Crime Library: Criminal Minds and Methods

Charles Cullen: Healthcare Serial Killer


While people argue over whether Cullen murdered from "pure" motives like compassion, there are indicators that support the likelihood that he gained something for himself from killing patients. People may sometimes reveal things about themselves despite that they may be saying. Let's look at some of his behaviors.

  1. Cullen's agreement to be interviewed by detectives without an attorney, coupled with his quick and shocking confession, suggest that he wants the full extent of what he did to be known: it may be that, having been caught, he wants to show how clever he was (similar to the home break-in when he called the victim to let her know what he could do). The length of the initial interview — seven hours — also affirms this, as does how much often repeats information about his state of mind and his circumstances. He betrays a "poor me" attitude.
  2. His claim, "I didn't intend for these people to suffer," may well be true, but he fails to actually view them as people. He never asked, never considered what they might have wanted. They were instrumental to his ends. Abusers often have been abused. It may be safe to say that his idea that he wanted to spare them from being "dehumanized" indicates that he has felt some significant dehumanizing forces in his own life. And they probably made him angry or frustrated.
  3. Cullen was advised to step away from nursing, yet he didn't. He knew what he was doing, yet he did not stop. Even so, it was not compulsive in the sense that something came over him and he surrendered to it (as Ted Bundy described). While someone like Bundy prepared a "murder kit," and was thus considered an organized killer, he generally prepared for opportunities rather than specific individuals. Cullen knew who he wanted to kill and then learned and manipulated the system to make this occur.A lot of preplanning is involved with that. It can then become compulsive, but probably did not start out that way.
  4. He claimed that walking away was not an option. Of course it was. There are other jobs. He offered no indication that he even looked for options. That's just an excuse. His elaborate explanation about finances and child payments is another way of blaming an external force. Lots of people have that situation but don't act out in the ways he did. If he knew it was wrong and he had some insight about it, then he could have stepped away. Could he really believe that not keeping up with child support payments was worse than killing people? If so, then he has an elaborate rationale in place. The experience may have become addictive for him, in terms of the rush of anticipation and the ultimate feeling of having this power over others. How can anyone say "I had no choice but to do a job that put me in a situation where I would have to kill people"?
  5. Then he blamed stress that made him want to work more hours. It's always something outside him that gets the blame. The fact that he didn't have someone in his life, the fact that he was in debt, his depression. He takes no responsibility for making some rather dramatic decisions on behalf of people who did not seek his help.
  6. Cullen knew exactly how to kill people with medication, and yet his own suicide attempts are inevitably inept. That's inconsistent. He could have gotten legal prescriptions for the right types of drugs. He knew what to do.
  7. The question he dances around is why he feels "driven to end people's suffering." It's easy to say that he was projecting his own pain and then trying to eradicate it that way, but there's probably a better explanation that pinpoints his way of dealing with things throughout his life. You don't kill just because you hurt — or we'd all be out there killing people. There's a reason that he chose that particular way of dealing with his own life issues, as well as why he not only continued to do that but eventually felt driven to do it. I think he became addicted to the rush of anticipation, the energy of finding a way to do it, and the exhilaration of those moments when one realizes one has gotten away with such an act. This pattern has been true of many serial killers. The victims matter less and less (Cullen says they're all in a fog now, he can barely remember them), and the experience becomes increasingly more gratifying, so that the activity tends to escalate into more intensity and more frequency.
  8. "It was not something I was ever wanting to tell people about," he says, but then he confessed it right away once he was caught. He did want to tell. It would have been a simple thing to have said, "Yes, I did some things to those two people in New Jersey" and left it at that. Instead, he confessed to everything.

The compartmentalizing evident here is similar to many serial killers. They are able to live on "levels." On one level, they can act and think this way, on another level, that way. And the two (or more) can be in complete conflict. They can dissociate themselves from the morality of their killing but still dictate morality to others about other types of behavior. They can lie about what they're doing but still value the truth. They can treat family well but see victims as less than human. It's a type of logic that works when one can step in and out of various identities. It becomes a way of life, not necessarily something they actively calculate in every situation. In an environment where medical mistakes do get made and people do die as a result, it's not hard to mimic that and get away with it, especially since the healthcare industry relies on an atmosphere of trust and concern for others.

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