Perfect Poison (8 page)

Henry Hudon spent the night of December 7 vomiting and having diarrhea.

“Momma, I still feel sick,” Henry said over the phone the next morning. “Take me back, Momma. I'm still throwing up.”

Julia Hudon noticed the weakness in his voice. But she was relieved that he was alert and aware enough to call her.

Henry lived in a small, one-room efficiency apartment on Mill Street in Springfield. It wasn't much, but it sure beat living on the street in his car, where he had recently lived.

When Julia arrived, she could tell by looking at her son's apartment that he'd had a rough night. From one end of the room to the other, the floor was slick with bodily fluids. Yet Henry was up and around, walking back and forth.

“You need to eat something, Henry,” Julia said as they made their way to her car. “I'm stopping at McDonald's.”

But Henry didn't have an appetite, and wasn't likely to keep anything down. So he sat in his mother's car and tossed French fries to the sea gulls that were flocking around the parking lot.

“They're beautiful, aren't they, Momma?”

“They sure are, Henry.”

As Henry continued to feed the gulls, Julia Hudon thought about how she was going to get her son readmitted to the VAMC. She knew the hospital was going to hassle Henry about taking off the previous day, and thought it was even likely that they would deny him a bed.

So she hatched a plan.

“Listen, Henry,” she said. “If you have to tell them you took pills—red, yellow, green, whatever—you tell them anything.
Just get that bed.”

Henry understood he needed to be back on his medication and that whatever he said would have to be convincing. So after parking the car and speaking to an orderly, Henry and Julia walked into Admissions, and Henry showed the clerk at the desk the bracelet he still had on from the previous day.

“I took thirty red pills last night and twenty this morning,” Henry said. “I drank a twelve-pack of beer.”

“Okay . . .” the clerk said, and handed Henry some paperwork to fill out.

As Henry and his mother sat and waited for a nurse, Henry said, “I have to go to the bathroom.”

“You better hurry . . .”

By then, RN Cynthia Galante had been briefed about what Henry had said.

As Julia waited outside the bathroom, she could hear Henry dry-heaving and gagging to the point of choking. When she saw Jack Harris, a security guard Henry had known, Julia yelled, “Hey, Jack, can you go in there and check on my son?”

Harris then went over and knocked on the bathroom door.

“Are you okay, Henry?”

Getting no answer, he used his master key to unlock the door, and walked in.

“Are you okay, man?”

Henry got up off the ground, wiped off his mouth on his shirt sleeve, and said, “I took an overdose of drugs because I want to kill myself.”

“Come on, Henry. Let's go get you some help.”

While helping him into a wheelchair, Harris, a trained medical emergency technician, noticed that Henry had a “steady gait, his speech was not slurred and his pupils were not dilated or constricted.” When Harris looked into the toilet bowl to see if there was any blood, all he saw was “white sputum,” but it had no odor and didn't smell of alcohol. Added to the fact that, besides vomiting, Henry wasn't impaired in any way, Harris became curious.

As Cynthia Galante watched Harris wheel Henry into Admissions, she stopped what she was doing, took the wheelchair from Harris, and led Henry into the triage room, where he was placed on a stretcher.

Harris filled her in.

A few minutes later, at 12:05, Galante took Henry's vital signs for the first time. His temperature was 97.9; pulse 80; respiratory rate 28; and his blood pressure 138 over 84.

Henry Hudon had the vital signs of a healthy twenty-year-old.

Galante also noticed that he appeared to be alert, coherent and cooperative. She noted that his intake vital signs were normal and, oddly enough, “did not exhibit the symptoms of a drug overdose.”

“I am used to seeing a patient who is unable to respond,” Galante later recalled, referring to veterans who come in drunk, or on drugs. By contrast, Henry was talking and having no problem answering questions.

“Mr. Hudon,” Galante asked, “what's going on with you?”

“I took an overdose of pills . . .”

“Why?”

“Because of increased pain.”

For the next thirty minutes, Henry was assessed and his vitals were monitored. His condition never changed. At one point, he told Galante that his arm and chest hurt because he had been in a fight just days ago and had gotten punched in the chest.

Then Dr. William Smith came in and made the determination that Henry was admitted for a “drug overdose for pain,” but he was “not suicidal,” and that he took the “pills for a sore arm.” Dr. Smith asked Henry several questions, but Henry refused to answer, only saying that his right elbow was sore.

Waiting patiently in the triage room, Julia Hudon finally got the answer she had been hoping to hear since she picked Henry up hours ago—that he would be admitted to Ward C.

Moments later, Jack Harris pushed Henry over to the elevator so he could be taken up to the ward and formally admitted.

“Momma, I don't want to die,” Henry said as the elevator doors began to close.

“It's a hospital, Henry. They are going to make you better. You go back up and get stabilized. I'll bring you one of your Christmas gifts tomorrow when I come back.”

The frosty air outside the hospital enveloped Julia Hudon as she opened the door and headed for her car. The sun was propped up just behind the pointed peaks of the Berkshire Mountains, and the blood-red sky was getting ready to give way to the night over the horizon. It was a quiet and beautiful winter day in the mountains of New England, and Julia Hudon could now rest assured that her son was in good hands.

On December 8, RN Elizabeth Corey worked the dreaded 6:00
A.M.
to 6:00
P.M.
shift. That it was a Sunday only added to the day's longevity. When she admitted Henry Hudon to the four-bed ICU of Ward C at around two o'clock, she too noticed right away that something wasn't quite adding up.

It was obvious that Henry Hudon had lied about his condition. He was not showing any signs of a drug overdose or drunkenness. And sure enough, a breathalyzer test administered when he had first come in had now come back negative and his preliminary blood test results came back negative for both alcohol
and
drugs.

At 2:15, Corey gave him a shot of benadryl, “to help him rest.” Profuse vomiting during the last twenty-four hours was taxing on the human body. A few hours of uninterrupted sleep would do Henry some good.

Shortly after giving him the shot, Corey checked his vital signs. Again, they were normal and stable. His heart rate, with a normal sinus rhythm, was about seventy to eighty. Perfect. Henry Hudon was a typical healthy, physically fit, thirty-five-year-old schizophrenic suffering from a severe case of the flu.

Nothing more. Nothing less.

As hospital protocol dictated, RN Corey had checked Henry's vital signs once again before she handed him over to Gilbert at about five o'clock. His heart rate and rhythm, Corey noted, were, again, normal and stable. For the three hours Corey had spent with Henry Hudon, his condition hadn't changed one bit.

 

 

Dr. Gregory Blackman was a young and energetic radiologist when he began working at the VAMC in April 1993. Working full-time at Baystate Medical Center in Springfield, Blackman, the father of two kids, moonlighted at the VAMC to help make ends meet.

Ever since he'd started his second job, Blackman had worked the weekend evening shift. While on duty, his responsibilities included making the rounds through the ER and Admissions. He wore a pager so he could respond to any codes called in the hospital during his shift.

His first night at the VAMC back in 1993 was a night Blackman will likely never forget.

After an unsuccessful code, Blackman got upset that one of the nurses didn't “bay the patient properly,” meaning that the nurse, by his estimation, had failed to ventilate the patient accurately. Although it wasn't the nurse's fault that the patient died, afterward Blackman snapped at her.

“Next time, you need to bay him correctly!”

As Blackman was leaving the room, Gilbert grabbed him by the arm and pulled him aside.

“You need to adjust your attitude,” she said. “We are not at the university anymore. This is a VA hospital . . .
doctor.”

It was the first time Dr. Blackman had met Kristen Gilbert.

 

 

On Sunday, December 8, 1995, Blackman got to work around 5 :15. Within an hour, it would be another night he would never forget—and, notably, it would involve Kristen Gilbert once more.

Making his rounds, Blackman went into Henry Hudon's room around 5:30 and, like everyone else, assessed him as being “alert and comfortable.” By this time, Henry had seen eight people. Each person had agreed that, aside from being in the throes of schizophrenia and suffering from a bout with the flu, there was nothing else wrong.

“Henry wasn't drowsy or sleepy at all,” Blackman later recalled.

For about two minutes, Blackman watched Henry's heart rate on the telemetry monitor RN Corey had hooked him up to before she left, and decided that there was nothing out of the ordinary. The only danger Henry Hudon faced was himself: He needed to stop running away from the hospital and get his meds stabilized. After that, everything would fall into place.

The previous night, Gilbert and Perrault were down at the VFW throwing darts with some friends. One time, Perrault purposely botched a shot and nicked Gilbert's toe. She had been teasing him about it the entire day, on December 8, before they got to work.

At 5:18, Perrault sent Gilbert an e-mail on the VAMC's computer network. He said he felt bad about what had happened at the VFW, but he knew that she wasn't
really
mad at him, and that it was all just a cute little act.

“[B]ut please don't remind me of what I did. I didn't want to hurt you. . . .”

The remainder of the e-mail consisted of Perrault's telling Gilbert about some chicken he had put in the oven before he left for work. Then he went on to explain about an upcoming Christmas party he was going to in Worcester, Massachusetts, on the following Sunday. It was a yearly military outing. He wanted Gilbert to meet him after his maneuvers so she could attend the party with him.

Thirty minutes after Perrault sent that first e-mail, for no apparent reason, Henry Hudon's condition dramatically changed. His heart rate, doubling, went from 80 to 160, and his blood pressure went from 138 over 84 to a whopping 200 over 120, all in a matter of moments.

After Hudon went into sudden cardiac arrest, Gilbert called a code and began resuscitation efforts as staff poured into the room. Henry Hudon, a young man who had come into the VAMC merely five hours ago suffering from the flu, was now fighting for his life.

“He had a seizure. . . .” Gilbert said when Dr. Blackman came into the room. “He's asystole. . . .”

Asystole is not something a doctor wants to hear when arriving on the scene of a code. It is a “cardiac standstill with no cardiac output and . . . eventually occurs in all dying patients.” There is no heart activity. The heart is flatlined . . . and it is almost impossible to get a patient back once his heart is in asystole.

Blackman was beside himself. It was shocking to hear that Hudon, a man he had just seen, was now, suddenly, this close to death. But not only that, Gilbert had said he'd gone into a seizure. Seizures don't cause asystole; one can get respiratory arrest from a seizure, but even then, it's rare.

Nothing was making any sense.

To get air into his lungs, respiratory therapist Michael Krason intubated Henry right away. They couldn't shock Henry's motionless heart because once the heart is in asystole, a defibrillation shock can cause death. The only other thing the doctor could have done at that point was give the patient a drug called epinephrine, a synthetic form of the naturally occurring drug adrenaline. Epinephrine will shock the still heart of a dying man back into some sort of rhythm. Doctors order it all the time during codes.

Given to a healthy man, however, it would kill him.

Dr. Blackman ordered five “bristo-jet” packages of epinephrine to be pumped directly into Henry's IV.

After twenty-five minutes, Blackman and his crew brought Henry back to life. The young doctor was shaken, but he was overwhelmed by Hudon's desire to fight, and couldn't believe they had brought him back. Within moments, Hudon was opening his eyes and responding. Not only had they gotten him back, but it was evident that being dead for fifteen to twenty minutes hadn't affected Hudon's brain function.

When Blackman saw Henry open his eyes, he wanted to walk around and high-five each member of the crew. They had done the unthinkable.
What a job!
Henry Hudon was going to live.

Gilbert, watching Blackman celebrate, walked over and said, “Dr. Blackman, slow down a little . . .”

“Excuse me?” Blackman said.

“Don't be so happy. It wasn't
that
great of a save.”

“He's a schizophrenic, you know.”

Blackman was shocked.
How dare she ruin such a moment!

But instead of confronting Gilbert under these tremendously exhilarating circumstances, he simply said, “I still think it was a good thing.”

Before he left the room, at about 6:15, Blackman gave strict orders to keep Henry medicated and on a ventilator. “And one last thing: make sure to notify me immediately if his condition changes.”