Death Follows Art

There were no obvious clues--no telltale marks on the body. Yet the deaths occurred so quickly and unexpectedly that the staff realized that they could not have been accidental. A killer was on the loose in the hospital, someone intimately familiar with all of modern medicine's lethal drugs and tools. It was a psychopathic physician whose mind had twisted from healing to homicide.

This macabre fantasy, conceived by Playwright Paddy Chayefsky for the 1971 black humor film The Hospital, has been overshadowed by reality. Last week investigators were virtually convinced that many of the two dozen puzzling deaths at the Veterans Administration Hospital in Ann Arbor, Mich., last summer and at a small suburban New Jersey hospital a decade ago had actually been murders committed by members of the hospital staffs. The two cases:

THE MICHIGAN MURDERS

In only six weeks last July and August, 27 patients at the Michigan VA Hospital suffered respiratory arrests that left them unable to breathe without mechanical aid. Some patients were stricken more than once; eleven of them died. So many breathing failures could not be accidental; patients and staff alike began to wonder whether a psychopath or a misguided mercy killer was in their midst.

An investigation indicated that at least 18 of the victims--including nine of those who died--had been given Pavulon, or pancuronium bromide, a synthetic variant of curare, the lethal plant toxin used by South American Indians to tip poison darts. Anaesthesiologists sometimes administer Pavulon to surgical patients to relax their muscles, but hospital records showed that no doctor had prescribed its use on any of the victims.

FBI agents called into the case soon found more cause for suspicion. Most of the breathing failures had occurred in the intensive-care unit during the afternoon shift. All of the victims there were being fed intravenously, but the drug could not have been mixed into the IV solutions; it would have become too diluted to work. The agents concluded that the intravenous flow had apparently been interrupted and Pavulon pumped directly into the feeding tubes.

Painstakingly checking work records, the FBI narrowed the list of suspects to two Filipino nurses, Leonora Perez, 31, and Filipina Narciso, 29, both of whom were on duty when--and where --most of the trouble occurred. Subpoenaed before a grand jury, the women denied any involvement in the deaths. But at least one of them was directly implicated by a survivor.

As part of the investigation, Dr. Herbert Spiegel, a New York psychiatrist and hypnotist, put some of the surviving patients into trances and let the FBI question them. At least one, under hypnosis, suddenly seemed to recall forgotten details of his near fatal day. Richard Neely, 61, a retired auto worker who was being treated for cancer of the bladder, said that he remembered experiencing unexpected breathing difficulties and calling out to a passing nurse of Asian origin, who turned and fled at his cry. Later, shown photographs of the hospital's nurses, he picked out one of the Filipino suspects.

Though federal authorities have given no motive for the crimes, they named both nurses (who are no longer working with patients) as suspects in a brief filed earlier this month in U.S. district court. The Government is seeking court permission to take formal testimony as quickly as possible from the seriously ailing Neely for fear he may not be able to appear at a subsequent trial. A hearing is scheduled this week.

THE NEW JERSEY KILLINGS

The ten-year-old New Jersey case was reopened in part as a result of the publicity over the Michigan deaths. Over a ten-month period, starting in December 1965, at least 13 patients died mysteriously at Riverdell Hospital in suburban Oradell, less than an hour's drive from Manhattan. Most of them had undergone surgery but seemed well on the road to recovery.

Stirred by what he called "post-Watergate pangs of conscience," a knowledgeable source--possibly a member of the hospital staff--told New York Times Reporter M. A. Farber of his suspicions. Intrigued, Farber began questioning doctors, survivors and local officials. He soon found numerous loopholes in the testimony of the man originally suspected in the case, one of the hospital's surgeons. Because the doctor had never been charged with homicide and still practices medicine elsewhere in New Jersey, Farber, in his stories, identified him only as "Doctor X."

County Prosecutor Joseph C. Woodcock, whose interest in the case had been stirred by the Michigan affair, was impressed by Farber's information, but realized that pressing charges against Dr. X would need more evidence than had been presented in 1966.

According to the Times, several of the staff physicians during that period noted that Dr. X had been on duty near many of the victims around the time they died. They included a four-year-old girl who had undergone surgery for removal of intestinal cysts and a 36-year-old woman who had given birth by caesarean section; none of the 13 was Dr. X's patient. Opening Dr. X's hospital locker, a fellow doctor found 18 vials of curare, most of them empty. Former County Prosecutor Guy W. Calissi questioned Dr. X, but the surgeon insisted that he was merely using the muscle relaxant for spare-time experiments on "dying dogs." Told that it was impossible to detect curare in tissue so many weeks after death, says Calissi, now a judge, he dropped his inquiry.

In the current probe, Prosecutor Woodcock got court permission to exhume five of the bodies. Then he sent tissue samples off to different specialists, some of whom used detection techniques so subtle they can identify a substance weighing only a trillionth of a gram.

Last week the Times revealed that traces of curare had definitely been found in the body of the little girl and possibly in two others as well.

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