The Caretaker

In 1982, Dr. Kathleen Holland opened a pediatrics clinic in Kerville, Texas.  She hired a licensed vocational nurse named Genene Ann Jones, who had recently resigned from the Bexar County Medical Center Hospital. Then over the next two months, seven children had seizures. The staff at the hospital where she transported them was suspicious.  Holland had no idea what to say, and then one of the children died.

However, a bottle of succinylcholine, a powerful muscle relaxant, had turned up missing, and then suddenly Genene Jones located it.  Holland dismissed Jones, and was later to learn that the bottle had been filled with saline.  In other words, someone had been using this dangerous drug.

It wasn't the first time Jones had been in trouble.

In February 1983, a grand jury was convened to look into 47 suspicious deaths of children at Bexar County Medical Center Hospital that had occurred over a period of four years---the time when she had been a nurse there.  A second grand jury organized hearings on the children from Holland's clinic.  The body of Chelsea McClellan was exhumed and her tissues tested; her death appeared to have been caused by an injection of the muscle relaxant.

The grand jury indicted Jones on two counts of murder, and several charges of injury to six other children.  Anyone who knew Jones was not altogether surprised.  She could be inordinately aggressive, had betrayed friends, and often resorted to lies to manipulate others---a classic psychopath.  While she'd wanted children all her life, the two she had she'd left in the care of her adoptive mother. 

The first child she picked up in her job at Bexar County Medical had a fatal intestinal condition, and when he died shortly thereafter, she went berserk.  She brought a stool into the cubicle where the body lay and sat staring at it. 

By 1981, Jones demanded to be put in charge of the sickest patients.  That placed her close to those that died most often.  She loved the excitement of an emergency, and even seemed to enjoy the grief she experienced when a child didn't make it.  She always wanted to take the corpse to the morgue.

It became clear to everyone that children were dying in this unit from problems that shouldn't have been fatal.  The need for resuscitation suddenly seemed constant---but only when Jones was around.  Those in the most critical condition were all under her care.  One child had a seizure three days in a row, but only on her shift. "They're going to start thinking I'm the Death Nurse," Jones quipped one day.

Then a baby named Jose Antonio Flores, six months old, went into cardiac arrest while in Jones's care.  He was revived, but went into arrest again the next day during her shift and died from bleeding. Tests on the corpse indicated an overdose of a drug called Heparin, an anticoagulant.  No one had ordered it. 

Then Rolando Santos, being treated for pneumonia, was having seizures, cardiac arrest, and extensive unexplained bleeding.  All of his troubles developed or intensified on Jones's shift.  Finally one doctor stepped forward and told the hospital staff that she was killing children. They needed an investigation.  Yet the nurses protected her.  Since the hospital did not want bad publicity, they accepted whatever the head nurse said.

Another child was sent to the pediatrics unit to recover from open-heart surgery.  At first, he progressed well, but on Jones's shift, he became lethargic.  Then his condition deteriorated and he soon died.  Jones grabbed a syringe and squirted fluid over the child in the sign of a cross, then repeated it on herself.

Finally, a committee was formed to look into the problem.  They decided to replace the LVNs with RNs on the unit, and Jones promptly resigned.  To their mind, that took care of the problem.

All it did was let her know she could get away with medical abuse, and she moved on to the Kerrville clinic.  Despite the risk of exposure in such a small place to inject children to the point of seizure, she didn't stop.

Although Dr. Holland was warned in veiled tones not to hire Genene Jones, she viewed Jones as a victim of the male-dominated patriarchy.  She had no idea that by teaming up with this woman, she was about to kill her own career, her marriage, and one of her young charges.

At trial, prosecutors presented Jones as having a hero complex: She needed to take the children to the edge of death and then bring them back so that she could be acclaimed their savior.  One of her former colleagues reported that she wanted to get more sick children into the intensive care unit.  "They're out there," she supposedly said.  "All you have to do is find them."

Yet her actions may actually have been inspired by a more mundane motive: She liked the excitement and the attention it brought her.  The children couldn't tell on her; they were at her mercy.  So she was free to recreate emergencies over and over.

In a statistical report presented at the second trial, an investigator stated that children were 25% more likely to have a cardiac arrest when Jones was in charge, and 10% more likely to die.

On February 15, 1982, Jones was convicted of murder.  Later that year, she was found guilty of injuring another child by injection.  The two sentences totaled 159 years, but she's eligible for parole after 20. 

Clearly, Jones made the deliberate effort to kill, but not all female killers are as aggressive.  Yet denial can still play a part in the tragedies they cause, as was the case with the next woman, who became quite famous for her unintentional crimes.

CrimeLibrary.com

by Katherine Ramsland

Too Young to Die

Petti McClellan took her blond, blue-eyed baby daughter Chelsea into the new pediatric clinic. It was Friday, September 17, 1982.  The clinic had just opened the day before in Kerrville, Texas, not far from the trailer home where she and her husband Reid lived.  Chelsea was just 8 months old, but she had a cold, and her mother wanted to be safe.  Chelsea had been born premature, with underdeveloped lungs, so she was prone to infection. Early in her life, she had spent time on a hospital respirator.  She had also experienced what Petti described as "spells" of losing her breath.  Chelsea was the clinic's very first patient.

In Women Who Kill, Carol Anne Davis (who bases much of her account on Deadly Medicine) wrote that pediatric nurse Genene Jones took the child to another area of the clinic to play with a ball while Dr. Kathleen Holland talked with the mother.  Soon after, Jones told them that Chelsea had stopped breathing.  She placed an oxygen mask over the baby’s face and they rushed her to an emergency room at nearby Sid Peterson Hospital.  To everyone's relief, the child recovered.  Chelsea's parents were grateful that such a competent nurse was on staff there.  They spread the word to other parents.  

Nine months later, they brought Chelsea in again.  This time the results were drastically different.   Peter Elkind, a journalist who briefly met Genene Jones, offers a fuller account in The Death Shift.

“Chelsea was the first appointment of the day, just a routine check-up.  Petti McClellan brought her in around midmorning, and Dr. Holland ordered two standard inoculations.  Shortly after nurse Genene Jones injected the first needle, Chelsea started having trouble breathing.  It appeared that she was having a seizure, so McClellan asked her to stop.  Jones ignored her and gave the child a second injection.  Then Chelsea stopped breathing altogether.  She jerked around as if trying to breathe, and then went limp.”

An ambulance was called and they transported Chelsea to Sid Peterson Hospital, where she arrived in nine minutes with a breathing tube down her throat. Jones carried the child in her arms all the way there.  Chelsea tried to remove the tube, so Dr. Holland replaced it with a larger one and then gave her something to make her sleep. Jones allegedly said, "And they said there wouldn't be any excitement when we came to Kerrville."  In fact, there was to be plenty of excitement at that clinic—more than most clinics get--and Jones was always at the center.

Holland arranged to transport Chelsea to a hospital where neurological tests could be performed, and while she was in the ambulance, Chelsea stopped breathing again and her heart stopped.  Jones gave her several injections while Dr. Holland performed a heart massage, but there was no response.  They pulled into a nearby hospital and continued treatment.  But after 20 minutes it was clear that they had failed.  Chelsea McClellan was dead. 

Jones sobbed over the body as she cleaned it up and wrapped it in a blanket for the McClellans.  Petti McClellan believed that her daughter was merely asleep.  No matter what anyone said to her, she could not come to terms with the fact that Chelsea was dead.

They all returned to Sid Peterson Hospital, and Jones carried the child downstairs to the hospital morgue.  Dr. Holland wanted an autopsy.  She was not going to just let this go as a cardiac arrest.  The whole thing had been too unusual.  Chelsea had not even come in with a complaint.  She had been there for a routine examination.

The autopsy was performed and Holland waited for the results.  In the meantime, the McClellans arranged the funeral.  After a few weeks, it was determined that Chelsea had died of SIDS, an often fatal breathing dysfunction in babies.  But new tests would later challenge that conclusion.

Petti McClellan was unable to cope, according to Elkind.  At the funeral, she screamed and fainted, and her relatives sent her to get psychiatric help.  Thanks to that, she had spent a considerable amount of time in a haze, but the sharp grief had not yet dulled.

One day, a week after the funeral, she went to the Garden of Memories Cemetery to lay flowers on her daughter's grave. 

As she approached the grave, she saw the nurse from the clinic, Genene Jones.  Oddly, she was kneeling at the foot of Chelsea's grave, sobbing and wailing the child's name over and over.  She rocked back and forth, apparently in deep anguish, as if Chelsea had been her own daughter.

"What are you doing here?" McClellan asked. Did this nurse feel guilty about her role in Chelsea's death?  Perhaps she had neglected to do something that had made the crucial difference?

Confronted, Jones returned a blank stare, as if in a trance, and walked away without a word.  When she was gone, McClellan noticed something else.  While Jones had left a small token of flowers, she had taken a bow from Chelsea's grave. 

Wrong Turns

In The Encyclopedia of Serial Killers, Michael Newton describes Jones’ background.  She had been a beautician before going into nursing in 1977 and had worked at several hospitals in the San Antonio area.  Peter Elkind says that she had claimed to have grown up feeling unwanted and unloved. 

Genene was born on July 13, 1950, and was immediately given up for adoption.  Her new parents were Dick and Gladys Jones, who adopted three other children as well—two older and one younger than Genene.  They lived in a two-story, four-bedroom mansion just outside San Antonio.  Dick was an entrepreneur and professional gambler.  He worked in the entertainment business, operating nightclubs.  Somewhat larger-than-life, he was free-spending and generous, but his lifestyle eventually took a toll on his family.  The nightclub went south and there was less money to spend.  Jones tried a restaurant, but that venture failed, too.

When Genene was 10, her father was arrested.  It seems that a large safe had turned up missing from a home owned by a man who had been at Jones' club at the time of the burglary.  There was $1,500 in cash and some valuable jewelry inside.  A priest turned it over to police, protecting the one who had given it to him, but the police went after Dick Jones.  He confessed but claimed the episode was a practical joke.  The charges were dropped. 

Then Jones opened a billboard business.  For Genene, according to Carol Anne Davis in Women Who Kill, riding around in the truck with her father while he put up billboards was the happiest time of her life.  Other than that, she had a hard time getting attention.  She felt left out and unfavored by her parents. She went around calling herself the family's "black sheep."

Sometimes she would pretend to be ill in order to get people to notice, and at school she became bossy.  She was short and overweight, which added to her loneliness.  There were acquaintances who called her aggressive and friends who said she had betrayed them.  She was known for lying and manipulating people.

Genene was close to her younger brother, Travis, who loved to be in their father's shop.  When he was 14, he put together a pipe bomb that blew up in his face, killing him.  Genene was 16 at the time, and during the funeral, she screamed and fainted.  She had lost her closest companion. Some believe this trauma fed her peculiar cruelty.  Others said she was just histrionic and grabbed any opportunity for attention.

During her senior year of high school, Genene's father began to get sick.  He was diagnosed with terminal cancer, refused treatment and went home to die.  He made it through Christmas 1967, but died shortly afterward at the age of 56, just over a year after the death of Travis.

Genene was devastated and, though she hadn’t yet finished high school, believed that the remedy to her pain and loss was to get married right away.  She and her mother fought over it and Gladys soon turned to the bottle, getting drunk frequently but refusing to give permission for Genene to marry.  It was too soon after the family tragedies.

Finally when Genene graduated, she married a high school dropout, James “Jimmy” Harvey DeLany Jr.  (Davis claims that she trapped this man into marrying her by pretending she was pregnant.)  He, too, was overweight, and he cared only about hot rods.  After seven months of marriage, he enlisted in the navy and Genene, who was reportedly voracious in her desire for sex, was immediately unfaithful.  Intense and dramatic, she went after other men as if to fill the void left by her father's untimely death, and she bragged openly about it.  She even had affairs with married men and she began to spread rumors that she had been sexually abused as a child.

She depended on her mother for money, so Gladys urged her to think about a career.  With no real plans, Genene enrolled in beauty school.  Jimmy returned from the navy and they had a child.  After four years of marriage, she left her husband while he was recovering in the hospital from a boating accident.  Her divorce papers indicated that he had been violent with her.  They reconciled and then parted again for good.

Soon after, Genene's older brother died of cancer.  It was yet another loss, and her developing fear of cancer from working with hair dyes made a career change necessary.  She had worked in a hospital beauty salon, so it wasn't a far stretch to train as a nurse.  She was also pregnant, so now she had two children to care for.  Although she had wanted children all her life, she ended up leaving them in the care of her adoptive mother. 

Genene had reserved her special ardor for doctors, seeing them as mysterious and powerful.  She wanted to get near them, so she trained for a year to become a vocational nurse, and LVN or licensed vocational nurse.   She was good at it, although she was not altogether happy about being at the bottom of the medical totem pole.  Her interest in medicine began to take on mystical dimensions and, as acquaintances put it, she became obsessed with diagnosing people.

After only eight months at her first job at San Antonio's Methodist Hospital, she was fired, in part because she tried to make decisions in areas where she had no authority, and in part because she made rude demands on a patient who subsequently complained.  It wasn't difficult for her to find another job, but she didn't last long in that one either.  Eventually she was hired in the intensive care section of the pediatric unit of Bexar County Medical Center Hospital.  It was here that she would leave her mark—a tragic one.

Her Own Special Shift

The first child she picked up had a fatal intestinal condition, and when he died shortly after surgery, she went berserk.  She brought a stool into the cubicle where the body lay and sat staring at it.  The other nurses could not understand her behavior.  She hadn't even known the child and had barely been around him, so why the excessive grief?

It soon became clear to associates that Genene liked to feel needed, and she would often spend long hours on the ward during her 3-11 p.m. shift, insisting that her attention was important to a certain patient.  However, she skipped classes on the proper handling of drugs and in her first year made eight separate nursing errors, including while dispensing medication.  She sometimes developed a dependency on sick children, so she would refuse specific orders because she wanted to do what was "best" for the child. 

While there were sufficient grounds for dismissal, including coming in one night drunk, the head nurse Pat Belko liked and protected her, which gave Jones a feeling of invincibility.  She never liked to admit any mistakes, and now she had someone in power to back her up.  She tried to bully new nurses into looking to her for help, and more than one nurse transferred out of the unit to get away from her.

As she took charge, Genene grew more arrogant, aggressive and foul-mouthed.  She liked to talk about her sexual conquests, both past and future.  Not many people liked her.  She would make harrowing predictions about which baby was going to die, which upset the new nurses she was training.

Then a new doctor came to the ward, James Robotham.  Hired as the medical director of the pediatric intensive care unit, he took more responsibility for patients than other doctors had, and that meant edging out the nurses.  He also made them more accountable, which didn't sit well with them.  All except for Genene, who welcomed the opportunity to bring more problems to someone's attention—because that meant attention for her.

Her other means for getting noticed was to go to outpatient clinics for minor physical complaints of her own, which Elkind says she did 30 times in just over two years.  Although she was never officially diagnosed, she may have been suffering from a form of Munchausen Syndrome, in which people become "hospital hoboes" to get attention from caring staff that they feel they missed out on as children.  Even when Genene wasn't at some county clinic, she was complaining about her health and seeking some leverage with it.  One physician said her problems were psychosomatic. 

In 1981, Jones demanded to be put in charge of the sickest patients.  That placed her close to those who died.  She seemed to thrive on the excitement of an emergency and even on grief when a child didn't make it.  While she prepared a body, she would sing to it and she always wanted to take the corpse to the morgue.  This routine was a regular procession, with a security guard walking ahead of her to close patients' doors.  Genene often cried as she performed this task, but then again, it did seem as if she liked to cry.

No one seemed concerned that many medications were freely available on that ward in an unlocked cabinet -- not until later.  Nor did they give any thought to the fact that the hospital where Genene had last worked had not given a reason for her dismissal.  No one followed up, although Genene was placed in a role of significant responsibility.  Her special talent, Elkind points out, was putting intravenous tubes into veins.  She requested special seminars handling certain drugs and asked many questions.  People were impressed by how much she wanted to learn.

It eventually became clear to everyone that children were dying in this unit from problems that shouldn't have been fatal.  Davis claims there was one two-week period where seven children died.  The need for resuscitation suddenly seemed constant---but only when Genene was around.  Those in the most critical condition were all under her care.  There was no denying the excitement that an emergency situation engendered, and Genene even commented on several occasions that it was "an incredible experience."  One child had a seizure three days in a row, but only on her shift.

"They're going to start thinking I'm the Death Nurse," Jones quipped one day.  In fact, some of the staff called her on-duty hours the Death Shift, based on the many resuscitations that were going on during the hours she was there—and the many deaths.

She even seemed to enjoy calling parents to let them know about their child's death and to commiserate. If a baby's health was bad, she would announce to the other nurses, "Tonight is the night."  If a child was near death, she always took a special interest.  She clearly wanted to be there when it happened.

While rumors were passed around that Genene was doing something to these children, Pat Belko defended her.  It was just gossip from nurses who were jealous of her competence.  She refused to listen.

Then a baby named Jose Antonio Flores, six months old, came in with some common childhood symptoms: fever, vomiting and diarrhea.  While in Genene's care, he developed unexplained seizures and went into cardiac arrest.  

The Death Shift

It took doctors almost an hour to save young Jose, but they did.  They noticed he was bleeding badly and they could not determine the cause.  They found that his blood was not clotting, but eventually the problem subsided and he seemed okay -- until the following day during the 3-11 shift.

Once again, Jose went into seizures and began to bleed.  Early the next morning, his heart stopped beating.  Cause of death: unknown.

When a doctor told Jose’s father about losing his son, the man had a heart attack.  While helping Mr. Flores to the emergency room, Genene allowed Jose's older brother to carry the baby’s body.  Then she grabbed the dead baby and ran down the hospital corridor.  Several members of the family ran after her.  She lost them and went into the morgue.  No one could figure out what her behavior meant, but blood testing on the body indicated an overdose of a drug called heparin, an anticoagulant.  No one had ordered it, and her superiors became suspicious.   

Then two resident physicians who were treating a 3-month-old boy named Albert Garza found that Genene probably gave him an overdose of heparin.  When they confronted her, she got angry and left, but the child recovered.  This incident also resulted in tighter control over the staff’s use of heparin, making nurses more accountable and records more precise.  Children whose health declined were to be subject to extra lab tests.  If someone was doing something to children on this ward, she was going to get caught.

It was at this point that Genene's health seemed to be suffering.  She also refused drugs prescribed by doctors to improve her condition. Often when she complained of something, there was no evidence for it.  Again, it appeared she was angling for attention.  Dr. Robotham, who had once been her ally, began to complain formally about Genene Jones.

In November 1981, the hospital administration, somewhat resistant to an internal investigation of the pediatrics ward, had a meeting.  They decided that Dr. Robotham was overreacting.  The struggling hospital did not need the possibility that such suspicions would come to the public's attention, so they declined to follow through.  Yet that did not end Robotham's efforts to launch a formal investigation.  He continued to watch the records of the 3-11 shift.

While heparin use was carefully monitored, another drug suddenly showed up in the death of  Joshua Sawyer, age 11 months.  He was brought in suffering from the effects of smoke inhalation after a fire at his home.  He'd had a cardiac arrest, and doctors ordered Dilantin.  He remained in a coma, but doctors expected him to make progress.  Genene told his parents that he would be better off if allowed to die, however, since he would surely have serious brain damage.  Then quite suddenly, Joshua had two heart attacks and died.  His lab tests showed a toxic amount of Dilantin in his blood.  Clearly someone's handling at the hospital had killed him, but the test results went unnoticed.

When Genene became aware that those who had always supported her were now suspicious, she turned to blackmail.  She said she had records on every child that had died there and she knew which doctor had killed them.  Robotham requested that she be fired, but no one listened.  They also did not listen to the nurse who kept reporting that supplies were missing.

Then Rolando Santos, a 1-month-old baby being treated for pneumonia, was suddenly having seizures, cardiac arrest, and extensive unexplained bleeding.  All of his troubles developed or intensified on Genene's shift.  He began to urinate so badly that he suffered extreme dehydration.  For the three days Genene had off, the baby improved, but the afternoon she returned, he began to hemorrhage.  Then he had a heart attack.  Lab tests showed an excessive amount of heparin.  Initially, a doctor took over his care, but after Genene got hold of him, he worsened again and went into a coma.  Blood came up into his throat and his blood pressure dropped dangerously.  A doctor saved him and then ordered him removed from the pediatric ICU and placed under 24-hour surveillance.  Only under these conditions did he improve enough to be released to his parents.  Rolando survived his encounter with Genene Jones.  He was one of the lucky ones. 

Finally one more doctor stepped forward to tell the hospital administration that Genene Jones, the afternoon shift nurse, was killing children.  He had found a manual in her possessions about how to inject heparin subcutaneously without leaving a mark, and he had evidence of how Rolando Santos had suffered during Genene Jones’ working hours. The hospital resisted, however, not wanting bad press.

Another child was sent to the pediatrics unit to recover from open-heart surgery.  At first, he progressed well, but on Genene's shift, he became lethargic.  Then his condition deteriorated and he died.  The doctors were puzzled and could only attribute his death to some infection.  In view of everyone in the room where the child had succumbed, Genene grabbed a syringe and squirted fluid over his forehead in the sign of a cross, then repeated it on herself.  She grabbed the dead baby and began to cry.

More doctors complained and finally a committee was formed to look into the problem.  Pat Belko and James Robotham were in charge.  An outside team of investigators came in and determined that there was clearly a problem, but they declined to pin it on a single nurse.  In the end, the committee decided to replace the LVNs on the unit with RNs, which meant that Genene would be transferred away from the babies.  She reacted to this change by resigning.  The administrators were relieved.  In their minds, that took care of the problem.

All it did, however, was transfer the problem.  The medical emergencies on the afternoon shift returned to manageable numbers, but they started up elsewhere. 

Death Moves On

In 1982, Dr. Kathleen Holland opened a pediatrics clinic in Kerrville, Texas.  Needing help, she hired Genene Jones.  She had worked at Bexar County Hospital with her and had even testified on her behalf during the investigation.  Although Dr. Holland was warned in veiled tones not to hire Genene, she went ahead and did it, viewing Genene as a victim of the male-dominated medical patriarchy.  She believed that Genene was a competent nurse who just needed a chance, and she gave her the title pediatric clinician.  According to Carol Anne Davis, Holland helped to move Genene to Kerrville and rented rooms to her and her two children. 

Just months after Genene left Bexar, someone found a novel with her name in it called The Sisterhood, written by best-selling ER physician Michael Palmer.  The plot centered on a group of medical professionals who were pledged to end human suffering by terminating patients who they believed would be better off dead.  They had a specific protocol in place to ensure the most careful scrutiny, but as always in fiction, someone took things too far. 

In Murder Most Rare, Michael D. Kelleher and C.L. Kelleher reserve a chapter for “lethal caretakers,” medical professionals who kill their patients.  This contemporary form of the Angel of Death, they say, "embodies an especially pernicious darkness in our humanity by systematically attacking the weak and defenseless who have been involuntarily placed into her care or must rely on her for comfort and support."  These people carry out their crimes within institutions where chemicals and syringes are abundant and where they can hide their behavior for long periods of time.  Typically they select patients whose deaths are explainable because they were in some weakened or near-fatal condition already. Easy to kill, easy to cover up.

Yet what motivates these people?  "Ego and a compulsion for domination," say the authors. "She is obsessed with the need to control those who are completely dependent on her.  Some, like Genene Jones, are also motivated by a need for attention.  While they appear to be going about their routines, they are making decisions about who should live and who should die.  What happens to the patient does not matter to the caretakers; what matters is what the incident does for them.”

Many parents around Kerrville were happy to have Dr. Holland's clinic available, but during a period of two months that first summer, seven different children succumbed to seizures while in her office.  In one case, Genene told a worried mother that the child was just having a tantrum---an understatement that nearly cost the child her life.  Holland transferred each of them by ambulance to Kerr County's Sid Peterson Hospital, never thinking the seizures were suspicious.  Yet Genene's accounts of these incidents always differed from those of other professionals involved—and one of them had seen her inject something into a child who then had seizures.  From the sheer numbers of children afflicted in the same clinic, the hospital staff thought something odd must be going on, especially since the kids always recovered quickly while in the hospital.

Holland assumed the severity of the situation was because she was a specialist, not a generalist, so the worst cases were brought to her.  At least they had all recovered. 

But then Chelsea McClellan died while en route from the hospital to another facility.  Dr. Holland was devastated, as were Chelsea's parents.  The child had not even been very ill.  The same day, after Genene had returned to the clinic to see another patient, the boy went into seizures and had to be resuscitated.  The child stabilized and his parents later commented that Genene had appeared to be quite excited over the incident, even happy.  Tests afterward indicated there was no reason for such an unexpected episode.

At about that time, a doctor at Sid Peterson discovered the high number of baby deaths at the hospital where Genene Jones had previously worked.  He brought this to the attention of a committee, and they began to realize that she was doing something to these children.  They brought in Dr. Holland and asked if she was using succinylcholine, a powerful muscle relaxant.  She said she had some in her office but did not use it. Without telling her, someone on the committee notified the Texas Rangers.

Holland told Genene about the meeting, and Genene assured Dr. Holland that she had found the bottle of succinylcholine that was missing.  The cap was gone, and Holland began to have suspicions.

On September 27, while Genene was at lunch, Dr. Holland examined the bottles of succinylcholine.  They were both nearly full, but one of them had pinprick holes through the rubber stopper. When Genene could not give a credible accounting of it and even suggested they just throw the bottle away to avoid questions, Dr. Holland was alarmed.  She later learned that the near-full bottle had been filled with saline.  In other words, someone had been using a lot of this dangerous drug, which paralyzed people into a sort of hell on earth: they lay inert but aware and unable to get anyone's attention.

Before she could take any action, Dr. Holland was faced with another crisis: Genene told her that she had taken an overdose of doxepin, a drug to fight anxiety.  She had to have her stomach pumped, but it turned out that she had not overdosed at all.  She had taken only four of the pills, but she had faked a semi-coma, forcing emergency personnel to treat her.

Then Holland discovered that another bottle of succinylcholine had been ordered but was missing.  On September 28, she fired Genene and offered any help she could to the investigation.

Even so, families left her practice and Sid Peterson suspended her privileges.  For hiring Genene Jones, Holland was losing everything.  Even her husband divorced her.  On top of that, she saw evidence that Genene was trying to frame her and she began to fear for her own life. 

Justice

On October 12, 1982, a grand jury in Kerr County organized hearings on the eight children from Holland's clinic who had developed emergency respiratory problems and the one who had died—Chelsea McClellan.  Her body was exhumed to examine the tissues with an expensive test that had just been developed in Sweden to detect the presence of succinylcholine.  The test showed that her death appeared to have been caused by an injection of the muscle relaxant.  However, it was exceedingly difficult to get real proof against the nurse.  No one had seen her give the actual injection.

In February 1983, another grand jury was convened in San Antonio, to look into a stunning total of 47 suspicious deaths of children at Bexar County Medical Center Hospital.  All had occurred over a period of four years and all coincided with Genene Jones's tenure at that facility.  There was plenty of testimony from coworkers about Genene's behavior, but again, no real proof.

Three former Bexar employees, including Jones, then 32, were questioned by both grand juries.  Dr. Holland was also questioned, and Chelsea's parents named her and Jones in a wrongful death suit.  Holland had turned against Genene, offering the district attorney ammunition against her former nurse, specifically in her discovery of the bottles of succinylcholine.

At some point, Genene married a 19-year-old boy, possibly to deflect tabloid rumors that she was a lesbian.  She was caught trying to flee with him.

The Kerr County grand jury concluded first and indicted Jones on one count of murder in Kerr County, and several charges of injury to seven other children who had been injected with muscle-relaxing drugs.  For these, she faced a possible sentence of 99 years and she was held in the Kerr County jail in lieu of a $225,000 bond.

Then in November, the San Antonio grand jury indicted her for injuring four-week-old boy Rolando Santos with a deliberate injection of heparin almost two years earlier.  He had nearly died from it.  Jones remained a suspect in 10 other infant deaths at the hospital.

Administrators at the facilities where she had worked were appalled.  They were also embarrassed, because it became increasingly clear that they had known something and had not acted.

While awaiting trial Jones supposedly told someone, according to Elkind, "I always cry when babies die.  You can almost explain away an adult death.  When you look at an adult die, you can say they've had a full life.  When a baby dies, they've been cheated."

She claimed she was receiving death threats, although the notes she showed people bore the same handwriting and misspellings as those she herself had sent to a nurse once in San Antonio.  When her trial was moved to a new venue in Georgetown, Texas, her attorney asked to be replaced. She gave interviews freely to reporters that undermined his attempts to build a defense and he feared that she would do the same on the witness stand.

There were two separate trials, and the first one began on January 15, 1984, for the murder of Chelsea McClellan and injury to other children.

Prosecutors said Genene Jones had a hero complex: She needed to take the children to the edge of death and then bring them back so that she could be acclaimed their savior.  One of her former colleagues reported that she had wanted to get more sick children into the intensive care unit.  "They're out there," she supposedly said.  "All you have to do is find them."  Witnesses testified that she would contradict herself by telling one person she had injected a specific type of substance, and another person that it was something else.  All in all, her pattern of behavior was clearly suspicious, including the fact that she had asked for an educational seminar specifically on the use of succinylcholine.

Yet her actions may actually have been inspired by a more mundane motive: She liked the excitement and the attention it brought her.  There was no doubt that her behavior had escalated and that she had taken more risks.  The children couldn't tell on her; they were at her mercy.  She was free to create emergencies over and over.  It was Munchausen syndrome by proxy: getting attention from doctors by making someone else sick.

No one raised the possibility that Genene had acted out something that had been done to her as a child.  While she had hinted at abuse to friends, there was no one to confirm that.

Much of this was replayed at the second trial, but specifically in regard to her behavior at Bexar.  In a statistical report presented at that trial, an investigator stated that children were 25% more likely to have a cardiac arrest when Jones was in charge and 10% more likely to die.  A psychiatric exam failed to provide her with the testimony she would need for an insanity defense.  Instead, her lawyer brought in witnesses to testify that Genene was devoted, competent and responsible.

The first jury deliberated for only three hours.  On February 15, 1984, Jones was convicted of murder and she was given the maximum sentence of 99 years.  Later that year, in October, she was found guilty of the charge of injuring Rolando Santos by injection.  The two sentences totaled 159 years, but with the possibility of parole. 

Although she was suspected in the deaths of other children, the staff at the Bexar County Medical Center Hospital shredded 9,000 pounds of pharmaceutical records, thus destroying potential evidence that was under the grand jury's subpoena. 

Most of those at Bexar who had protected her ended up resigning, and the clinic settled the legal suit brought by the McClellans.

Jones came up for parole after 10 years, but relatives of Chelsea McClellan successfully fought to keep her behind bars, where she will remain until at least 2009, when she is again eligible for parole.

Bibliography

• Alt, Betty and Sandra Wells.  Wicked Women.  Boulder, CO: Paladin Press, 2000.

• Davis, Carol Anne.  Women Who Kill: Profiles of Female Serial Killers.  London: Allison and Busby, 2001.

• Elkind, Peter. The Death Shift: The True Story of Nurse Genene Jones and the Texas Baby Murders.  New York: Viking, 1983.

• Hickey, Eric.  Serial Murderers and Their Victims.  3rd Ed.  Belmont, CA: Wadsworth, 2000.

• Jones, Richard Glyn, ed.  The Mammoth Book of Women Who Kill.  New York: Carroll & Graf, 2002.

• Kelleher, Michael D. and C. L. Kelleher.  Murder Most Rare.  New York: Dell, 1998.

• Lane, Brian and Wilfred Gregg. The Encyclopedia of Serial Killers.  New York: Berkley, 1995.

• Moore, Kelly and Dan Reed.  Deadly Medicine.  New York: St. Martin's Press, 1988.

• Newton, Michael. The Encyclopedia of Serial Killers.  New York: Checkmark Books, 2000.

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