Doctoring the Truth
Welcome to Doctoring the Truth, a podcast where two dedicated audiologists dissect the world of healthcare gone rogue. Explore jaw-dropping stories of medical malfeasance, nefariousness, and shocking breaches of trust. The episodes provide deep dives that latch onto your curiosity and conscience. It's a podcast for truth-seekers craving true crime, clinical insights, and a dash of humor.
Doctoring the Truth
Ep 61-Twelve Deaths in Thirteen Days: A Nursing Home Death Spike
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Five people are reported murdered in their beds at 3 a.m. and the scene makes no sense. No broken windows. No forced entry. No masked intruder. Just a nursing home hallway, a butcher knife, and a night-shift supervisor with a wound that looks more staged than survived. We walk through the North Horizon Healthcare Center case and the 1984 timeline that still feels unreal: twelve deaths in thirteen days in a 50-bed facility, many tied to insulin overdose and at least one to manual strangulation.
If you care about patient safety, true crime, nursing home oversight, and how systems can fail quietly until they don’t, press play. Subscribe, share with a friend, and leave a review, then tell us: what safeguard do you think would have stopped this sooner?
Resources:
https://www.tampabay.com/archive/1990/08/25/deaths-investigated-in-nurse-s-prior-jobs/
https://www.upi.com/Archives/1986/03/30/Nurse-linked-to-deaths-had-lost-license/9239512542800/
https://www.oxygen.com/true-crime-buzz/fargo-real-life-killer-nurses-like-the-angel-of-death
http://unknownmisandry.blogspot.com/2019/10/bobbie-sue-terrell-dudley-serial-killer.html
https://vocal.media/criminal/twelve-deaths-in-13-days
https://pubmed.ncbi.nlm.nih.gov/1402747/
https://www.bbc.com/news/world-48600478
https://digitalcommons.usf.edu/cgi/viewcontent.cgi?article=2379&context=etd
https://www.ncbi.nlm.nih.gov/books/NBK217552/
https://www.nursinghomeabusecenter.com/resources/nursing-home-reform-act/
https://www.pbglaw.com/florida-nursing-home-abuse-lawyer/safety-measures/
https://www.ncbi.nlm.nih.gov/gene/9381
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Beach Return And Bug Chaos
SPEAKER_01Amanda. Hi, Janet. I sounded like a cow in here.
SPEAKER_03I don't know why Mammo does that, but listen, Ellie Cat. I'm there for it. How you doing?
SPEAKER_00Hi. Well, I'm fine. I'm great, grand. All the good things. I want to know how you are. You have returned to us from the beach. And guys, she is looking golden. She's looking good. Get it, girl.
SPEAKER_03Look at my tan. I got the I got the lots of bugs since I've been gone. But yeah, I went to Cancun and I laid a nice sunburn as a base. And now it's turning tannish, except for my nose, which is blistering and peeling. Which is, you know, when you see that out of the corner of your eye on the top of your nose, it's really hard to avoid like trying to scratch it. But I'm trying not to, but I'm kind of going cross-eyed. Anyway, it was amazing. Weather was wonderful. And I brought the sunshine back to Minnesota. It's gorgeous out.
SPEAKER_00Thank you so much. Appreciate that.
SPEAKER_03You're welcome.
SPEAKER_00Yeah. Yeah, yeah, yeah. Cool. It's all good. Spring is sprang in. And you know what? I know you never got rid of the ladybugs, but those little bastards are back. And I was out on my deck today just enjoying the old sunshine. And oh, one landed on me and decided to take a little nibble out of my shoulder. I was like, why are they like that?
SPEAKER_03Yeah. No, listen, they're now nasty. And they have realized that the cat was away, so they decided to play and multiplied exponentially since I've been gone. So I I expected that. I should have bombed the place. I don't know. I just hate the thought of all those chemicals on everything, but I just okay.
SPEAKER_00But also you're like eating ladybugs in the night because they're in your drinking water.
SPEAKER_03Yeah, that's true. So unless I get a lizard or something, eats them all for me, which I'm not gonna do because I have enough pets.
SPEAKER_00I was gonna say you could add to the zoo or you could just put some chemicals in down.
SPEAKER_03We're gonna be blasting off some bombs this weekend when I leave. So bug bomb. Yeah, so these little you hear that guys as they're flying around here. Enjoy the rest of your week, buddy. And it's not pleasant for you. Okay.
SPEAKER_00Dun dun dun. So, any correction section for this week?
SPEAKER_03Well, yeah. First of all, I overestimated my abilities to get stuff done and pack and go. So we had a little spring.
SPEAKER_00So we did not record last week.
SPEAKER_03We took a week off. Surprise. We had a little beach vaccine some of us. Woo-hoo. And then the the second surprise is I was fully prepared to go off with episode or part one of Lucy Letby, but I haven't started part two because I didn't bring any work to do on my trip. And Miss Amanda has has has really just come through for me. She's she's ahead of the game and she offered to go today instead of me to give me more time. So ever grateful. Thank you.
SPEAKER_00So you're welcome. And sorry guys, you have me two in a row, but you got a week off, so you're fine. So I guess I actually was gonna share this side conversation last week, and so I don't remember as much about it this week, but I gotta tell you. Yeah, no, tell me. So my in-laws were here visiting, and my father-in-law was like, Did you hear what Sandy, my mother-in-law, did you hear what Sandy bought me? And I said, No, because Sandy shops all the time. So, like, I don't know, tell me, tell me. Mind you, Sandy loves a thrift store. Yeah.
SPEAKER_01Yeah, yeah.
SPEAKER_00He goes, She bought me an urn from the thrift store.
SPEAKER_03I was like, That's one of those gifts where you're like, I'd rather have a blender. What are you trying to tell me? I was like, is it used? If you're gonna pick an urn out before you die, don't you want to be the one involved in the decision making? It's used. He goes, Do you think do you think I should take a picture with it? How funny. Oh, what did how did she react? I know. Did she think it was funny? Was she offended? She used it, yeah. Oh, she, yeah, I thought it was hilarious. She was like, it was a great deal. So she's liking the deal. I mean, was someone in there and recycled?
SPEAKER_00Like that's what I asked.
SPEAKER_03I said it wasn't used. He goes, I didn't think of that. It could be two souls blended for eternity in the recycled thrift store urn. And maybe even recycled before that. Who knows?
SPEAKER_00Yeah, it just, you know what? It's the gift that keeps on giving, apparently.
SPEAKER_03Oh my gosh, I love that. I love that so much. So your family or your in-laws have a quirky, quirky sense of humor. Love that for them.
Sponsor Break And Housekeeping
SPEAKER_00Yeah. So anyway, hi, Sandy. Uh sorry, I had a little ADHD moment there. I was like, are those deer running through that field or is that a dog? No, it's a scroll. So it's definitely definitely uh definitely a dog. Okay, so sponsor one, because I don't want to have 11 minutes of word vomit again. Sponsor number one today is our good old Yarick Plant-based hair care. You too can elevate your hair care with Yark Plant-Based Hair Care, the ultimate fusion of nature and luxury. Their organic vegan shampoos, conditioners, and mousses are meticulously crafted to feed your hair with a potent blend of vitamins, minerals, and essential oils. Free from alcohol, parabens, and sulfates, the products deliver a nourishing experience that your hair honestly deserves. Embrace the power of clean beauty with Yarick, where every drop is thoughtfully curated to enhance your hair's natural beauty while respecting the planet. Transform your hair care regime into a holistic self-care ritual with Yarick because your hair deserves nothing but the absolute B-E-S-T best. Visit yarkhair.com. That's Y-A-R-O-K-H-A-I-R.com for 15% off with our code stay suspicious.
SPEAKER_02Awesome.
SPEAKER_00Obviously, all resources will be listed in the show notes. If I sound surprised during any of this, it's because I'm actually two episodes ahead. So this one I did like a while ago.
SPEAKER_03What a flex, Samanda. What a flex. I'm so proud of that.
SPEAKER_00I only mentioned that because I just saw the trigger warnings and I was like, oh my God, that's right. That's why. Yeah. Yeah. So you guys, this is a bad one. I mean, they're never good, but the trigger warnings include elder abuse, homicide by injection, and manual strangulation, exhuming bodies. Let me just expand my page here. Yeah, exhuming bodies, discussions of mental illness, and a brief mention of animal abuse.
SPEAKER_03Okay, Amanda, can I just say, like the last, I can't even count how many last episodes you've done. You pretty much blasted through the trigger warnings, like, ah, there's none. And now you've got all the worst of the worst.
SPEAKER_00I know how. Are you kidding me?
SPEAKER_03This sounds bleak. But yeah, no, I'm also very, very intrigued.
The Whispered 911 Call
SPEAKER_00Yes. So, as you guys would have noticed from the title, 13 Days of Twelve Deaths. Let's get into it. St. Petersburg, Florida, November 27th, 1984. It's three in the morning. A 911 dispatcher picks up the phone and hears a woman's voice, barely above a whisper. She says five people have been murdered in their beds at a nursing home called North Horizon. By the time the police arrived, they found no masked intruder, no broken windows, no sign of forced entry. But what they did find was a nurse lying on the floor of a hallway with a self-inflicted stab wound in her abdomen and a nine-inch butcher knife nearby. Her name was Bobby Sue Dudley, and within days, investigators would come to believe that the only killer inside the building was her.
SPEAKER_02Holy buckets. This is horrific.
SPEAKER_00To understand what happened at North Horizon in November of 1984, we need to understand what kind of place it was and what kind of person worked there. North Horizon Healthcare Center was a relatively small facility with around 50 beds, located in St. Petersburg, Florida. By all accounts, it was a respected nursing home, and the staff cared about their residence. The pace of life was measured. Deaths happened, of course, after all the residents of the facility were elderly and often frail people, but they happened at a predictable, natural rate. A few per month. The kind of losses where families grieve quietly and nurses process in private. That rhythm broke on October 4th, 1984, when Bobby Sue Dudley took a position as a night shift nursing supervisor. She had a quote, childlike quality, the director of nursing later recalled. Not quite what you'd expect from a seasoned supervisor, but nothing that raised a formal alarm. Her Florida nursing license checked out. She was hired and given the keys to the medicine cabinet. She was put in charge of the most vulnerable hours of the day. What the director of the nursing home could not have known, what nobody in Florida could have known, was the trail that Bobby Sue Dudley had left behind in Illinois. She was born Bobby Sue Robinson on October 16th, 1952, in Woodlawn, Illinois, a small, unincorporated community in the southern part of the state. She and her six siblings grew up in a trailer in an economically deprived area. Her childhood was shaped by illness in ways that would echo through everything she did afterwards. Four of her five brothers suffered from muscular dystrophy, and two of them would die from the disease while Bobby Sue was in her 30s. In a household constantly orbiting medical crises, it was her brothers who received the attention, the care, and the bedside vigils. Bobby Sue was the healthy child, the invisible one. She is remembered as a shy, loving, and trusting child with few friends. She received good grades in school, was a member of the school choir, and played the organ and was pretty religious. Experts who later analyzed her case pointed to this early dynamic as foundational. She learned very early that sickness could make the world stop and pay attention to you, that the person closest to a dying body, the one holding the hand, calling the doctor, controlling the information, that held the kind of power that nothing else in the world could match. Bobby Sue Dudley is an absolute case study of Munchhausen by proxy that extends even further to be a nurse who would kill patients. This is a very lethal way of being in the world. That's a quote by B. Yorker, who's a professor of nursing and criminal justice. After graduating high school in 1973, she pursued nursing with the intention of becoming a geriatric nurse, a logical extension, perhaps, of the world she grew up in. She became a nurse's aide at Good Samaritan Hospital in Mount Vernon, Illinois, from 1974 to 1976 while in nursing school, and she later earned a nursing degree from Casakaya Community College in Centralia, Illinois. She married Danny Dudley in 1976. Danny. Sounds made up though, right? Danny Dudley. I know Danny Dudley. He's like a cartoon character. Exactly. So the two married in 1976 and they longed to have children, but they would later discover that Bobby Sue was infertile, unfortunately. After the crushing journey of infertility and finally learning that she was not able to have children at all, their marriage began to crumble because Bobby Sue was becoming extremely depressed, and the depressive state lifted when the two adopted a child. But it wouldn't be long before the depression crept back in and she would later seek professional help, which is great. By 1979, she had been diagnosed with schizophrenia and was prescribed medication for the condition. However, the medications only seemed to exacerbate her symptoms. In 1980, their son was hospitalized, and according to her husband, she was to blame because she had given her own child an overdose of her medications.
SPEAKER_02Oh. Okay.
SPEAKER_00He also claimed that this wasn't the first time their son had suffered an overdose at the hands of his mother. Oh, red flags. She had been accused of doing so on at least three other occasions. Three once could be an accident. Three? Yeah. Really, really, really wanted that child, huh? Oh God. Yeah. Yeah. So Danny filed for divorce. Good for you, Danny, and was awarded full custody of their son. Thank God. And so for the next few years, Bobby Sue suffered from many physical and psychological issues. She was in and out of the hospital and had many surgeries. She spent over a year in a mental health facility. And when she was feeling better, she was released and resumed working as a nurse. In July 1983, she began working at Hillview Manor, which was a nursing home in Greenville, Illinois. And shortly after she began, the staff members noticed that she had, you know, some strange behaviors. Most notably, she began fainting while on duty with no apparent cause. Weird.
SPEAKER_04Mm-hmm.
SPEAKER_00Yeah. Doctors were not able to find anything wrong with her that would explain the fainting spells, and the staff began to assume that she was doing it to get attention. So things escalated very much so when she used a scissors to stab her vagina repeatedly and had to be rushed to the hospital from work.
SPEAKER_03I'm so sorry. I'm so sorry. Like, oh, I'm fainting here and there. That's not enough attention. I'm going to stab myself in my nether regions. That escalated really quickly.
SPEAKER_00I was going to say that is an escalation. Holy underlined bold exclamation point. Expecting. Oh my god. Okay. I very casually went into that. Yes, you did. And then I was like, I was like, oh yeah, that's right. I'm flabbergasted. All right. Oh my goodness. Yeah. Okay.
unknownUm.
Dudley’s Past And Warning Signs
SPEAKER_00So after being treated for these self-inflicted wounds in the Nether regions, she was let go. Shocking. And told by the nursing home to get some psychiatric care. Sorry, I was fighting through a yawn there, y'all. Okay. Illinois authorities reviewed her fitness to practice and eventually suspended her license. Go, Illinois. And she had told Illinois investigators that she had hurt herself to get attention.
SPEAKER_03I mean, there's ways to hurt yourself, like, you know, trip over a step or, you know, shut your finger in a door. Honestly, taking the scissors to your hoo-haw. What the heck was she thinking?
SPEAKER_00That's so crazy. You know, never, never an act that has ever crossed my mind. Never, never, never. I mean, I mean, like, it's not crossing my mind, but like my mind could not fathom such an act.
SPEAKER_03Oh, I'm gonna fake an illness to get attention. Oh, I'm gonna tell people I vomited, or I'm gonna pretend to pass out, which she was doing. But then to escalate to I'm taking scissors to the most vulnerable area of my body, like that's just weird. Yeah. Beyond. She definitely needed was she not on her meds? I don't know. You're gonna talk about this.
SPEAKER_00Oof. Yeah. So what Bobby Sue Dudley did next was breathtakingly simple. She didn't seek professional mental health. Why would she? She moved. And on July 18th, 1984, she roll relocated to St. Petersburg, Florida.
SPEAKER_03If anyone's a Taylor Swift fan. But also Florida. Florida's where all the sane people are, right? You never hear anything crazy happening in Florida. Am I right?
SPEAKER_00I mean, if there's a wild clickbait, it's sometimes it's Florida. Oh man. So her move to Florida is where one of the most critical systemic failures in this entire story enters the frame, y'all. So we are in 1984, and there was no national registry of nursing licenses at the time. Each state, yeah, awesome. Each state issued and tracked its own credentials independently. Florida had no mechanism for discovering that an applicant had lost their license in another state. Bobby Sue simply applied for a new one, listed no prior disciplinary actions, and she got a new license. A clean slate, a fresh badge, and a new set of keys. This was before there was a national registry of nursing licenses, said B. Yorker. The National Practitioner Databank was not established until 1990, six years after those murders, and partly as a direct response to licensing gaps such as this one. And so Bobby Sue Dudley walked into North Horizon Healthcare Center with a valid license, a history no one could see, and unrestricted access to a locked cabinet full of medications.
SPEAKER_03Oh wow. I mean, I know hindsight's 2020, but honestly, this wasn't just for nursing. There was just such a big gap between each state and actually being national information, you know, database information. Yeah.
SPEAKER_00For the first few weeks, nothing seemed out of the ordinary. Dudley worked her shifts, and the facility's rhythm continued as normal. Then November arrived, and on the 13th of November, a 97-year-old resident named Aggie Marsh died during the night shift. She was elderly and frail, and nobody looked twice. In a nursing home, death is part of the landscape. You grieve, you document, you move on. And so a few days later, a 94-year-old named Anna Larson was found in a coma. And when doctors ran a blood panel, it came back with a result that made no medical sense. Massive amounts of insulin in her bloodstream. Anna Larson was not diabetic. There was no reason, no prescription, no diagnosis, no standing order for her to have received insulin. She was rushed to the hospital, and remarkably, she survived. Their survival would later become the fulcrum on which the entire investigation turned. And we've talked about this in previous episodes about the insulin and how it works in the body.
SPEAKER_02We're gonna talk more about it with Lucy Leppy, too. So this is very timely. Yeah.
SPEAKER_03There's certain biological markers that occur when insulin is produced naturally versus coming from an external source. So yeah.
SPEAKER_00Yeah. So the director of nursing at North Horizon found Dudley's reaction to the Larson incident deeply strange. Rather than expressing alarm, she seemed almost disengaged, detached in a way that didn't match the gravity of what happened. The director noted it in her mind and moved on. She would have no reason to remember it soon. Oh, I'm sorry. She would have reason to remember it soon. Between November 13th and November 23rd, seven more patients died. All during or immediately around Dudley's 11 p.m. to 7 a.m. shift. Former director of nursing, Linda Hoffmister Warman, later told investigators plainly, from the 13th to the 23rd, seven people died. Then, in a single 24 hour window, beginning on the 26th of November, five more residents died. And let us just take that in for a minute, let it sink in, because While this is a story that's being retold, these are not just statistics. These are people who had names, families, and decades of life behind them. And that is a whopping amount of people to pass in such a short amount of time.
SPEAKER_03Unbelievable. Red flag. I mean, and this wasn't a hospital. This was a home. If they were in critical condition, they wouldn't have been in the home. Yeah. Right. That's crazy.
Chart Note: Gene Therapy Restores Hearing
SPEAKER_00Yeah. So I'd like to take this time to recognize the ones that I was able to find information on because we love to highlight them when we can. So some of them I was not able to get a lot of information on, some there was a lot more. So obviously it was not picking favorites, it's just what's on the internet. So Miss Aggie Marsh was 97. Her cause of death was strangulation. Leithy McKnight was 85, and she died on 1123 from a massive insulin overdose. Mary Carter was 79. Stella Bradham was 85, and I found some information on her. So her granddaughter, Cecilia Bradham Mansfield, would later tell investigators that her grandmother had been in, quote, perfect health before entering North Horizon just three months earlier. Three months, that is all it took. And there were others, at least eight more, whose deaths fell within that same narrow window, all on the same shift, all under the same care of that same woman. The 12 deaths in 13 days in a 50-bed facility. So this is not a natural death rate. Not at all. This is something else entirely. And then came November 27th. The whispered 911 call. The police arrived at 3 a.m. to find Dudley on the floor with a shallow abdomen wound and that butcher life butcher knife lying nearby. She told them that a prowler had broken in and attacked her. Detective Robert Engelk of St. Petersburg Police Department listened to every word. He walked the perimeter, checked the doors and the windows. He also studied the wound. Nothing in the facility was stolen or broken, and her wound was superficial, barely a puncture. In his experience, that didn't match an attack. It matched something a person does to themselves. At that moment, his working theory was locked into place that the only killer in the building was wearing scrubs. Yeah. LOL. Not lol to this story. LOL to I was like, what was my chart note? Oh my gosh. Okay. Welcome to the chart note segment, y'all.
SPEAKER_01Note chart note.
SPEAKER_00I'm getting ahead of myself.
SPEAKER_01Welcome to the chart chart.
SPEAKER_00Do do do. Welcome to the chart note segment. Where we learn about what's happening in medicine and healthcare. Okay. So it says, because I wrote. Alright, we've got some news in the Hearing Healthcare wing. And I will be curious to see Jenna's reaction. But I wrote the summary as if I am not an audiologist, rather, just someone who found an encouraging article. I literally, you guys put this article into AI and I asked it to summarize it for me. So this is what AI told me is happening for Hearing Healthcare. Are you ready? I don't think I'm ready. I just looked ahead. No. That's why I saw it and I was like, oh well. Oh. Okay, so buckle up. All right. Scientists have taken a major step forward in treating certain types of genetic deafness, and it involves a single injection that can restore hearing. Bazinga. In a recent clinical study led by researchers at Karolinska Institute, which is a medical school in Sweden, patients born with a rare form of congenital deafness caused by a mutation of the OTOF gene, and I made a note that the OTOF gene is critical for hearing, encoding a protein that acts as a calcium sensor in inner hair cell ribbon synapses to trigger neurotransmitter release. Mutations in OTOF cause DFNB9, a form of non-syndromic congenital profound deafness and auditory neuropathy, often leaving outer hair cells intact. These genes were treated with a one-time gene therapy. The therapy works by delivering a healthy copy of the gene directly into the inner ear and allowing the body to finally produce the protein needed for hearing. And the results? Out of 10 patients, ranging from young children to adults, and I did find the study, it was a one-year-old ranging to 24 years, all showed measurable improvements in hearing, some within just weeks of treatment. Even more promising, the therapy appeared to be safe with minimal side effects reported. These side effects were not noted. What makes this especially groundbreaking is that it doesn't just manage symptoms, it targets the root genetic cause of the condition. And that's a major shift from traditional treatments like hearing aids or cochlear implants, which compensate for hearing loss rather than correcting it. Researchers say this could be just the beginning. If future trials confirm these results, similar gene therapies could be developed for other forms of genetic hearing loss, and even beyond that, for a wide range of inherited conditions. And I will now give the floor to Jenna.
SPEAKER_03I mean, I'm all for this, and I know that the research is continuing, and there are a lot of different trials going on for this kind of therapy. So what happens in order to deliver the therapy, the therapeutic agent, the only reason it they can get it into where it needs to go in the inner ear is by delivering it with a virus, right? So that's how it gets into where it needs to go. So the first time you do that, you can get the medication where it needs to go. And then the therapy or the protein that you're introducing can get to work and do its thing. The problem is the second time you do that, the body says, ah ha ha ha, this is a virus. We we we recognize this bastard, we're going to not accept this protein because it's in the company of this virus that we've met before, right? The reason why you need more than one is because this doesn't last. So these if you take this study further, these 10 people had a dramatic shift in their hearing. Wonderful, but mostly only lasted five to six months. And they can't get another therapy because the virus that they're using to introduce the protein is recognized as problematic by the body by that point. So that's not that's my oversimplified, like obviously a lot of this is over my head, but that's my understanding of how this works. So it's promising, but it doesn't last, and you can't use it again. So they have to figure out another way to introduce this or a way to make it stick. Because it's almost like is it beneficial to show people what they're missing? Give it to them for six months and then it goes away. There was a movie with Robin Williams and God where everyone was in a catatonic state, and and it's based on a true story, and I forget what it's called. Awakenings, I think is the name of the movie. Old movie. Based on a true story where these patients were all catatonic, and he discovered some kind of remedy or therapy for them, and they woke up and became sentient and cognant and cognizant, and it was just a joyful situation. They went from vegetables to uh, you know, being themselves again, but it wore off and the second dose didn't work. So then it's like the ethical dilemma is do you bring people back to show them what they I mean, that was extreme that that situation in that movie, but yeah, to show them what they missed, only for them to be told you can't ever get this again. I don't know.
SPEAKER_00Right. And then for the family to be like, oh my gosh, this is amazing, like the medication is back, or like the extreme of that movie, which you are correct. I Googled it, Awakenings.
SPEAKER_03Is it Awakenings?
SPEAKER_00Yeah, it's correct 1990 film. And then you kind of have to like go through that grieving process all over again.
SPEAKER_03Honestly, though, if I was catatonic or deaf and I was given the opportunity to have even six months of something, I would I you know I would take it. So yeah, yeah, quite an interesting study. So we gotta keep our eyes on this because someday someone will figure out they're right.
Missing Insulin And The War Room
Factitious Disorder And Power Over Patients
SPEAKER_00Someday, someday. For now, and until then, keep using those traditional treatments. Okay, back to the story. Before investigators could build a case, Dudley disappeared into the system. She admitted herself into a state mental hospital, placing herself at least temporarily beyond the reach of an arrest. It was a calculated move, or desperate, or I don't know, both, but the investigation didn't stop nonetheless. They discovered her history of schizophrenia, undiagnosable illnesses, and termination of her job in Illinois. When investigators shared this information with her supervisors, she was fired from her job as night shift supervisor, to which she responded by filing a workers' compensation claim against them because of the stabbing incident that had allegedly occurred while she was on duty. The psychiatrist who evaluated her for the nursing homes insurance company determined that she suffered from borderline schizophrenia and Munchausen syndrome and said she most likely stabbed herself. Her license was temporarily suspended because she was believed to be a harm to herself and to others. After her release from the hospital, she met and married Rob Terrell, an unemployed plumber. The two adopted a dog and moved into a one-bedroom apartment in downtown Tampa. It wasn't long before Bobby Sue was back to her old ways of harming others, this time the couple's dog, who she overdosed on a heartworm medication, which I did look up, and it is possible to do that. I just am like, oh the the dog was rushed to an emergency vet and did survive, thank goodness. But yeah, so then she was again admitted to a psychiatric unit for treatment, and her license was suspended for five years. The suspension specified that she would be unable to get the license back until she proved that she was not a threat to herself or to the public and that she'd be able to work competently within the field. With neither her or Rob holding employment, they couldn't afford their apartment anymore, so they opted to move into a tent. And the tent would prove to be only a temporary living situation because the St. Petersburg police assembled what they called a war room. Medical records from every patient who had died during Dudley's tenure were pulled and spread across the tables. Nurses' notes were analyzed shift by shift, and medication logs were compared against physician orders, and the pattern was stark. One caregiver had been present at every single death, and you already know Bobby Sue Dudley. She was the one and only staff member with a key to the locked cabinet that contained the facility's insulin supply. When investigators checked the cabinet, shocking, the insulin was missing. Authorities obtained a search warrant and found under her mattress in her beautiful tent, they found five handwritten pages. Each page listed the names of patients who had died, identified by their name, and the time of their death. It was meticulous. A doctor who had worked with Dudley years earlier in Illinois had once noted that while most nurses might write a few lines about a dying patient's final hours, Dudley, quote, literally used up an entire page, end quote. He had called it at the time a quote, little overattention to detail, end quote. Now that detail had a different name. Evidence baby. Bobby Sue was only 33 years old when she was arrested. Another critical break came when they turned their attention back to resident Anna Larson, the 94-year-old woman who had survived the insulin overdose. Her blood work had captured the evidence in real time, dangerously elevated insulin levels in a woman with no diabetic diagnosis. Because she had survived, investigators had something rare in a case like this, which is a living witness to attempted murder. But the real turning point came from the earth itself. In May 1985, nine bodies were exhumed from cemeteries around St. Petersburg, including the body of Stella Bradham. Forensic pathology teams went to work and the stakes were clear. Without physical evidence of homicide, this was a circumstantial case built on shift schedules and missing insulin vials. With it, it was murder. Case closed. Four out of the nine autopsies returned conclusive evidence of homicide. Two of the victims had been killed by injection of an unknown substance, most likely insulin, though tracing insulin post-mortem is notoriously difficult because the body metabolizes it rapidly. The window for detection is narrow, and by the time these bodies were exhumed, months had passed, but the tissue evidence was still there. Two others had been strangled, and one of those was Stella Bradham. Her autopsy revealed something that changed everything. The hyoid bone, which is a small horseshoe-shaped bone at the base of the tongue, suspended in the muscles of the neck, was fractured. The fracture is significant in forensic pathology because the hyoid can only be broken by direct external force applied to the throat. It doesn't fracture in falls or from natural causes. According to peer-reviewed research published in the Journal of Forensic Sciences, hyoid fractures occur in 25 to 50% of manual strangulation fatalities and in frail and in a frail elderly woman, the bone would have required even less force to break. Investigators theorized that the insulin injection Dudley had given Bradham was taking too long to kill her. Whether out of impatience or panic or something even colder, Dudley had finished the job with her hands. The bodies exhumed gave investigators proof of homicide, but they still needed to connect Dudley's hands to the bodies. So before we get into the courtroom, I want to spend some time inside the psych the psychology of this case because Bobby Sue Dudley is, in many ways, a textbook illustration of one of the most dangerous psychiatric patterns in forensic science. She was diagnosed with Munchausen syndrome, known today as fictitious disorder, imposed on self. And we've covered this in other cases too. So this is brief, but if you haven't listened to those episodes, do yourself a favor and go back. But for now, I will share with you that this is a condition in which a person fabricates or induces illness in themselves to receive attention, sympathy, and care. The patterns showed up early for Bobby. The self-inflicted wounds, fainting episodes, the parade of ailments and surgeries. She reported and accumulated throughout her 20s and 30s. She had a hysterectomy, stomach tumors, pneumonia, ulcers, gallbladder issues, and broken bones. Her medical file read like someone who was constantly, conspicuously unwell and always at the center of medical drama.
SPEAKER_03I just wanna I just want to say, have you ever met someone like this in your practice when you were chronical? Yeah. Yeah. I'm just saying, you know it when you see it. There are people who thrive on the drama of medical issues, right? Usually they have it might not be, you know, but usually they have some nebulous stuff that can't be proven, and so they get given like a bucket diagnosis. They're just constantly searching to be given that attention. Usually they're a vestibular patient.
SPEAKER_00And then you get to spend a lot of hours getting to know them real close by the time you leave. Yeah. Yep, yep, yep. But you know what? That rotary chair still puts them to sleep.
SPEAKER_03Or they puke one way or the other.
SPEAKER_00Open your eyes. Okay. La la la. Dudley had some issues, but she didn't stop at herself. And that's the tragedy. Yeah.
SPEAKER_03Right? That's the difference between these patients who are real focused on themselves. They want to identify as someone with medical issues and get that attention. But when you start hurting other people, I mean it's not great to do that to yourself, but when you start hurting other people, it's beyond. Yeah.
SPEAKER_00Yeah. So she also exhibited what clinicians call factitious disorder imposed on another, historically known as Munchosen by proxy.
SPEAKER_03Can I just say fake sorry factitious disorder imposed on another? I don't want to try to prove their like it's not, it doesn't roll off the toe.
SPEAKER_00I don't know why we had to change the name. So this is a pattern where a caregiver doesn't just fake their own illness, they create illness or death in someone under their care. The poisoning of her adopted son with her own tranquilizers was in retrospect a rehearsal. The nursing home was the performance. Professor Katherine Ramsland, a forensic psychologist who had spent decades studying healthcare serial killers, has identified a 22-point checklist of behavioral red flags common to this kind of perpetrator. Fun fact.
SPEAKER_03I know. So we've got the uh psychopath checklist. Now we've got a non Munchausen, but uh fictitious disorder imposed on another healthcare worker checklist.
SPEAKER_00Yeah. So fun fact when I was looking up this Catherine Ramsland, I shouldn't say this, like she's like a brilliant woman. She is a professor in Idaho, and she was a key. How do you say that she testified for the Brian Brian Kroger? Is that what his name is? I was gonna say Brian's name is Brian Douche. I don't know.
SPEAKER_03He doesn't even deserve to be. Yeah, he doesn't even deserve.
SPEAKER_00And she he was a student of hers, in she was a yeah. Oh uh, I bet she's got a story there. I thought her name sounded familiar.
unknownOkay.
SPEAKER_00So anyway, that's a random sidebar of what I found when I was researching. But she identified the 22-point checklist, behavioral red flags. And she notes that a few of these would not be alarming in isolation, but a cluster of five or more would be cause for concern. And the list includes things like they prefer night shifts, they predict when patients are going to die, they move between facilities, leaving unexplained deaths behind them. They resist when colleagues try to check on their patients, they show unusual interest in the process of dying. And Dudley fit nearly every single item on the 22-point checklist. Oh wow. All of her behaviors are indicative of a serial murderer, said Detective Engelki. I've got chills. That's so scary, so creepy. The deeper question is why do people like Dudley become nurses in the first place? This question has been examined by criminologists. Criminologists.
SPEAKER_03Criminologists. And behavioralist.
Plea Deal And Unanswered Motives
SPEAKER_00I added an extra lolol in there. Criminologist and behavioral scientists for decades. David Wilson, who is a criminologist who has written extensively on their profession, not by compassion, but by the power dynamic it creates. A nurse on a night shift holds near total control over patients who cannot advocate for themselves. Elderly residents in a nursing home at 3 a.m. cannot call for help, they cannot fight back, and they can't always report what was done to them either. They, for the most part, depend entirely on the person in the room. And so for Bobby Sue Dudley, that dependency appears to have been exactly the point. The killing wasn't random. It was the logical endpoint of a lifelong pattern. A woman who had learned as a child that the person closest to death holds the most power, and who spent her adult life getting closer and closer to it. On April 10th, 1986, more than a year and a half after the last death at North Horizon, Bobby Sue was indicted on four counts of first-degree murder and one count of attempted murder for the insulin poisoning of Anna Larson. Her defense team mounted an insanity defense, shocking. As I'm sure, you know, all of us would have assumed, a competency hearing was held and the court ruled her competent to stand trial. I love that. I love that just as much as I loved earlier when I noted that the workers' comp claim Psyche Val was like, yeah, no, she did it to herself.
SPEAKER_03Yeah. They were on it. They were on it. Yeah. Yeah.
SPEAKER_00Mm-hmm. Over the next two years, her legal team delayed proceedings through psychiatric evaluations, procedural challenges, and continuations. And then on February 23rd, 1988, 39 months after Stella Bradham drew her last breath, Dudley accepted a plea bargain. She pled guilty to four counts of second-degree murder and was sentenced to 65 years in prison. She received an additional 30 years for the attempted murder of Anna Larson for a total of 95 years. Investigators believed she was responsible for all 12 deaths, but only convicted of four. Cecilia Bradham, the granddaughter of Stella, spoke to reporters after the sentencing. Her words were blunt. Quote, I was not happy she did not get the death penalty because I felt she deserved it, end quote. Bobby Sue Dudley Terrell died in prison on August 27, 2007, at 54 years old. She had served 22 of the 95 year sentence. She never explained why she did it. No confessions or interviews, no letter left before her dying days. Whatever drove those 13 days of killing, she took it with her.
SPEAKER_03Do we know if she died of natural causes or what yes, I believe it was natural causes. That's awfully young.
System Failures That Let It Happen
SPEAKER_00But 54 is young. Yeah, thank you. Every case like this leaves a wound that goes beyond the individual who held the needle, or in this case, the needle and the hands are on the throat. The Bobby Sue Dudley case exposed fault lines in the American healthcare system that had been ignored for years. The first and most obvious failure was the licensing portability. In 1984, a nurse could lose their license in one state and walk into another state's licensing board as if it had never happened. The National Practitioner Data Bank that I mentioned earlier is the centralized registry that now tracks disciplinary actions against healthcare workers in all 50 states. But again, that did not exist until 1990, which feels wild to me because that does not feel like that long ago. But here we are again. And cases like Dudley's were part of the reason that it was created in the first place.
SPEAKER_02Sadly.
SPEAKER_00No, let me restart that. The public outrage generated by cases like this one helped build the political will to pass it. The third failure was the epidemiological goddamn. The third failure was epidemiological.
unknownWhy can't I say it?
SPEAKER_03You said it right the first time. You just didn't like the way you said the sentence.
SPEAKER_00Well, you say it so I can hear it quick. Epidemiolog.
SPEAKER_03And we should put this into a bloopers thing. Epidemiological, epidemiological, epidemiological. Okay.
SPEAKER_00The third failure was epidemiological. 12 deaths in 13 days at a 50-bed facility. The numbers alone should have triggered an investigation before the 911 call ever happened. But in 1984, there was no systemic mechanism for flagging anomalous. Anomalous death clusters at care facilities. Today, healthcare surveillance tools are specifically designed to identify unexpected spikes in adverse events that deviate from the statistical baselines. In 1984, those tools did not exist. The data was there, sitting in paper logs, and nobody was reading it. And the fourth failure, the quietest one, the one that enables all the others, was a theme that we talked about before and often culture. Nursing home deaths are easy to overlook because the residents are old and they're frail. Death is expected. And when an 85-year-old dies in a care facility at 3 a.m., few people ask the hard questions. Fewer still demand autopsies. And it's believed that Dudley understood this. And that is why she chose, presumably, the population whose deaths would attract less scrutiny, and those that were isolated had few advocates, and those whose passing would be accepted as the natural order of things. Bobby Sue Dudley was, as Professor B. Yorker put it, quote, an absolute case study, end quote. A convergence of childhood trauma, untreated mental illness, institutional blindness, and unchecked access to vulnerable people. She was not caught because of a smoking gun. She was caught because a detective refused to believe a shallow stab wound came from a prowler. Because investigators built a war room and read every shift log by hand. Because forensic pathologists exhedies and found what the living had missed: a broken bone in the throat of a woman who was supposed to have died peacefully. And because someone found five handwritten pages under a mattress. The residents of North Horizon did not have powerful advocates in life, but in death, the evidence spoke for them.
SPEAKER_03Oh my gosh, Amanda. This is so tragic and so compelling, and such I don't even know. Did you read my script for my part one of Lucy Leppy?
SPEAKER_00No. Okay.
SPEAKER_03You haven't even shared it with me yet. Oh, okay. Well, it's on the drive, but don't read it. But this is such a classic and beautiful segue into what I'm about to talk about. We're talking about people who have mental illness and factitious disorder who want the attention for whatever reason and the power, and they're giddy with it, and they're they're taking advantage of vulnerable people vulnerable people, whether they're seniors or they're infants. So there's so much commonality between this and what we're gonna talk about in the next couple weeks that I really it kind of opened my eyes to some of the things in the next case we're gonna talk about. But when you first described, or you you were you were talking about how her Bobby Sue's personality as an adult, as a professional, had a childlike quality. I just got this creepy chill, like why? Yeah, I don't know. I can just yeah, that was the detail that stuck out for me. The fact that she grew up with four out of five of her brothers with muscular dystrophy. I mean, honestly, I can understand why that would be traumatizing for a child, like all of her siblings getting all of this attention and needing all of this care, and she probably had to participate in that care. And depending on your personality, I mean, you might be a bit understandably resentful of that. Oh, yeah. She was the healthy one. Yeah, and then two of the her brothers died, which is so tragic. But also, like, she's like, What can I do to get some attention and love? Yeah, you know, and that's so sad that it ended up because a lot of people might be in that position, but something in her personality and her mental health then took it further to a point of no return. I feel sorry for all of the victims that and the victims' family, victims obviously, but also the victims' families that didn't get closure, not even closure, but didn't even get the justice of you know being able to prove that she had you know taken their loved ones from them. But you know, it's kind of like she died super young, so to me that's a bit suspicious. But if you say it was natural causes, then that's what it was, but she would have been in there for life anyway. Yeah, that hyoid bone is a big deal, like you hear it talked about with like the did Epstein really commit suicide, you know, this kind of thing. Was the hyoid bone intact? So you hear about that a lot in in true crime. So that was really interesting. So this is all circumstantial, I will point out that even though they dug up people that were obviously didn't die of natural causes, which they thought, which is an important finding, and even though she was on shift and all these people died, it still doesn't prove that she murdered them. But I think it's the constellation of these things. Uh, can you prove within a reasonable doubt that she was the one that did it? Right, right. I think the fact that she had I I don't think the fact that she wrote down who died in in in great detail, because that's neither here nor there. She was maybe someone who's fascinated in the details of final moments of someone's life. That doesn't prove that she's a murderer. Nobody saw her injecting insulin. But I think, you know, the fact that you have circumstantial evidence that this person died on her shift and the insulin went missing at this point in time and she was the only one with the key.
SPEAKER_00You know, if that's the case, and the yeah, the death spike didn't start until after she was hired either.
SPEAKER_03Yeah, and did it did the death spike stop after she left? It's still circumstantial, but it's compelling if you get enough of it together. And we're gonna talk a lot more about that for the Lucy Leppy case as well.
SPEAKER_00So I just want to think Okay, well, actually, I'm glad that this worked out the way it did then, because it sounds like this was good to have as a segue into Lucy Leppy, and would maybe be like not as great if it followed Lucy Leppy, because I know that's gonna be a big, a big one. Yeah. And then mine would be like, here's mommy so Dudley.
SPEAKER_03No, not at all. I think they they just naturally, whether before or after, they it raises similar questions. But absolutely compelling and disgusting that yet another nurse, and I'm apologize to the nurses out there because we love you, and my sister who's a nurse, but she's the one telling us to do the nefarious ones. It's just so crazy, and that's why we talk about it. It's because it's so crazy to think that someone who's dedicated their their education and their livelihood to taking care of people is actually doing the opposite.
SPEAKER_00So yeah.
SPEAKER_03Excellent, excellent episode. Thank you for bringing this up. I'd never heard of her.
Sponsor: Strong Coffee Company
SPEAKER_00So thank you. I mean, you're welcome. Yes, thank you. Thank you, and you're welcome. Sponsor number two, gonna be real important here in less than two weeks. Y'all going back to work.
unknownAh!
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SPEAKER_03You got all the good bits. Absolutely. That's a great deal. But now is it time for a medical misshead?
SPEAKER_01Medical misshead. Yes.
SPEAKER_03All right. The title of this email is The Test I Almost Failed Without Knowing It. And it starts, dear Amanda and Jenna. I could go on for a long time about how awesome you guys are, but let me just get to the point because everybody knows you guys are great. It starts. I I didn't realize that I'd done anything wrong, which is probably the most concerning way to start a medical story. It all began with a routine appointment. My doctor wanted some fasting blood work. There weren't any special instructions, just the standard don't eat after midnight. All right, easy. Done that before. So the night before I ate dinner, set a mental reminder that I couldn't have breakfast, and I went to bed feeling ultra responsible. Adulting, am I right? The next morning I woke up, got dressed, and headed to the lab, feeling like the model patient. They'll be so proud of me, I thought, organized, prepared, thriving. I even remember thinking, wow, this is the easiest medical thing I've ever done. Oh, bless your heart, because I don't think that's easy. I I think, oh my god, I can't have my latte or my coffee this morning. Err. So good for you. At the check-in desk, the receptionist asked if I had been fasting. Yes, I said confidently and proud, like with my whole chest. I said, yes, like you bet your ass I've been. Easiest medical instructions ever. She was not as enthused as I was, rightfully so, and handed me a clipboard and I took a seat. Everything was going perfectly fine until about five minutes later when I was called back. And before I let them choose which arm to drain, oh my god, what a what a thought that is. Which arm to drain. I casually reached into my bag and pulled out my coffee. Oh dear. No dear. That's what I was saying. I I didn't even read this email first. So, oops, yeah. Not black coffee. Coffee with cream and sugar. I froze. My thought, damn it. The person drying my blood saw my wheels turning. I had made the coffee without thinking and I drank it without a care in the world. I stared at the cup like it had personally betrayed me. Now I had a decision to make. Do I say something or do I pretend that this never happened and just hope for the best? For a solid 30 seconds, I considered saying nothing. Not because I wanted to lie, but because I'd already committed to the role of the quote, excellent person who followed instructions. End quote. But then I spiraled thinking about the call I'd surely get later, like, your labs are dot dot dot confusing. So I looked at the gal and I said, hi. I think I accidentally drank coffee with cream this morning. They didn't even flinch. She just smiled and said, It happens all the time. We'll just reschedule. Oh, that was nice. I'm glad she wasn't judgy. And just like that, my perfect patient streak was over. I came back the next day, actually fasting this time. And of course, everything went smoothly. But I couldn't help but think how easy it is to think you followed instructions perfectly when you've actually missed something small that's so routine that would change everything. And now anytime I'm told to fast, I treat it like a full event. No food, no drinks, no autopilot. I even put a note on my coffee, my coffee maker that says, no, just in case. He's so cute. I love this writer. And okay, okay, I know it was just routine fasting blood work, not heart surgery, but this is all I've got to send in. Oh my God, we're so grateful you sent this in. And they continue to say, thank you both. Thank you both for making space for stories like this. The ones that aren't dramatic, but they still remind us how human we all are in healthcare. Courtney.
SPEAKER_00Courtney, Courtney, Courtney. You're hilarious. Thank you so much for sending that in. Model patient. The streak.
SPEAKER_03Yeah. You are. You know what, Courtney? You're you're a model patient. They should have said this includes your coffee in the morning. I mean, everybody has a coffee routine in the morning.
SPEAKER_00So I'm like, you're still the perfect model patient because yeah, you admitted it. You rescheduled, you came back.
SPEAKER_03Yeah. The thing is, you lie and then they're gonna say, Oh, you got high cholesterol because you had some cream and yeah, but you did the right thing, Courtney. We're proud of you, and we're just so grateful that we don't not everything has to be an ER drama type situation. We, you know, this is everyday stuff that all of us can really not everyone's scrotum's getting stable to their legs, guys.
SPEAKER_00It's fine. Sometimes you just have coffee with cream in the morning and you shouldn't have.
SPEAKER_03Oh, Adam, if only you realized how famous you are. I hope you don't tell him. Oh my god.
SPEAKER_00Does he listen? So actually, um we he met some of my coworkers recently, and I don't know. I was like, oh my gosh, Adam. Oh wait, no, okay, yeah, he did. But I I I was like, okay, Adam, you know, they all listen to podcasts so they know about your like downstairs situation. But also that reminded me um when our son was in the hospital, you know, they get their hearing tested. I knew the person that tested the hearing, and so I had said to him also, you know, this person may listen to the podcast, and then therefore may know about your situation. Oh my god.
SPEAKER_03Oh bless. So you know what? He's a hero in my book for agreeing to share that with us.
SPEAKER_02Yeah.
SPEAKER_00Well, I guess we already know we're gonna hear Lucy Latby next week, and it's a Tupada, which you told us.
SPEAKER_03And so I've told you repeatedly and haven't delivered.
SPEAKER_00So we're gonna do it. You know what? I still have one in the wings. If you don't get it done, I'm just saying I didn't finish Jolly Jane for eight months-ish. And I actually hated still how it turned out. I'm gonna redo it. I don't know how it's too soon is too soon, but I was like, I should do that sooner than later because it's fresher right now, you know, you know, you know.
What’s Next And How To Reach Us
SPEAKER_03Oh, oh well, first of all, I loved it. But if you feel you you want to add to it, it's a fascinating story. So absolutely, yeah. I think it's daunting to do these big ones. Yeah, you know, especially it's like widely covered, so much covered. Yeah, yeah, yeah. Okay. So I'm I hope I bring something to it. But uh you know, unless the universe just like a snorting fog impludes, implodes, implodes, implodes. I'm gonna I'm gonna do my damnedest. You're gonna do good. But meanwhile, honey, for that photo confidence. But meanwhile, don't miss a beat. Subscribe or follow Doctoring the Truth wherever you enjoy your podcasts for stories that shock, intrigue, and educate. Trust, after all, is a delicate thing. You can text us directly on our website and please do at Doctoringthetruth at buzzsprout.com. Email us your own story ideas and comments at Doctoringthe Truth at Gmail. A lot of our topics and stories come from our listeners reaching out to us. So let us know what you want to hear. And be sure to follow us on Instagram at Doctoring the Truth Podcast and on Facebook at Doctoring the Truth. We're on TikTok at Doctoring the Truth and ed odd pod E-D-A-U-D-P-O-D. Don't forget to download, rate, and review so we can be sure to bring you more content next week. Until then, stay safe and stay suspicious.
SPEAKER_01Bye.
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