Cullen stated he administered overdoses to patients in order to spare them from being “coded” — going into cardiac or respiratory arrest and being listed as a Code Blue emergency. He told detectives that he could not bear witness to or hear about attempts at saving a victim’s life. Cullen also stated that he gave patients overdoses so that he could end their suffering and prevent hospital personnel from dehumanizing them. However, not all of his victims were terminal patients. Some, like Gall, had been expected to recover before Cullen killed them. Nurse Lynn Tester described many of the victims as “people on the mend” in a police interview.
Instead of using common painkillers and stimulants, access of which was strictly regulated by hospitals due to their value as street drugs, Cullen chose instead to use as his tools of choice drugs such as digoxin and insulin which had little use outside of a hospital setting and were less likely to attract attention.
Investigators stated that Cullen may have caused patients to suffer, but that he appears not to realize this, contradicting his claims of wanting to save patients. Similarly, Cullen told investigators that although he often observed patients’ suffering for several days, the decision to commit each murder was performed on impulse. Cullen told detectives in December 2003 that he lived most of his life in a fog and that he had blacked out memories of murdering most of his victims. He said he could not recall how many he killed or why he had chosen them. In some cases, Cullen adamantly denied committing any murders at a given facility, but after reviewing medical records, he admitted that he was involved in patient deaths.
