Fatal (10 page)

In her own perverse way, Jane reciprocated their affection. She was particularly fond of certain patients, and felt so sorry to see them discharged that she would take steps to prolong their stay. Sometimes, she would falsify their records, inventing symptoms that they didn’t really have or adding a few degrees of temperature to their fever charts. When that wasn’t sufficient, she would administer small doses of medication that would make them feel worse—not seriously ill, just sick enough to remain in the hospital for an extra week or so.

And those were the patients she
liked
.

There were some that she actively despised. She was especially contemptuous of the elderly, and on more than one occasion was heard to remark that “there was no use in keeping old people alive.” She said it with a smile, and her listeners assumed she was joking. But she wasn’t. She was deadly serious.

Exactly how many patients died at Jane Toppan’s hands during her time at nursing school is unclear. Even she couldn’t say with any certainty, though, according to her estimate, she was responsible for at least a dozen murders during those years. In both their commission and concealment, her crimes were carried out with a methodical cunning. There was nothing haphazard about Jane’s approach. On the contrary, she brought a terrifying rationality to the outrages she perpetrated. She set about studying the tools of her trade with a scholar’s diligence, frequently asking her teachers
questions about the properties of various poisons. She knew that her curiosity on the subject wouldn’t arouse suspicion—not at a time when substances from arsenic to strychnine were routinely prescribed for a range of ailments.

She also pursued her researches in private. In later years, when investigators went through her belongings, they discovered a well-worn medical textbook from her student-nursing days. When they picked it up, the book fell open to a section that Jane had obviously pored over many times. It was the chapter on opium.

Throughout the nineteenth century, opium was a cheap, legal, over-the-counter drug—as easy to buy as aspirin is today. As a common ingredient in the countless patent medicines that flooded the marketplace in the 1800s, opium was used to relieve teething pains in infants, menstrual cramps in women, and diarrhea in dysentery patients. Insomniacs took it to promote sleep and consumptives to suppress coughing. Morphine, the principal derivative of opium, came into particularly wide use during the Civil War, when it was employed as a surgical anesthesia and painkiller. Some doctors also recommended it as a substitute for whiskey, believing that, of the two evils, morphine addiction was preferable to alcoholism, since (as a physician named J. R. Black wrote in 1889) morphine “calms in place of exciting the baser passions, and hence is less productive of acts of violence and crime.”

Dr. Black, of course, had no knowledge of his deranged contemporary, Nurse Toppan, when he published those remarks. In her hands, morphine became everything he claimed it was not—productive of the most appalling acts “of violence and crime.”

It is impossible to say exactly when Jane began conducting what she called her “scientific experiments.” By the time she was caught, she had perpetrated so many of them that she could no longer remember all the details. She herself had become a kind of addict, profoundly dependent on the ecstasy—the intoxication—of murder. Poisoning, as she put it, had became “a habit of her life.”

At first she appears to have relied exclusively on morphine, injecting it into her victims, then standing at the bedside to observe the effects. She liked to see their pupils contract—listen to their breathing grow loud and stertorous—watch as a clammy sweat covered their faces. With a large enough dose, they would sink into a coma almost immediately and die within a few hours. Sometimes, they simply stopped breathing. She found it far more satisfying, however, when—as occasionally happened—their deaths were accompanied by violent convulsions.

Her serious experimentation really began when she started combining the morphine with another drug: atropine. Derived from both the belladonna and datura plants, atropine has been employed throughout history—particularly in India—as a particularly deadly poison. In Victorian America it was used, like morphine, both as a painkiller and as a treatment for dozens of ailments: asthma, earache, night sweats, rheumatism, seasickness, tetanus, whooping cough, and many more.

Its symptoms, however, are very different from—and in some cases diametrically opposite to—those produced by morphine. The mouth and throat grow parched, and the pupils widely dilated. Victims lose control of their muscular coordination and reel around
like drunks. They are possessed by a strange sense of giddiness that soon passes into a wild delirium. They may babble incoherently, burst into maniacal laughter, or emit constant, anguished groans. Perhaps the most grotesque symptom of all is their incessant picking at real or imaginary objects. They pluck at their clothing—pull at their fingers and toes—snatch at invisible objects in the air. Even when they lapse into their final stupor, they continue to mutter feverishly and make constant spasmodic motions, clutching at the bedclothes or grasping at phantoms floating over their heads.

In experimenting on her victims, Jane began dispensing morphine and atropine in varying combinations. Often she would inject the morphine first, then—just before the patient lost consciousness—force him to drink a glass of water in which she had dissolved an atropia tablet. Or she might wait until the victim had lapsed into a coma, then roll him over and administer an enema laced with atropine, letting the poison flow directly into his bowels.

There was a twofold motivation to her method. First, it allowed her to mask her crimes. By varying the dosages and timing of the drugs, she produced a set of symptoms so perplexing that the doctors couldn’t ascertain the true nature of the patient’s condition, often ascribing it to diabetes or heart failure. Second, she did it for fun. She derived a keen, sadistic pleasure from playing with her victims—from doing terrible things to their bodies and watching the results—before deciding it was time for them to die.

Not that she killed every patient she poisoned. Sometimes, she waited until her victim was near death, then did everything in her power to save him. When she
succeeded, she seems to have felt genuinely proud of herself, taking a deep sense of satisfaction in her professional skill. (In this respect, Jane Toppan was similar to other homicidal health care workers who have followed in her wake—Richard Angelo, for example, the Long Island “Angel of Death,” who, in the 1980s, administered lethal injections to an indeterminate number of hospital patients so that he could rush to their aid and feel like a hero.)

The gratification she derived from being a savior, however—from rescuing one of her own victims from the brink of death—was nothing compared to the feelings she experienced when they succumbed. In describing that sensation, Jane tended to rely on Victorian locutions—“delirious enjoyment,” “voluptuous delight,” “greatest conceivable pleasure.” In the end, however—and much to the horror of her contemporaries—she was extremely direct in her admission.

Killing, she would ultimately confess, gave her a sexual thrill.

The art of the poisoner is habit-forming; once the secret dose has been successful, the poisoner is urged on by a desire to repeat his triumph.

—H
ENRY
M
ORTON
R
OBINSON
,
Science Catches the Criminal

A
T THE SAME TIME THAT
J
ANE
T
OPPAN WAS ATTENDING
nursing school, her great contemporary, Herman Melville, was at work on his final masterpiece,
Billy Budd
. Once a celebrated author, Melville had long since dropped from public sight. In 1887—the year Jane began her training at Cambridge Hospital—he was residing in utter obscurity in lower Manhattan, having retired from his job as a deputy inspector at the New York City Customs House, where he had worked for nineteen years. When he died in 1891, his passing would go virtually unnoticed. In a perfunctory, three-sentence obituary, the
New York Times
would describe him as a once-popular writer of “sea-faring stories” and give his first name as “Henry.”

In the few years between his retirement and death, Melville’s creative energies were devoted to the composition of
Billy Budd
. The work—which would not be published until 1924, and even then in a seriously flawed transcription—deals with one of Melville’s obsessive themes: the eternal struggle between good and evil, as embodied in its title character, the “handsome
sailor,” Billy Budd, and his nemesis, John Claggart, the diabolical master-at-arms who sets out to destroy the innocent hero for no other reason than his hatred of Billy’s beauty and goodness.

At one point in the novella, the author pauses to contemplate the source of Claggart’s villainy. Living in a pre-Freudian age, Melville does not use the clinical language of modern-day psychology in accounting for the character’s behavior, relying instead on such old-fashioned phrases as “natural depravity” and “the mania of an evil nature.” But his description of the master-at-arm’s malevolent personality makes it clear that Claggart is a classic instance of what we now call a criminal psychopath:

Though the man’s even temper and discreet bearing would seem to intimate a mind peculiarly subject to the law of reason, not the less in heart he would seem to riot in complete exemption from that law, having apparently little to do with reason further than to employ it as an ambidexter implement for effecting the irrational. That is to say: Toward the accomplishment of an aim which in wantonness of atrocity would seem to partake of the insane, he will direct a cool judgment sagacious and sound. These men are madmen, and of the most dangerous sort, for their lunacy is not continuous, but occasional, evoked by some special object.

Given his understanding of mankind’s darker nature, it surely would have come as no great shock to Melville that, even as he composed this description, a being who matched it precisely—whose “even temper
and discreet bearing” masked a heart that “rioted in” evil—was living in Boston. He might well have been amazed by one thing, however. Like most people, Melville apparently assumed that such extreme depravity was limited to members of the male sex—to “madmen.” It would have undoubtedly surprised him to learn that the real-life counterpart of his fictitious maniac—a creature every bit as malign and diabolical as the fiendish Claggart—was a woman.

•   •   •

Despite the intense dislike she provoked in many of her acquaintances, Jane always had her champions. Cunning and manipulative, she was able to make a highly favorable impression on influential people. In 1888, that ability stood her in good stead when she decided to seek wider training at Massachusetts General Hospital, whose nursing school was one of the most respected in the nation.

The head nurse—an unreconstructed bigot who sniffed at Jane’s “low origins”—initially opposed her admission. Jane’s letters of recommendations, however—written by some of the most prominent physicians connected to Cambridge Hospital—were full of such glowing testimonials that the head nurse finally relented. Not only did Jane pass her probation without trouble; she struck her superiors as so proficient that, when the head nurse took a leave of absence the following year, Jane was named as her temporary replacement.

Like all sociopaths, however, Jane could not keep her worst impulses in check. It wasn’t long before her behavior became a subject of whispered gossip among the other nurses, many of whom detested her. As in the past, she was widely perceived as a self-promoting
liar, who routinely disparaged the efforts of her colleagues while taking all the credit for herself. There were constant rumors of falsified fever charts, tampered medical records, and petty thefts. And graver charges, too: of medications dispensed with such reckless disregard for proper dosages as to put the patient’s health in jeopardy.

Even her most ardent detractors, however, never suspected the full appalling truth: that at night, when no one was about, Jane continued to conduct her secret “experiments” on unwitting patients.

As with her time in Cambridge Hospital, there is simply no way of telling how many people Jane killed during her stint at Massachusetts General. It appears that a fair number of patients died unexpectedly in her care. But in nineteenth-century America—when bleeding was still an accepted medical procedure and stomachaches were treated with strychnine—that was true for even the most respected physicians. Thanks to a striking piece of testimony, however, we do know something about the method she used. As it happened, one of Jane’s intended victims managed to survive, and the story she would ultimately tell sheds chilling light not only on Nurse Toppan’s MO but on the perverse erotic quality of her crimes: how tenderly she killed her victims, how lovingly she watched them die.

The woman’s name was Mrs. Amelia Phinney. Thirty-six years old, she had been confined to the hospital with a uterine ulcer, which the doctors had subjected to the usual treatment, burning it with nitrate of silver, a powerful caustic agent. On the night following the procedure, Mrs. Phinney lay tossing on her cot, the pain in her lower body making it impossible for her to sleep. All at once, she became aware that
someone was hovering over her bed. Opening her eyes, she saw the looming figure of Nurse Toppan, whose portly face—illuminated by the dull glow of the bedside oil lamp—wore a look of peculiar intensity.