Fatal (11 page)

When the nurse asked Mrs. Phinney how she was feeling, the poor woman gasped that she was suffering dreadfully, and implored Nurse Toppan to send for a physician.

“There is no need for that,” Nurse Toppan said softly. “I have something to make you feel better. Here.” Bending, she slid an arm beneath Mrs. Phinney’s shoulders, raised her slightly from the pillow, and held a glass to her lips. “Drink this.”

Mrs. Phinney swallowed the bitter-tasting medicine. Before long, a numbness began to spread through her body. Her mouth and throat felt uncomfortably dry, her eyelids heavily weighted. She felt herself subsiding into unconsciousness.

All at once, through her dimming perceptions, she became aware of something so peculiar that, for a long time afterward, she thought she must have dreamed it. She felt the bedclothes being pulled back—heard the creaking of the cot-frame—felt the mattress sag as another body slipped into bed beside her.

It was Nurse Toppan. Gently, she began stroking Mrs. Phinney’s hair, kissing her all over her face, whispering softly in her ear that everything would soon be all right. At one point, she knelt on the bed and, bending low over the drugged woman, turned back her eyelids and peered intently at her pupils. Mrs. Phinney could feel the other woman’s rapid, excited breathing on her face as Nurse Toppan examined her.

Moments later, Mrs. Phinney felt the glass being placed to her mouth once again, and heard Nurse
Toppan say in a husky voice: “Come, dear. Drink just a little more.”

With all the strength she could muster, Mrs. Phinney tightened her lips and twisted her head to one side. Just then, something caused Nurse Toppan to rise hurriedly from the bed and flee, as though alarmed by the unexpected approach of another person.

The next morning, Mrs. Phinney was roused from a profound slumber by a young trainee named McCutcheon. Mrs. Phinney felt sick to her stomach, and so terribly groggy that it took several hours for her head to clear. Her recollections of the preceding night were so bizarre and bewildering that she hesitated to mention them to anyone. Surely, the whole dreadful experience
must
have been a bad dream.

It wasn’t until years later—when jovial, fun-loving Jane was finally exposed for the monster she was—that Amelia Phinney realized just how close she’d been to death on that long-ago night when Nurse Toppan came to her bed.

•   •   •

While Jane’s seriously criminal activities went undetected at Massachusetts General, the other infractions she committed—and the growing distrust she engendered in certain members of the staff—eventually got her into trouble.

Like other training facilities for nurses, the school at Massachusetts General followed the model established by Florence Nightingale, who had developed her methods during the Crimean War, when she was in charge of British army medical services in Turkey. Reflecting this military influence, early nursing schools demanded strict obedience from their students. Discipline was strictly enforced, and trainees who failed to
display the requisite “ladylike” qualities—cheerfulness, piety, uncomplaining acceptance of their chores, and absolute submission to authority—were branded as incorrigible troublemakers and summarily dismissed.

In spite of the high regard in which she was held by various physicians—who swore by her competence and insisted on having her as a helper—Jane had managed to alienate a significant number of women on the nursing staff by the end of her first year at Massachusetts General. Increasingly, she was regarded as a “slippery” character, with a devious soul, a duplicitous tongue, and distinctly larcenous tendencies. She was suspected of stealing money from the hospital cash box, supplies from the storeroom, and a diamond ring from a wealthy patient. As usual, Jane made sure that nothing could be proven against her. She indignantly denied the accusations and did her best to shift the blame onto others.

Perhaps out of hubris, perhaps out of the compulsively self-destructive behavior that often undoes even the most cunning criminals, she finally made a mis-step. In the summer of 1890, she committed a flagrant violation of the hospital rules, leaving the ward without permission. When her absence was brought to the attention of her nursing supervisors, they grasped at the opportunity to rid themselves of their increasingly troublesome subordinate. Though Jane had already passed her final examination and her diploma had been signed, she was discharged at once from the nursing school without receiving her license.

For a year, she worked as a private nurse in Cambridge and Lowell, garnering high recommendations from the doctors she assisted and the families she served. In the fall of 1890—seeking to obtain the license she’d failed to
get at Massachusetts General—she returned to Cambridge Hospital. Before long, however, the old patterns reestablished themselves. On the one hand, her professional skill and personal charm made her a great favorite among the doctors and patients. At the same time, she was secretly and steadily engaged in a series of criminal activities, from larceny to homicide.

One of her intended victims was a nineteen-year-old trainee named Mattie Davis. Falling ill with a fever, the young woman took to bed and was tended by Nurse Toppan. After imbibing the medicine Jane gave her, Miss Davis, according to official accounts, “was seized with a sudden and violent collapse.” Luckily for her, a doctor named Cleland happened to be passing by her room and, rushing to her aid, managed with great effort to save her.

Early the next morning, Jane reappeared in Miss Davis’s room, with the evident intent of treating her to a second and more definitive dose of the medication. She was prevented from accomplishing her deadly purpose, however, by the presence of another nurse, who had been assigned to watch over Miss Davis by Dr. Cleland.

Though Cleland was deeply perplexed by Miss Davis’s symptoms, he never suspected that she’d been poisoned. At least one other physician on the staff, however, began to have serious doubts about Jane after several of his convalescing patients died unexpectedly while under her care. To be sure, even he could not bring himself to believe that the affable, matronly nurse was a killer. He suspected, however, that she was dispensing opiates and other drugs with a dangerous disregard for the prescribed dosages—a charge that had been whispered about Jane throughout her career.

In the spring of 1891, he shared his doubts about Nurse Toppan’s performance with the board of trustees, who wasted little time in dismissing her from the hospital.

She was now thirty-two years old. After four years of training, she had been discharged from Boston’s two leading nursing schools without receiving her license. She had also left a long trail of corpses in her wake—perhaps two dozen in all—though no one, of course, was aware of that grim reality at the time.

Another person in Jane’s position might have felt concerned about her prospects. But like other psychopaths, Jane possessed an unnatural sangfroid that allowed her to remain completely unfazed in situations that would engender intense anxiety in more normally constituted personalities. “I didn’t care,” she would breezily declare in later years when recalling her dismissal from Cambridge Hospital. She had already spent a year working for some of the most prominent families in Cambridge and knew that she “could make more money and have an easier time by hiring myself out.”

And so, in the summer of 1891, Jane Toppan embarked on her career as a full-time private nurse.

In our society, the roles of women are still primarily those of homemaker, of the preparer of meals, of the rearer of children, of the nurse of the sick. . . . Abundant temptations to commit crimes and opportunities to carry them out in a secretive fashion follow from these roles. Actually, woman’s task of preparing food for the members of the family has made her the poisoner par excellence, and her function in nursing the sick has had a similar effect.

—O
TTO
P
OLLAK
,
The Criminality of Women

I
T WAS TRUE—AS
J
ANE BLITHELY DECLARED—THAT SHE
could do better financially by going out on her own. Private-duty nurses did, in fact, receive good pay—but only in comparison to the scandalous earnings of other women in the late nineteenth century. According to a survey conducted by the Department of Labor in 1888, salaries for all female workers across the country averaged from four to six dollars per week, hardly enough to buy the bare necessities of life. By contrast, the average weekly pay for a highly trained private nurse was twenty-five dollars.

Of course, like other freelancers, private nurses tended to alternate between periods of intense, fulltime work and intervals of unemployment. And some clients, even those who could afford it, failed to settle up their accounts. Not infrequently, a nurse had to accept
a fraction of her contracted wage, or even take barter goods in exchange for her services—food, clothing, household items.

As a result, even a successful nurse like Jane Toppan could count on a yearly salary of perhaps $600. To be sure, that was significantly more than her hospital salary. Still, it was hardly exorbitant—particularly given the grueling nature of the work.

True, not every nurse was terribly overburdened. The authors of a standard history of American nursing cite the case of “one trained nurse sent from New York to Europe, who found that her sole job was to make sure that the daughter of a millionaire never went out in damp weather without overshoes.” In general, however, exceptionally heavy demands were made on full-time private nurses by the well-to-do families they served.

For the weeks or even months of her employment, the nurse was expected to keep virtually round-the-clock vigils at the patient’s bedside. If the patient were seriously ill, she might, if she were lucky, snatch two or three hours of sleep each day on a couch beside the sickbed. If the patient suffered from insomnia, she was expected to stay up with him all night, tending to his comfort.

She was expected to anticipate the patient’s every need, to obey the doctor’s every direction, and to carry out the wishes of the family without question. While performing her duties, she was required to be a constant but unobtrusive presence, stepping softly when she moved about the sickroom, and refraining from making the slightest noise that might disturb the patient’s repose. If she read a newspaper while the invalid slumbered, she took care not to rattle the pages;
if she passed the time knitting, she made sure the needles didn’t click.

She was expected to maintain irreproachable personal habits, an unwaveringly cheerful disposition, and a docile manner, never displaying the slightest trace of discourtesy, fatigue, or irritation. If the patient were well enough to do without her care for a few hours, she was obliged to help around the house with the sewing, laundering, and other domestic chores. Circumstances permitting, she was allowed to take a brief daily walk. Otherwise, she had no time off, spending her days within the closed and fetid confines of the sickroom at the continuous beck and call of her employers.

It’s no surprise that, after enduring such trying conditions for several weeks or longer, nurses themselves needed time to recuperate, often taking extended respites between jobs.

In spite of its demands, private-duty nursing suited Jane Toppan very well. At thirty-four, she possessed the physical stamina and practical experience necessary for the job. Her competent, take-charge manner inspired confidence in her employers, and her lively personality made her a household favorite. For a period of eight years, from 1892 until 1900, she was reputedly the most successful private nurse in Cambridge, highly recommended by respected physicians and eagerly sought-after by some of the city’s best families.

To be sure, her reputation during those years wasn’t entirely spotless. Some of her employers were taken aback by her tendency to spin elaborate lies about her life and accomplishments—though, for the most part, they dismissed her fondness for extravagant tale-telling as a function of what they euphemistically
called her “Celtic ancestry.” She also had a habit of borrowing small sums of cash from her employers and neglecting to repay her debts. And on several occasions, she was suspected of committing small thefts. At least one of her employers took the precaution of making periodic counts of his silverware while Jane was employed in his home.

Even he, however, never thought seriously about dismissing her. Whatever her minor flaws—her chronic fibbing, her cavalier attitude toward borrowing money—she was an indispensable person to have around at times of crisis, when a sick wife or suffering child required the best care available, and the other members of the household relied on the reassuring presence of a cheerful and capable nurse.

If Jane was able to beguile her employers with her professional skill and personal charm, there were others who saw through her pleasant facade. To the household servitors she worked among and the friends she socialized with, she often showed a very different face: jealous, bad-tempered, vindictive. While she always took care to appear well-mannered to her employers—using ladylike language and abstaining from drink—she loved to guzzle beer on her off-time and tell dirty stories whose vulgarity often shocked her listeners. She delighted in gratuitous troublemaking—in carrying tales, spreading rumors, turning people against each other for no apparent reason.