just fine, Mr. Hollandsworth,” she said. “I wasn’t so upset that I would want to kill anyone. I would never kill anyone, Mr. Hollandsworth. I’m a nurse. My duty is to care for people. I promise you that killing is something I couldn’t do.”

But at another point during our interview, when we were chatting casually about life at the hospital, I happened to ask her if she had ever come across anyone she had known from her days at Nocona High. Vickie began telling me a story about seeing two women who had been cheerleaders. She said they lived in a neighborhood that Nocona’s poorer residents referred to as Snob Hill. The two women had come to the hospital to see one of their mothers, who was a patient, and as they stood by the bed, Vickie came in to check on the IV. “They never looked my way,” she said. “But I changed the IV bag and took care of my patient. That’s my duty.”

There was a silence, and then, to my surprise, the same cold look returned to her face. “It would have been so easy for them to have said hello or thank you,” she quietly said. “But they looked right through me.”

I stared at Vickie, wondering if she had just given me another clue about what had happened to her that year. By then, she had spent almost two decades taking care of Nocona’s residents, working her fingers to the bone for them, fluffing their pillows, fixing their medicines, cleaning up their vomit, and always reminding them, as they drifted off to sleep, to dream sweet dreams. When it was time for those patients to leave the hospital, she had helped them to their cars and then stood in the parking lot, waving good-bye.

Yet most of her patients and their families were just like the cheerleaders: They looked right through her. Indeed, during my visits to Nocona, when I asked townspeople about Vickie, they told me that although they knew who she was, they knew very little about her. For them, Vickie was just Nurse Vickie, the quiet wallflower from Henrietta Street who wore the cheap perfume.

Was it possible that Vickie, in her depressed state of mind, had begun to resent those people? Had she begun to brood over the fact that they got to have such good lives, in some measure because of her service to them, and she barely got to have any life at all?

And was that why, on December 11, 2000, Vickie filled a syringe with mivacurium chloride and walked into the room of a one-hundred-year-old widow named Donnie Jennings, the matriarch of one of the town’s pioneer families?

Jennings was known to be an imperious, demanding woman who was not happy when she did not receive enough attention. “She complained a lot, and she’d spit on you and strike you with her hand if she didn’t get what she wanted,” Vickie said about Jennings, whom she had met a decade earlier at the Nocona Nursing Home. Then, as if realizing she might have given something away, Vickie added, “But I liked her very much.”

Or did she? Maybe Vickie had gotten sick and tired of having to deal with the widow Jennings, who had been admitted to the hospital because of constipation and dehydration. Maybe she was equally fed up with the members of Jennings’s family, who never took the time to say much at all to her.

Mivacurium chloride is used by doctors to momentarily paralyze a patient’s respiratory system so that an oxygen tube can be inserted into the trachea. As soon as oxygen starts flowing, the effects of the drug quickly wear off. But if the dosage is high enough, and if no tube is pushing oxygen into the lungs, then the drug is deadly.

Vickie probably used a portal in Jennings’s IV to inject the mivacurium chloride. The drug ran through a tube into her arm, and within seconds, she was having trouble breathing. Soon she was turning blue and foaming at the mouth. She tried to cry out for help. But because her paralyzed lungs were unable to suck in any oxygen, she could make only a faint, gasping noise—before she suffocated to death.

A nurse’s aide found Jennings at 1:45 a.m. Although it seemed odd that she would simply stop breathing—when she was last checked at midnight, her vital signs had been normal—her death wasn’t considered remarkable, because of her age. Vickie, standing by the nurses’ station, stepped forward and said that she knew the family and would call them with the news.

“But I just saw her earlier that night,” Juvine Foster, one of Jennings’s daughters, said when Vickie called. “Mama smiled at me!”

“Oh, Juvine, life can be so hard sometimes,” Vickie said, her voice as buttery as a biscuit. “I personally know so well how hard it can be. Juvine, I cannot tell you how sorry I am for your loss.”

It’s possible that Vickie had no grand plan to murder her patients. Maybe, at that point, she hadn’t completely lost her mind but had only lost her temper. In a moment of anger, she had decided to shut up the widow Jennings, and that was going to be the end of it—a simple, one-shot deal. But perhaps, after Jennings’s body was wheeled away, another feeling came over Vickie. She knew what she had done was wrong, but now that it was over, it was, well, exhilarating. After all those years of performing acts of mercy, there was something overpowering about committing an act of vengeance.

In the early hours of December 20, Vickie walked into the room of an 87-year-old farmer named Elgie Hutson, who had been admitted to the hospital with a broken leg. She pulled out a syringe and injected him with mivacurium chloride. Less than twenty minutes later, she walked down to the other end of the hallway and injected mivacurium chloride into Sanford Mitchell, a 62-year-old retired supervisor for an electric company who had been admitted for cirrhosis. She then walked back into Hutson’s room, where nurses were gathered around his bed, frantically trying to save him, and said, “Y’all, someone needs to check on Mr. Mitchell. He’s slumped over.”

Four days later, on Christmas Eve, she went after 50-year-old Barbara Atteberry, who had come to the hospital for back pain, and later that day, she did away with 87-year-old Boyd Burnett, who had been brought into the hospital because he felt disoriented.

Five days after that, on December 29, she killed 80-year-old James Gore, who had been admitted to the hospital because he aspirated some food, and a mere seven hours later, she got rid of 79-year-old Gertie Matthews, who had been admitted to the hospital because of dementia and a urinary tract infection. As nurses tried to revive Gore and then Matthews, Vickie stood in the back of each room and watched, saying very little.

In the month of December alone, seven patients from Nocona General died after going into respiratory arrest. None of them had had any history of serious respiratory problems. Two patients had suddenly stopped breathing within minutes of each other—an event unheard of even in larger hospitals. How could the doctors not have suspected something bizarre was taking place?

Yet Dr. Chance Dingler, one of the handful of physicians who worked at the hospital—his brother, Dr. Len Dingler, was chief of staff—later said in a civil deposition that he “assumed” the hospital was “just having a run of bad luck.” In another deposition, the hospital’s CEO, Charles Norris, said he didn’t believe “anything abnormal” was taking place because almost all the patients had been elderly. Furthermore, he said, older patients tended to die more frequently during the winter months.

Incredibly, the doctors and administrators didn’t even get suspicious when five more patients died after going into respiratory arrest during the first eight days of January. The administration, in fact, was so happy with the way things were going that it approved an advertisement, nearly a full page in size, that began running in the Nocona News. It featured all the hospital’s nurses and nurse’s aides.

“Nurses are some of the many stars who offer quality, compassionate care at Nocona General Hospital” read the first line of the advertisement. And who was placed at the very top of the ad? It was Nurse Vickie, smiling pleasantly, her blond hair pulled back in a little knot.

By mid-January Vickie was growing bolder. One night she injected mivacurium chloride into Jimmy Ray Holder as his wife sat beside him. She then went after another patient, 95-year-old Oma Wyler, twice. The first time she injected her, other nurses found Wyler still breathing and were able to resuscitate her. Four days later, Vickie slipped back into Wyler’s room and injected her again, this time killing her.

Maybe the doctors weren’t perplexed by the deaths, but people in town certainly were. Tracy Mesler, the editor of the Nocona News, told his wife, Linda, who sold all the ads, that he had never before had to run so many obituaries: He was up to five or six a week, instead of the usual three or four. The owner of one of the town’s floral shops mentioned to a friend that she was doing nearly record-breaking business selling arrangements to mourners, and the directors of the town’s two funeral homes—one catered mostly to Baptists and Methodists, the other to everyone else—were having such a banner year that they started talking about buying new hearses.

About the only Nocona business that was taking a hit from all the deaths was the Dairy Queen, which always sent paper plates and cups to the homes of anyone who died so that they could be used for the post-funeral receptions. “I began thinking, ‘If this dying doesn’t slow down, we’re liable to run out of paper products,’ ” said Sandra DeMoss, who was then the Dairy Queen’s manager.

In truth, a few nurses at the hospital were befuddled by the deaths. A couple of them jokingly, but a little uneasily, started calling the night shift the “killing crew.” One nurse did find it odd that Vickie was the last staffer whom several of the patients had seen before dying. Another nurse also found it odd that instead of calling from the room, Vickie had rather casually walked up to the nurses’ station a couple of times to announce that she had noticed that a patient was having trouble breathing.

And Donna McIvor, one of the RNs on the night shift, noticed that whenever patients were acting rude or unruly, Vickie, her eyes looking “glazed over, as if in a fog,” would be the first one to head toward their rooms, saying, “I’ll take care of it” or “I’ll fix it.”

Perhaps if the nurses had known more about Vickie’s relationship with some of the patients who had died, they might have put two and two together. Barbara Atteberry and Boyd Burnett, for instance, had family members who used to make fun of Vickie during their days together at Nocona High School. Sanford Mitchell used to stare at her breasts and call her Nurse Tits. Elgie Hutson’s son, who was an EMT at Nocona General, worked part-time as a minister at a small evangelical church. Periodically, when he wasn’t on call, he would hunt down Vickie and blithely tell her that all her personal problems would be resolved if only she would be born again.

And, if they had known all that, the nurses might have been far more curious about the very strange events that occurred on the night of January 11. Only three hours after a nurse found a dead pneumonia patient, J. T. Nichols, a retired 82-year-old machinist who over the years had helped out some younger Nocona women by lending them money, another nurse found a dead John Williams, a retired 78-year-old rancher and oilman who was in the hospital because of a sore on his foot. Vickie stood right by the front door of the hospital, waiting for Williams’s family to show up. Among the first to arrive was Pat, Williams’ son, a strapping maintenance supervisor for a pipe-manufacturing facility. In her younger days, Vickie used to moon over Pat, who, like his brothers, ignored her. When he got to the hospital, Vickie walked straight up to him and said, “Pat, I’m so, so sorry for your loss. I know how you must feel.”

“She then told me she had taken Dad outside earlier that evening and let him smoke a cigarette and that Dad had said to her that he had lived a good life and was ready to go,” Pat later recalled. “I thought, ‘Dad wasn’t even that sick. Why would he have said that?’ Then she took me and my brothers into the room to see Dad. And I’ll never forget that scene for as long as I live. Vickie hadn’t fixed him up at all. His cheeks and eyes were sunk in, and his mouth was open, like he had been screaming. He looked like a ghoul in a horror movie.”

In the end, however, none of the nurses could make themselves believe that Vickie was somehow involved in killing patients. And why should they have? This was, after all, gentle, caring Vickie. According to Barbara Perry, the hospital’s director of nursing, throughout all of 2000, the hospital had not received a single complaint from a patient about Vickie’s personality or her nursing skills—not one.

But then, on January 30, all hell broke loose. That night, Vickie injected mivacurium chloride into the IV of 82-year-old Orvel Moore, a feisty former ranch hand who a day or so earlier had called Vickie a “fat ass.” Minutes later, she walked down the hall and entered the room of a 14-year-old girl, Lydia Weatherread, who was in the hospital with appendicitis. Lydia knew Vickie’s children: According to school gossip, she had recently turned down Curtis for a date.

“Hello, Lydia,” Vickie said as she injected mivacurium chloride into her IV, telling her the medication was a pain reliever. Vickie walked out of the room, and almost immediately, Lydia told her mother, who was sitting beside her, that her chest hurt. Suddenly she couldn’t speak, and she began scratching at her throat with her hands. Lydia’s mother started screaming, and a doctor who had been called to the hospital because of Moore’s respiratory arrest rushed into Lydia’s room with other nurses and quickly revived her.

One day later, Vickie went after two more patients. Right before the seven a.m. shift change, she injected mivacurium chloride into a 46-year-old woman named Donna Curnutte. While she was still conscious, Curnutte was able to reach her nurse’s button and whisper, “I can’t breathe. I’m having a reaction.” As a doctor and nurses raced into her room, a staffer shouted that another patient had gone into respiratory arrest. It was 35-year-old Lisa Pelkey—the same Lisa Pelkey who frequented the Third Spur. The doctor and nurses got to Pelkey in time to intubate her before there was any brain damage. Curnutte, however, never regained consciousness and died a few weeks later.

By now, the hospital was in an uproar. Four respiratory arrests in two days? What was happening? Then, a technician from the hospital’s pharmacy walked up to chief of staff Len Dingler and asked him if it was important that vials of mivacurium chloride were missing from one of the crash carts.

After reviewing their records, the hospital’s administrators learned that Vickie was not only working at the time of every respiratory arrest but that she was often the last staffer who had been seen checking on the patients who had died. While they were deciding what to do with her—at that point, they had no legal cause for firing her—they made a huge mistake. Inexplicably, they didn’t order anyone to keep an eye on her. And Vickie was given the chance of a lifetime to take out her revenge on her husband.

Kirk’s grandfather E. E. “Preacher” Jackson, a 91-year-old former cotton farmer, was admitted to the hospital because he had a high fever and cellulitis. On February 4 Vickie slowly walked up to the nurses’ station and in a quiet voice said that she believed Preacher Jackson was dead. She then told Kirk, who went outside and wept.

Two days later, Charles Norris, the hospital’s CEO, met with the town’s young police chief, Kent Holcomb, to talk about the deaths. Holcomb called the Texas Rangers and the FBI. When the law enforcement agencies realized that they didn’t have a shred of physical evidence that proved that Vickie was murdering patients, they set up a hidden camera aimed at a supply of mivacurium chloride, hoping they could catch Vickie stealing some vials. To keep Vickie from learning about their investigation, they also asked the hospital’s administrators and doctors not to reveal anything about what they were doing.

As a result, life went on as usual. In mid-February the night-shift staff even threw a birthday party for Vickie and her mother-in-law, Angela. They had a potluck supper and cake, and Vickie and Angela received candles, body lotion, and teddy bears. Vickie stood there, holding her teddy bear, telling the other nurses, “Thank y’all. Thank y’all. Y’all don’t know what this means to me.”

A couple days after the birthday party, one of Nocona’s best-known residents, 61-year-old Donnelly Reid, was admitted to the hospital for post-polio syndrome. He received some medication, quickly felt better, and prepared to return home. But in the early-morning hours of February 17, Vickie showed up at the nurses’ station and said, “You better go check on Mr. Reid. He is making a snorting, horselike sound.”

A doctor and other nurses were able to resuscitate Reid, and when they asked what had happened, he said a blond-haired nurse had come in and put something into his IV. She had then smiled and said, “Can I do anything else for you?” Before she was out the door, Reid said, “I felt like a spring was uncoiling in my head. I couldn’t breathe.”

Two days after the attack on Reid, law enforcement officers discovered a syringe in a garbage can at Vickie and Kirk’s home. Tests later proved that it contained traces of mivacurium chloride. When they interviewed Kirk, he said he had “no clue” how the syringe had gotten there. In a separate interview, Vickie said the same thing. With an earnest expression on her face, she insisted she was genuinely shocked that patients had been murdered. If there was foul play, she added helpfully, she could think of a number of staffers who might have been responsible, but for the time being she didn’t want to point fingers.

The next day, the hospital’s administrators fired both Vickie and Kirk. (Although no one believed Kirk had anything to do with the killings—as a nurse’s aide, he was not allowed to handle medication, and he had not been working when a couple of the murders had taken place—Norris said his termination was in the “best interest” of the hospital.) And it wasn’t long before the Dairy Queen was buzzing with the news that Vickie was under investigation for murder.

“You could have knocked us over with a feather,” said one Dairy Queen regular, retired Nocona rodeo cowboy and ranch hand Tom Hancock, who always wears spurs when he goes to the restaurant. “A lot of people came in and said she must have snapped, just like one of those women you see on TV who all of a sudden go from normal to flat-out crazy without ever taking the time to pause at peculiar. But I had trouble thinking that myself. I said to everyone, ‘Hold on, partners, the killer might still be out there.’ ”

Amazingly enough, Vickie didn’t go into hiding. She remained at her house on Henrietta Street, and she continued to show up at the Dairy Queen to order her taco basket. As she would walk to her back booth, she’d smile at the stunned diners just as she always had, telling anyone who asked that she had had nothing to do with the murders.

One afternoon, she even ran across Pat Williams, whom she had last seen at the hospital the night she killed his father. “How are you, Pat?” Vickie asked congenially. “It’s so, so good to see you.”

Williams was speechless. “I promise you, if a man who was suspected of murdering my daddy had come up and said hello, I’d have thrown him through a plate-glass window,” he told me. “But it was Vickie, looking all proper and whatnot. I went back out to my truck in the parking lot and called my wife and said, ‘Honey, good Lord Almighty, Vickie said hello. What do I do?’ ”

No one seemed more confused over the turn of events than Kirk. Although he admitted to his friends and to police investigators that Vickie had not been happy with the way their marriage had turned out, he said he could not imagine that she was so unhappy that she would want to kill people. (“A marriage can’t make a woman all that crazy, can it?” he asked his mother.) Eventually, however, he packed up and left town, telling Vickie he was having trouble sleeping. Apparently, he had been having nightmares about her stabbing him with a needle.

As soon as he was gone, Vickie returned with a friend to the Third Spur one night, wearing one of her short Western tops. This time around, some of the cowboys asked her to dance. Maybe they danced with her because the good-looking Lisa Pelkey was no longer there. (Pelkey had completely recovered from her attack and moved to the Northwest, where, she later told me, she had stopped drinking and begun attending church regularly—“My way of saying thank you to God for not letting me get murdered,” she said.) Or maybe they danced with Vickie because they someday wanted to be able to tell their grandchildren that they had two-stepped with a serial killer.

Regardless, none of it seemed to matter to her. “She smiled and smiled that night,” said her friend. “She really acted like she didn’t have a care in the world.”

Perhaps she was smiling because she really was innocent. Or perhaps she was smiling for a different reason altogether. For the first time in her life, she wasn’t being ignored or slighted. She was being noticed.

Before they could arrest Vickie for murder, police investigators had to be able to prove that patients had been killed. That meant they had to get a court order to exhume the bodies of those patients who had suffered respiratory arrests and then perform autopsies to determine if those bodies contained mivacurium chloride.

The exhumations did not begin until June 2001. By then, many of the families had already hired lawyers to sue the hospital and its doctors for negligence. One man who sued—Harry Don Reid, the son of Donnelly Reid—lived right across the street from Chance Dingler. The two nearly got in a fistfight after Harry Don shouted across the yard one day, “You let that crazy nurse run around in your hospital and you didn’t do a thing to stop her!”

Lydia Weatherread, the teenage girl who had been in the hospital with appendicitis, not only sued but also wrote a paper for her high school English class about her near-death experience. She later told me she was thinking about going to nursing school. “After what I’ve been through, I’ve decided we could use some better nurses,” she said.

Meanwhile, as the months passed, Vickie still acted as if she had done nothing wrong. She even went so far as to get a job as an LVN at a nursing home in Gainesville, just east of Nocona, telling the administrators, who obviously did not check references, that she loved working with older patients. But she was fired within a few weeks after the administrators suspected her of attempting to steal medication.

Finally, in July 2002, Vickie was arrested at a grocery store in Bowie, where she had gotten a job in the deli department fixing sandwiches. The shocked deli manager told a local newspaper, “They have the wrong person. She was delightful and loved telling funny stories.”

For reporters around the state, the story seemed too good to be true. Soon they were racing to Nocona, hoping to get Vickie to talk. But she refused all requests for interviews. At the Montague County jail, she spent her time reading issues of True Story and watching ER, and she also read the Nocona News’ coverage of her case, where she was regularly referred to as the “Angel of Death.”

She did become friends with a couple of female inmates, telling them that she was a loving nurse who would never hurt anyone. But according to an affidavit one of those inmates would later give to the district attorney, Vickie’s lawyer sent her a package filled with evidence that would be used at her trial. Included in the package were the autopsy photos that a medical examiner had taken of all the exhumed bodies. The inmate had said to Vickie, “How terrible it must be for the families of those who were killed.”

Vickie looked at her and suddenly let the other side of her personality come through. “Screw those families,” she said.

One year passed as the lawyers prepared for trial, and then another, and another—and then came the surprise plea. When reporters asked Vickie’s attorney, Bruce Martin, why she had pleaded no contest, he said that Vickie had told him it was important to her that a jury never find her guilty of murder. “She has never admitted guilt, and she was never convicted by a jury,” Martin said. “Those things meant something to her.”

It was a baffling statement, and it only set off another round of debate back at the Dairy Queen. If Vickie adamantly refused to admit that she was guilty of murder, why would she plead no contest to the murder charges and willingly accept a life sentence in prison? Had all her screws come loose? Was she so completely insane that she should be sent away to a mental institution instead of prison?

Apparently, no one brought up the possibility that Vickie had refused to plead guilty because she simply didn’t feel much guilt about what she had done.

During my first visit with Vickie, I did everything I could to get her to confess. Yet she kept telling me, over and over, that she was not a monster and that she felt sorry for all the families who had lost loved ones.

I visited her a second time, and I had her call me collect from jail on several occasions. She never changed her story. She also mailed me a number of letters politely reminding me that she hadn’t murdered anyone. At the end of each letter she asked me to pass on her best wishes to my family, and she always signed each letter, “Respectfully, Vickie Jackson.”

In April I went to see her for the last time. She had been transferred to a state prison outside Waco, and she came out in an all-white uniform. Her hair was neatly brushed, and she had some makeup on her face. For a few minutes, we caught up on her family. We talked about Curtis, who was still living in Nocona, doing part-time work, and we talked about Jennifer, who was joining the Navy.

We went over a few more details about what had taken place at Nocona General so many years ago. Vickie could sense that I didn’t believe one word she was telling me. But instead of having a dramatic confrontation where I called her a liar and a killer, I told her that her younger sister had sent me a letter. I read part of the letter out loud. “Vickie is a remarkable individual,” the letter began. “She shows compassion and concern for all types of people, with no regard to their background. She chose to begin her nursing career so that she could share that compassion and concern on a daily basis with people.”

There was another of those long silences. Just as she had at the county jail, Vickie stared off at a spot on the wall behind me. But there was one significant difference. For the first time since I had met her, Vickie blinked back tears. “I was a compassionate person,” she said, her voice so soft that I had to lean over the table to hear what she was saying. “I spent my whole life trying to be good. Did anyone in Nocona tell you that? That I did everything I could to be a good nurse and a good person?”

She was about to say more, but to my disappointment, she caught herself. I realized that was about as close to a confession as I would ever get: Vickie, for a few moments, talking about the girl she used to be.

We spoke for a few more minutes, and then a prison official told me it was time to leave. I stood up and wished Vickie luck. “Prison can be a lot rougher than a county jail,” I said.

“Well, real soon, they’re going to let me go outside with the other inmates to work in the fields and pick vegetables,” she replied. “And they have a nice medical infirmary here.”

“An infirmary?” I asked.

“A nice one,” she said, her face brightening. “Maybe someday they’ll let me work there.”