Behind the Murder Curtain: Special Agent Bruce Sackman Hunts Doctors and Nurses Who Kill Our Veterans
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Behind the Murder Curtain is the true story of Bruce Sackman, Special Agent in Charge of the Department of Veterans Affairs Office of Inspector General. Sackman’s main responsibilities had been investigating white-collar crimes such as embezzlement when he is drawn into the macabre world of doctors and nurses who murder their patients. Sackman evolves from an investigator of routine cases to the world’s leading expert on Medical Serial Killers—MSKs—doctors and nurses who ply their evil trade hidden behind the privacy curtain at a patient’s bedside.
Behind the Murder Curtain tells how this dedicated investigator brought down four MSKs in Veterans Hospitals while developing the RED FLAGS PROTOCOL, which is now taught to investigators and forensic nurses throughout the world as a tool for stopping an MSK.
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Behind the Murder Curtain - Bruce Sackman
Prologue
The young doctor with movie star looks, tanned and fit in a starched white doctor’s jacket, stethoscope looped over his left shoulder, aviator sunglasses dangling from his pocket, sat in the hard chair about eighteen inches from his patient’s bedside. They were alone, separated from the surrounding ward only by the thin curtain meant to offer privacy for the intimate interactions between doctor and patient. The only sounds were the mechanical clicks and beeps of the machines meant to monitor the life signs of the damaged men up and down the ward. The doctor sat for three hours, fixated on his patient, serenely watching the numbers on the monitor indicating the patient dying, dying, then dead. The doctor rose from his seat, made a notation on the patient’s file, drew the curtain and went to the next patient on his rounds. A few minutes later, he reported to the nurse on duty that one of the patients in his care had unexpectedly died.
CHAPTER 1
The Adventure Begins
Courage is knowing what not to fear.
—PLATO
My office, on the sixteenth floor of a bland government building adjacent to the Veterans medical center on Twenty-Third Street in Manhattan, was empty that day in May 2005 that I decided to pack up my personal property. My entire field staff was away for a week of training. There was no need for me to go because I would be gone when they returned. Retired.
So I was alone, sitting at my desk, which, like all the furniture in the building, was made by federal prisoners. I stared at the plaques and newspaper clippings on the walls. The clippings blared headlines that defined my career and my nightmares: Angel of Death Killed 60, Mad Doctor Killed for Fun of It, Scientist Let Patients Die, Nurse Could Not Stop Killing.
As a Special Agent in Charge of the Veterans Administration Office of Inspector General (VA OIG), I was responsible for the area ranging from West Virginia to Maine that included 250,000 VA employees. I was retiring as a GS 15, the highest paygrade you can get in government service. Not bad for a guy whose friends called him the nice Jewish kid from Brooklyn with a Glock on his hip.
VA OIG is a mouthful best explained as the office that investigates crimes that may have been committed against veterans and by employees of the Veterans Administration.
The preponderance of these crimes is nonviolent, like embezzlement, ID theft, petty theft of patient property, and fraud. They are crimes committed by aides, orderlies, clerks, pharmacy workers, and even nurses and doctors. People find it hard to believe that nurses and doctors may be criminals. We revere doctors in this country, and for the most part, they deserve our admiration and the rewards they receive. They save lives as commonly as a school crossing guard shepherds kids across the street. They enrich our lives and make us all better people for their efforts. And there are no people I admire more than nurses. They are the bedrock of our healthcare system. Without them, nothing gets done. And I found them to be the first line of defense against evil in the hospital wards.
That’s the way I felt when I started this job in 1980 and that’s the way I feel now. So you can imagine how reluctant I was to believe it, when I discovered about a decade ago, that there are doctors and nurses who purposely kill their patients. And when they killed, they killed in numbers that staggered the mind. I call them Medical Serial Killers (MSKs). as I filled a cardboard box with the mementos of my twenty-five years in VA OIG, it was the newspaper clippings headlined with the names Swango, Gilbert, Williams, and Kornak that slowed me down as I reread them. I remembered how I evolved from that nice kid from Brooklyn who investigated crimes that frankly were not challenging enough for me, into a homicide detective hunting doctors and nurses who killed for fun, greed, and misguided glory.
I was comfortable with my decision to retire. It was a financially sound one, and I was sensing a change in DC, where the current administration in 2005 seemed to be adding bureaucratic burdens, leaving less time in the field for investigations. My immediate supervisors down there wanted me to stay. Why not? I had put the VA OIG on the map with high-profile cases even though they were often embarrassing to the administration. I ran an efficient office. I created a team of nurses, scientists, medical examiners, and detectives who specialized in bringing down MSKs. But I was leaving things in good hands and would always be available as a consultant.
There was one piece of business to settle, however, before my caseload was totally clear. Doctor Paul J. Kornak was awaiting sentencing. A few weeks earlier, he pleaded guilty to criminally negligent homicide, making false statements, and committing fraud, in the death of an Air Force veteran named James DiGeorgio.
Kornak would be the last notch in my holster as a Special Agent. He was a different case than the other doctors and nurses I locked up for murder. He didn’t kill for the thrill of it or to play God, as in my previous cases. He killed people because he needed bodies for a research project. He would enroll patients who did not meet the criteria of the project in order to keep his funding. He did not care what happened to them once they were a part of the experimental treatment. They were put at deadly risk because their medical conditions should have precluded them from being used in the experiment.
Kornak pleaded guilty to one count of criminally negligent homicide in the death of DiGeorgio. That’s all the U.S. Attorney needed but I was hoping he would push for more charges and even a charge of murder. I believed Kornak and an accomplice were responsible for several deaths.
Yet as evil as Kornak was, he was a choirboy compared to Doctor Michael Swango.
CHAPTER 2
Double O Swango
When a doctor does go wrong he is the first of criminals. He has nerve and he has knowledge.
—SIR ARTHUR CONAN DOYLE
from The Adventure of the Speckled Band
In October 1995, I was just settling in to another day at the office, opening the file on an ongoing case, when Agent Tom Valery charged through my door and yelled, Boss, pick up line one right now!
Tom was easily excitable so I didn’t exactly drop the file I was reading and reached for line one. But when he continued into the room and took up position over my left shoulder, I sensed this call was out of the ordinary. I had no idea it would change my life forever. But it did.
This is Special Agent Sackman,
I said in my long practiced, measured what is this about?
tone.
This is Doctor Thomesen, I am a psychiatrist at Northport. You need to get out here right away. We have a doctor who is killing his patients,
was the response. Without taking a breath, she told me something about a television show and a doctor named Swango. How could this be happening?
I had no idea what she was talking about but again in my long-practiced manner, I thanked her for calling and promised I would look into it. Without another word, she hung up. I sensed she was a little frustrated. I shrugged my shoulders, hung up, and looked up at Tom, who had been bent over the phone trying to listen in.
I know what she is talking about,
he said. I think we should get out there. I’ll give you a fill-in in the car.
It was not my style to rush into things. While I investigated crimes in VA medical centers and was trained to use the 9 mm automatic on my hip, my work rarely called for a lights-and-siren response. I was known for being skeptical and careful. Some thought I was bored, but believe me, I took everything in. I had heard many outrageous claims in my career, but never anything like this. Tom was an experienced agent and as he was already putting on his jacket and grabbing the car keys, I told my secretary I was going out to Northport and followed him out the door.
In less than fifteen minutes after the phone call, we were in the bare bones Chevy Caprice supplied by the Veterans Administration for use by its investigators, on our way to the Northport VA Medical Center. About seventy miles from our Manhattan office, we had both been there many times before on routine cases.
I chose to drive because I thought Tom was too aggressive behind the wheel and our rule was the driver controlled the radio. I liked Frank Sinatra and he liked Johnny Cash. As we bucked the heavy traffic, I looked across at Tom and asked if he thought there was really any merit to Doctor Thomesen’s call? Of course, I wanted to ask him this as soon as I hung up the phone, but I did not want to dampen his enthusiasm, as he clearly had been eager to run out the door. The answer was typical in-your-face Tom: Damn right, boss! Everyone in the office has been talking about the television show last night. It was about this doctor, Doctor Michael Swango. They said he served time for poisoning coworkers in Illinois, paramedics no less, and that wherever he goes, he leaves a trail of death. He’s a resident at Stony Brook University Hospital in New York, practicing in Northport. The medical students call him
Double O Swango, Licensed to Kill and
Doctor Death."
I asked, The show said he killed people?
Well, they couldn’t actually say that, but clearly they believe it and so does anyone who watched it,
responded Tom.
Friends thought Tom and I were mismatched bookends. I’m a buttoned-down, conservative suit-and-tie guy who, I know, could pass for a Brooks Brothers salesman. I was a good listener and considered every move carefully; I tried to be the perfect image of an agent-in-charge. Tom, in contrast, was right out of a Damon Runyon story. He was old-school tough, quick with a joke, and disdainful of orders and anyone from headquarters.
In a dictionary, his picture would be included in the entry for politically incorrect.
We were about the same five feet, seven inches in height, but Tom was stocky and strong, the guy you wanted next to you in a foxhole. He was a volunteer firefighter in a town not far from where I lived, and many mornings he would show up to work after fighting a blaze all night. But together, our record proved we made a formidable team: I directed an investigation and handled headquarters,
and Tom followed his instinct and made noise when required (and sometimes when not required).
I drove on in silence. I was thinking about what I was getting into and how I would describe it to my bosses in Washington: Doctor,
"killer’. I was mostly concerned with white-collar crimes like embezzlement, identity theft, and, occasionally, pension fraud. I was pretty good at it. Once in a while, an investigation might involve missing drugs from a VA hospital pharmacy, and I would take part in a raid with the Drug Enforcement Agency (DEA) guys in their bulletproof vests and helmets, but that was about as extreme as it got. And even those suspects were not killers.
I thought to myself that I might not be the man for this particular job. Many years later, when I drive that stretch of the Long Island Expressway, I return to that thought. I also realized I had no choice in the matter. I was responsible for investigating all fraud and official misconduct at 295 VA facilities, including medical centers, cemeteries, and two hundred and fifty thousand employees. I ran agents like Tom Valery up and down the east coast. I could not remember any of them ever investigating a doctor killing a patient. This seemed like a case that might require me to involve the FBI—a thought that did not thrill me.
I was pleased that traffic was moving at a crawl; I was not eager to jump into these unknown waters. But I am not a guy who passes the buck. And there was no one to whom to pass the buck to. From the time I picked up line one, I owned this case, whatever the cost or reward.
I grew up in Brooklyn, both my parents were civil service workers and they pushed me in their direction. I attended Thomas Jefferson High School, a school with the reputation for a street-tough student body and a football team to prove it. The only jewelry I wore was my high school ring. The only decoration on the wall of my office was my diploma from Thomas Jefferson High School. On several occasions over my career, colleagues or suspects would notice the diploma and ask if I knew the school’s legendary football coach Moe Finkelstein. I knew him and would say so.
They assumed I played football for Moe. I never said I did, but they would take a step back and think I was a tough guy with a tough background. I would notice a new level of respect from then on and I liked it.
In truth, I was aware my toughness came more from my mind than my body. After high school, I went to nearby Long Island University, where I also received my master’s degree in political science. I could be like a dog with a bone but would rather outsmart opponents, be they embezzlers, drug dealers, or bureaucrats getting in my way. I was Columbo, not Dirty Harry.
As we approached Northport, I laid out a strategy. I thought I should have watched the television show the psychiatrist mentioned before we left the office. I wondered why nobody gave me a heads-up about it. Usually the press office in DC was on top of those things. Tom appeared to know all about it.
I understood I should not be so sure that we were on to a homicide case. So far, we were moving forward based solely on a panicky phone call from a psychiatrist I did not even know, and what was probably a lot of speculation from a television program.
If this did turn into something I knew I would have to prepare a thorough buttoned-up case so an Assistant US Attorney (AUSA) would be able to secure an indictment that would hold up in federal court. One AUSA once described me as rock steady.
That is what I needed to be now. My days of knocking down the doors of lowlifes who were stealing drugs from the VA medical center to sell on the street were far behind me. I never fired a shot in anger and hoped I never had to.
I knew I would have to call in the FBI if today’s interview developed any real leads. They knew how to deal with a killer, if, indeed, we’re dealing with one.
But in the meantime, this case was mine.
A detective relies on his experience. As special agent-in-charge, I knew my duty was to get to the bottom of the Swango story—even if the bottom was a dark place where I’d never ventured before and where the VA would not be happy about my shedding any light.
I shared my thoughts with Tom, who took a harder position. He didn’t think the television report would have implicated Swango the way it did if the reporters behind it weren’t sure.
He wasn’t concerned about moving in against a possible killer who might be more aggressive about avoiding arrest than the bookkeeper we arrested last week for stealing petty cash to finance a sweet-sixteen for his daughter. Tom was a genuine tough guy, fearless and impatient with paperwork and forensic accountants. He wanted to do a murder case. We were both excited by the challenge.
At Northport, we met up with VA Police Chief Hank Shemitz, who was in charge of the uniformed forces there. Shemitz had done some preliminary work and shared that Swango was a psychiatric resident at nearby Stony Brook University Hospital. Under a routine agreement with the VA, Swango was doing a rotation at Northport. Shemitz said Swango appeared to be a skilled liar, a con man. When he applied for the job as a psychiatric resident, he never told the administrators anything about what the television show claimed—like the fact that he served time for poisoning fellow paramedics by putting ant killer in their donuts.
Shemitz said Swango admitted to having trouble with the law. He said he was in a bar with a number of paramedics with whom he worked; they ribbed him about being a doctor and getting his thrills riding around with them. He told Stony Brook that as an ex-Marine, he was not used to being ridiculed; he admitted losing his temper, starting a brawl and roughing up some of his colleagues. He said he served some time but was eventually exonerated by the governor of Virginia. He was so smooth that he was hired without a further background check.
Though Shemitz found it hard to believe they didn’t do a formal background check, he told us that the university was having a difficult time filling certain job openings and they may have been eager to get a well-educated ex-Marine on their staff. Shemitz added, When you meet this guy, you might understand how they were influenced by him.
I was stunned about the lack of any background check. It was inexcusable. I was embarrassed that the VA was now caught up in a possible fraud case because the suits at Stony Brook were taken in by a liar. Before joining the VA, I worked as an investigator for the Department of Defense doing background checks on people needing top-secret clearances. I had an uncanny ability to sniff out a liar. And I knew by experience, it rarely took much digging to uncover one. This guy must be some operator,
I thought.
Shemitz had spoken to the psychiatrist who called me because of the television show, which reported that Swango poisoned the paramedics and had a reputation for his patients dying unexpectedly. She was afraid that Swango might have committed crimes—even murder—at Northport. As Tom had told me back in the office, the program said Swango was nicknamed Double O Swango, Licensed to Kill,
at a hospital where he worked in Ohio, and he was asked to resign under suspicious circumstances. The television program alleged a trail of death followed wherever he went, including the suicide of his fiancée.
I was a little pissed at Tom for not calling me the night he had seen the show. It might have given me time to prepare a little better. Maybe I could have initiated the call to Northport and taken the lead instead of following up on Doctor Thomesen’s call.
But here I was listening to these incredible stories about Swango. On the surface, it