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60 pages 2 hours read

Charles Graeber

The Good Nurse: A True Story of Medicine, Madness, and Murder

Nonfiction | Biography | Adult | Published in 2013

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Part 2, Chapters 51-57Chapter Summaries & Analyses

Chapter 51 Summary

Amy feels guilty as she continues to help the detectives, uncertain of where her nursing loyalties are. She prints off copies of the Cerner patient data, reviewing them and giving them to the detectives. The longer she does this, the more suspicious she feels and the more her stress manifests in physical symptoms. One night, while self-dispensing a Tylenol for a headache, she realizes that the Tylenol is kept in the same drawer as the digoxin. When the Pyxis door opens, the digoxin is accessible. Armed with this knowledge, she identifies a pattern that links Charlie ordering Tylenol to digoxin-related overdoses. She studies his other drug orders and realizes that he was creating his own drug cocktails for patients.

Chapter 52 Summary

Amy shares her discovery with the detectives. The next night, Amy studies Charlie’s Cerner data output and realizes that he was “hunting” for victims using the digital logs (205). She has another nightmare about Charlie’s drug dispensing. The next time she meets with the detectives, she provides background on the Cerner patient system and explains how Charlie frequently looked up patients that hadn’t been assigned to him, which contains proof that Charlie studied Reverend Gall’s data before his death. Amy realizes that she must have inadvertently delivered Charlie’s drug cocktails to patients.

Chapter 53 Summary

Reverend Gall’s toxicology report comes back and confirms that he died of a digoxin overdose. The police officers meet but find that despite all the circumstantial evidence pointing to Charlie, they have nothing definitive. Danny and Tim ask Amy to call Charlie and arrange a meeting, but he’s interested only when she acts as if it’s a date. Charlie brings up his feelings of sadness but resists her attempts to help, instead seeking sympathy. Tim grows frustrated with their slow progress, then decides to be more direct.

Chapter 54 Summary

Tim and Danny pull Charlie in for questioning, during which they tell him that he’s the target of their investigation. They lull him into a false sense of security by chatting with him and then interrogate him for hours. However, Charlie gives them no information during their extensive interview. They return him to his house at two o’ clock in the morning; Tim loses his cool and threatens Charlie with arrest the next time they see each other.

Chapter 55 Summary

While Charlie was being interrogated, a different police squad searched his belongings, but discovered nothing incriminating. Danny experiences anxiety and doubt over both failures, having gotten no useful information from Charlie. Danny and Tim discuss their frustrations, speculating that Charlie will get a lawyer and their case will go nowhere. Charlie calls Amy, leaving a voicemail describing his eventful day. He forgets to tell her that he found a new job.

Chapter 56 Summary

Tim goes for a drive so that he can make a private phone call to the FBI, intending to ask for help with the case against the prosecutor’s wishes. The case is unique for the FBI agents, who have dealt with killer nurses but nothing like Charlie’s description. They interrogate Tim about Charlie, making Tim feel increasingly unprepared and frustrated about his lack of evidence. The call ends with both parties vowing to reflect and devise a strategy. Meanwhile, Amy returns home, drinks some wine, and then notices a voicemail on her answering machine. She listens to the message: Charlie has found employment at Montgomery Hospital.

Chapter 57 Summary

Tim struggles to fall asleep after talking to Amy, who shared the news about Charlie’s new position. Finally, Tim calls Montgomery Hospital as a private citizen, warning them against hiring Charlie. The vice president of the hospital promises to let him go. However, Tim’s warning leaks to the press, and soon the police department is inundated with reporters. Tim and Danny feel the pressure, knowing that if they don’t act quickly, Charlie will never confess. They reach out to Amy.

Chapters 51-57 Analysis

The penultimate section of the text contains a series of failures that propel the detectives forward, acting as inspiration for their increasingly tense behaviors and hurried decisions. The key figures experience a series of escalations that they can’t resolve or mitigate, compounding the stakes and their worst fears. This tension shows that there are often no right choices, especially when people’s lives are at risk. In warning Montgomery Hospital, Tim inadvertently alerts the media to Charlie’s crimes; in talking with FBI agents, Tim experiences intense feelings of doubt, altering his mindset as he explores next steps. The high emotions of the case and proverbial ticking clock manifest in a final decision to have Amy draw a confession from Charlie, an act that puts her in the most emotional and physical danger. However, it’s the only course of action remaining to the detectives, having exhausted all other options.

Charlie’s newfound employment once again showcases the theme of The Fallibility of Institutions, just as Tim’s role in protecting the patients at Montgomery Hospital reinforces the theme of The Importance of Speaking Up. Somerset terminated Charlie’s contract but does nothing to prevent him from continuing in the nursing profession, just as Montgomery Hospital fails to do a proper reference check to confirm Charlie’s viability as a nurse. These two lapses in judgement would have given Charlie access to more victims had Tim not taken action. By speaking up, Tim advocates for victims and makes a clear challenge to the system that has empowered Charlie for so long. His one act of interruption saves lives, raising the question of who could have been saved had institutions listened more closely.

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