One of the best magazine stories I’ve ever read is James B. Stewart’s “Professional Courtesy,” which first appeared in The New Yorker nearly a dozen years ago. The piece recounts the sordid tale of Michael Swango, a health-care worker whose favorite pastime was injecting elderly patients with lethal drug cocktails. Stewart tracked Swango’s whole career, starting with his early days as a paramedic who fed his comrades poison-laced KFC, and ending with a murderous stint in Zimbabwe. (The article was later expanded into a book.)
Ever since reading “Professional Courtesy,” I’ve had something of an unhealthy obsession with so-called Angel-of-Death cases. It’s an obsession that’s kept me quite busy, seeing as how these tragedies pop up with alarming regularity. Another one’s coming down the pike in Angelina County, Texas, where a nurse at a dialysis center stands accused of pumping several patients full of bleach.
The ubiquity of Angel-of-Death cases raises a chicken-or-egg question: does the health-care industry attract more than its fair share of murderous souls, or do otherwise ordinary folks develop their destructive impulses due to their constant proximity to death? According to a 2001 study, it’s all a question of opportunity:
When this information is combined with Kinnell’s observations on Shipman and Nesset, it begins to seem plausible that all walks of life have people with the potential to murder. The key difference may be opportunity. The features associated with risk noted above suggest that access and a low chance of observation are important. The difference between nurses and doctors may be that doctors also control the means of disposal—in the case of Nesset and Shipman, they also provided the death certificate. The reason for the difference in the number of reported deaths may simply relate to the doctors’ greater opportunity to remain undiscovered.
In other words, every industry has the same percentage of potentially homicidal maniacs in its workforce. Doctors and nurses just have more opportunities to act on their darkest impulses.
This raises yet another question: what percentage of any given population will harbor secret fantasies of murder? And, more importantly, how do I avoid these people?