Book Review: The Good Nurse by Charles Graeber

Let me begin by saying that The Good Nurse hit home for me in ways I wasn’t expecting. As someone born and raised in New Jersey, I felt an undeniable pull to read about Charles Cullen, the infamous New Jersey native whose crimes shocked the nation. I was already familiar with the towns where Cullen grew up, the hospitals where he worked, and the prison where he is serving his life sentence. In fact, my brother even met Cullen while working at the New Jersey State Prison (formerly known as Trenton State Prison), where Cullen is incarcerated.

This connection made the book all the more personal, and I was eager to dive into the details of Cullen’s life, his crimes, and the psychology behind his actions. The Good Nurse follows Cullen’s journey from his troubled childhood to his rise as a registered nurse, and ultimately his shocking arrest and sentencing. In this blog, I’ll share an outline of key events from his life, followed by my thoughts on Cullen and the motivations behind his actions, as well as my overall take on the book itself.

*Alert: This blog contains spoilers!*

Overview

Upbringing

Charles Cullen’s childhood was far from idyllic.

Born in West Orange, New Jersey in 1960, Cullen was the youngest of eight children in a working-class Catholic family. His father, a bus driver, was 56 when Cullen was born, and tragically passed away when Cullen was just seven months old. His mother, burdened by grief and the responsibilities of raising eight children, struggled to provide the emotional support Cullen so desperately needed.

From an early age, Cullen faced bullying from classmates and his sister’s boyfriends. Many saw him as a misfit—socially awkward, strange, and withdrawn. By the time he was nine years old, Cullen made his first suicide attempt, drinking a dangerous mix of chemicals from a home chemistry set.

When his mother died in a car accident during his senior year of high school, Cullen was devastated. His anger toward the hospital for failing to notify him immediately of her passing, coupled with the insensitive handling of her body (they cremated her without his consent), sent him into a deep emotional spiral. In response to the grief, Cullen dropped out of school and enlisted in the U.S. Navy, though his time there was marked by instability and mental health struggles. A suicide attempt led to a medical discharge.

In 1984, Cullen began nursing school at Mountainside School of Nursing. He graduated in 1987 and went on to work at St. Barnabas Medical Center in Livingston, New Jersey—the first of many hospitals where he would leave his dark mark.

Marriage and Kids

In 1987, the same year Cullen embarked on his nursing career, he married his girlfriend, computer programmer Adrienne Taub. The couple had two daughters, but their marriage quickly deteriorated.

Adrienne noticed Cullen’s inability to connect emotionally with their children and his increasing withdrawal from family life. He often retreated to the basement to drink alone, and his disturbing behavior extended to their two Yorkshire terriers. He would abuse the dogs, leaving them tied outside in extreme weather, and once even shoved one into a bowling ball-sized bag and zipped it up, subjecting the dog to terror.

In 1993, Adrienne filed for divorce, citing “extreme cruelty.”

Murders and Arrest

Cullen’s killing spree began in 1988 and spanned 15 years, from 1988 to 2003. His method of murder was chillingly simple: he would tamper with drug protocols, delivering fatal overdoses to patients—patients who were often in the hospital for routine care, their deaths disguised as natural causes.

His first victim died in 1988 at St. Barnabas Medical Center when Cullen spiked an IV bag with a lethal dose of medication. Cullen continued to kill patients at several other hospitals, using various methods—often injecting lethal doses of digoxin or insulin. Despite mounting suspicions among hospital staff, Cullen was always able to move on to another hospital, leaving a trail of death in his wake.

Cullen’s downward spiral continued with incidents of harassment, stalking, and even arrest. At one hospital, he harassed a coworker, Michelle Tomlinson, obsessively calling her and eventually breaking into her home. He was arrested for trespassing but continued to kill at other hospitals.

Despite being treated for depression at several hospitals, Cullen’s crimes escalated. It wasn’t until he began working at Somerset Medical Center in 2002 that authorities started connecting the dots. With the help of his coworker Amy Loughren, detectives gathered critical evidence, and Cullen finally confessed to killing 40 patients. However, it’s estimated that the true number of victims may be closer to 400.

Cullen was arrested on December 15, 2003.

Sentencing

In exchange for his cooperation with prosecutors, Cullen avoided the death penalty. He pled guilty to 7 counts of murder and 3 counts of attempted murder in Pennsylvania, and 22 murders and 3 attempted murders in New Jersey. On March 2, 2006, Cullen was sentenced to 11 consecutive life terms in prison.

A Good Deed?

In an unexpected twist, Cullen donated a kidney to his ex-girlfriend’s brother in 2006. He claimed that his donation wasn’t intended to reduce his sentence, but the irony is impossible to ignore. After committing heinous murders without remorse, Cullen’s decision to save another person’s life raises troubling questions. How could someone capable of such cruelty suddenly want to do good? While I’m glad that a life was saved, I can’t help but feel uneasy about the contradictions in Cullen’s behavior.

Cullen’s Motive

Cullen himself gave several explanations for his murders, but they all seem to fall short. He claimed that he killed to end his patients’ suffering, but not all of his victims were terminally ill. I suspect Cullen’s actions were more about his own psychological need—perhaps the killings gave him a twisted sense of control or satisfaction. His struggles with mental illness, combined with a profound sense of alienation, may have played a key role in his descent into darkness.

The Hospitals: A Systemic Failure

One of the most disturbing aspects of this story is the role the hospitals played—or rather, failed to play—in preventing Cullen’s reign of terror. Despite mounting evidence and suspicious deaths, hospital administrators allowed Cullen to continue his work. The lack of transparency and accountability at these institutions allowed Cullen to move from one job to the next, while patient after patient died under his care.

Today, however, things are different. New laws in New Jersey, Pennsylvania, and other states require employers to provide honest appraisals of their employees, ensuring that no one with a history of suspicious behavior can slip through the cracks.

My Review and Rating

The Good Nurse is an eye-opening and disturbing account of one of the most prolific serial killers in U.S. history. Graeber’s meticulous research and storytelling dive deep into Cullen’s life, exploring his troubled childhood, his mental health struggles, and his horrific crimes.

What haunted me most while reading was the question of “Why?” Why did he do this? The book delves into the complexities of mental illness, and I found myself wondering how Cullen’s childhood, mental health issues, and the lack of intervention shaped his fate.

What’s more, the book raises critical questions about the institutions that failed to stop him—questions that are just as important today as they were then. The Good Nurse is a gripping, heartbreaking, and thought-provoking read that will leave you questioning the true nature of evil, and the flaws in our systems that allow it to thrive.

I found the book to be phenomenal and gave it a well-deserved 5-star rating, though it’s currently rated 3.81/5 on Goodreads.

If you’ve read this book, share your thoughts in the comments! I’d love to hear your perspective on Cullen’s story and the impact of this chilling account.