If you’re one of the many viewers who recently watched Tobias Lindholm’s The Good Nurse, which debuted on Netflix this past weekend, you were likely left reeling. The slow-burning thriller, which stars Jessica Chastain and Eddie Redmayne, tells the true story of how ICU nurse Amy Loughren aided in the arrest of her colleague and friend Charles Cullen—the man believed to be America’s most prolific serial killer.
The Good Nurse’s final scenes include subtitles that briefly summarize the real-life story’s epilogue: Cullen, responsible for killing an estimated 400 patients during his sixteen years of working at hospitals across New Jersey and Pennsylvania, pled guilty to the murder of 29 patients in 2003. He’s now serving 18 consecutive life sentences in New Jersey State Prison. As for Loughren, she now lives with her family in Florida. Still, as the credits roll, it doesn’t exactly feel like justice has been served. After all, there are many loose ends still floating in the ether–from unidentified victims, to hospitals’ unaddressed negligence, and, perhaps the most glaring loose end of all, the subtitle that reads, "He never explained why he did it."
Last month, Esquire interviewed Lindholm, Wilson-Cairns, and Loughren to get a clearer look at the true story behind The Good Nurse. (As messy as it may be.) Turns out, many of these loose ends were intentionally left open by Lindholm and screenwriter Krysty Wilson-Cairns when they adapted Charles Graeber’s 2013 book of the same name. Wilson-Cairns seems to have expected audience members to be frustrated–because having a full explanation to such atrocities can make us feel safer.
As for that climactic confession scene, when Loughren wraps her sweater around Cullen, before probing him to confess for the murder of multiple patients, Loughren confirmed that the depiction was "very, very real." Save for the difference in length (Loughren said the two talked for multiple hours before Cullen confessed, which was abridged for obvious reasons), Loughren says that the interactions were extremely accurate to what happened in real life, telling Esquire the reason why chose to put her sweater around Cullen in that moment. "I walked in the room when I was there to talk to him, and he's in scrubs," she recalls, "And I saw a scar on his arm that I had never seen before because he always wore long sleeves or had a sweater on.I saw the scar and I was like, ‘What is that?’ And he's like, ‘Another one of my failures in life. I can't even kill myself properly.’" Loughren said Cullen was also so cold that he was shaking, so, to protect his privacy and comfort, Loughren "instinctively" gave him the sweater off of her back.
Loughren also confirmed the relative accuracy of another pivotal scene, in which she puts together that Cullen was behind the mysterious string of deaths at Somerset Medical Center. Only Detective Danny Baldwin with her when he decided to throw a Hail Mary pass–handing Loughren medical records to inspect once the hospital’s risk manager had stepped out from the room. However, from Loughren’s account, it seems that her initial hesitation in the film to recognize that Cullen was a murderer may have been more immediate. "There were several things in that paperwork that were so blatant," she recalls now, adding "There was absolutely no reason that he would've taken out the medications that he took out except for something sinister."
Much of Loughren’s memory from that day, however, was muddled due to the pure shock of her realization. "I don't remember driving home that day," she told Esquire. "I don't even remember what I said to Danny that day. I remember him mouthing the words, when the risk manager came back in, ‘Will you help me?’"
Loughren also criticized Somerset Medical Center, asking, "If I could recognize that there was something sinister in that paperwork, the hospital definitely saw something sinister in that paperwork. And what was even more terrifying is, what if they didn't see?" Of course, as for the hospital's portrayal as reluctant to aid detectives Baldwin and Braun in their investigation, Wilson-Cairns and Loughren claim that this was accurate as well. Upon speaking with Baldwin and Braun, Wilson-Cairns compared their experience dealing with the medical system to "moving through foam."
Wilson-Cairns said that Graeber’s book details extensive accounts of information allegedly withheld by hospitals to avoid being liable for Cullen’s crimes. According to CBS, Detective Tim Braun even claimed in a 60 Minutes interview that Somerset Medical Center officials lied about computerized medical records. CBS also reported that Dr. Steven Marcus, director of N.J. Poison Control, had urged Somerset Medical Center Director William Cors to contact the police three months before authorities were contacted.
Though Loughren is primarily highlighted in The Good Nurse, Women’s Health reports that numerous nurses at the five hospitals Culled had worked at filed complaints against him. Despite all of this, as the film’s closing subtitles confirm, "There have never been criminal proceedings against any of the hospitals."
As for Cullen’s real-life victims, none of them were depicted in the film. Wilson-Cairns and Lindholm made a conscious choice not to use any real names or stories to avoid "re-traumatizing" families. Plus, Wilson-Cairns notes that many patients’ families were forced to sign NDAs. "They’re still unknown and a huge number," she says.
As for Cullen, New York Magazine reports that part of his plea deal required him to give his full cooperation in working to identify all of his victims. Still, the full truth of Cullen’s crimes–and the unjust system that allowed him to continue working for 16 years–unfortunately remains a loose end.
