Crime Library: Criminal Minds and Methods

Efren Saldivar: Hospital Executioner

The Development of a Psychopath

Saldivar was born in Brownsville, Texas, on September 30, 1969. Apparently his mother, who lived in Mexico, wanted her children to be U.S. citizens, so she went into Texas to give birth. It's not unknown and every border state faces the dilemma of treating nonresidents who come in seeking better medical care than they can get in Mexico. It's not illegal, but it drains American resources. Before he even had any awareness, Saldivar had a role model in his mother of exploiting others for her own gain and of acting with little regard for medical protocol.

His father, Alfredo, then moved his wife and two sons to Los Angeles in search of a job as a handyman. Efren's mother, Isaura, worked as a seamstress. She was a Jehovah's Witness and she raised her children to learn the faith and to spread it to others. They could get to heaven, they were told, only by piling up brownie points through their good deeds.

Efren applied himself in school but worked below his abilities. Teachers liked him because he had an extroverted personality. Then he began to observe the kids in gangs. They looked so cool and full of a form of personal power that he himself never felt. He desperately wanted to be a member. They were in high school and he was in junior high, so that was out of the question. Then to his disappointment, he got to high school, but all those cool dudes were gone. In fact, he didn't really fit in with anyone, not the jocks and not the scholars. He played in the band, and at 170 pounds, he was large and awkward, conspicuous in ways that he disliked.

Girls didn't seem attracted to him, at least not the ones he wanted, but he would become obsessed with them anyway. He'd risk ridicule by sending them intimate notes. Despite being outgoing, he had a shy side, so rejection was painful. He remained fairly withdrawn and stayed close to his family.

Saldivar had no life goals to speak of. He might go to college or enlist in the military. His plans were vague, with no real sense of direction. He didn't want to start a business or work for himself and he did not want to work around other people. As soon as he did get a job, which was in a supermarket, he acted irresponsibly. It was just a menial job with no future, but he'd steal things from the store for other guys.

In the meantime he was not keeping up with his grades and he ended up flunking out in his senior year, so he did not graduate in 1987 with his class. He stayed at the supermarket and decided to just do that. It was good enough.

Then he saw a friend in a uniform who was enrolled in the College of Medical and Dental Careers in North Hollywood. He wanted to look as good as his friend did. He had no particular medical aspirations but that kind of employment seemed better than working all his life at a grocery store. He took a high school equivalency test to finish his degree and then enrolled in the technical school himself in 1988. In less than a year, he had his certification, and a job waiting for him close to home. He was 19, uniformed, and ready to enter the working world. He had no interest in work as a caregiver. He saw himself as a technician. Eventually he hoped to work on the night shift when there would be less people around.

Part of his job was to learn to use a stethoscope and to put needles into arteries. He had to determine if patients were having difficulty breathing and if there was enough oxygen in their blood. His job also included respiratory rehabilitation and putting tubes down patients' throats when they couldn't breathe well on their own, especially during a Code Blue emergency. He placed people on ventilators that had to be monitored and adjusted. He had a lot of responsibility. Saldivar also did his homework. He knew a lot about drugs and computers, and he had a reputation for being able to talk with doctors about these things.

He quickly developed a real knack for the work, partly because he enjoyed talking with patients as they waited for some medication to activate and help them breathe better. They would tell him all about themselves and thank him for his help. Eventually he went on the "graveyard shift" at night. Just as he'd hoped, he ended up working pretty much on his own, without supervision or much accountability. During that time, there was only one other technician like him in the hospital. Their patients were scattered so they might work all night and rarely see each other. The work wasn't difficult, emergencies were few, and Saldivar was even able to offer his services part-time to other area facilities. It's likely now that they regret hiring him, but they were short-staffed and he had said he was working overtime to help pay expenses for his family.

To all who knew him, he seemed like a competent, responsible guy who was a bit awkward with women but always willing to do a favor. He even still lived with his parents and he had bought his mother a car. It was difficult for many to see how his perspective was becoming warped. For a while he took Zoloft to ease a longstanding depression, but then he stopped. That may have been a mistake.