Serial killer isn't the only evil: Nantucket author's 'Good Nurse' becomes Netflix movie with Oscar-winning cast

Nurse Charles Cullen may have been a serial killer, but he wasn’t the only villain in the story of people dying by his hand at New Jersey and Pennsylvania care facilities.

That wider perspective on who was at fault — which journalist/author Charles Graeber had worked for seven years to uncover — was a top priority when the Nantucket-based writer was considering offers nearly a decade ago from producers of potential movie versions of his 2013 bestselling book “The Good Nurse: A True Story of Medicine, Madness, and Murder.”

Cullen had indeed confessed in 2003 to multiple murders, largely through giving patients lethal drugs, resulting in him serving 11 life sentences in a New Jersey prison. But Graeber’s nonfiction book also spotlighted the fact that Cullen — dubbed one of the most prolific serial killers in U.S. history, possibly causing hundreds of deaths — had been allowed to work at multiple hospitals over 16 years despite frequently being under suspicion.

Both parts of the story are told in the final “The Good Nurse” film, which began streaming Wednesday on Netflix, starring Oscar winners Eddie Redmayne and Jessica Chastain. Graeber talked to audience members live Saturday at one of Nantucket's Dreamland screenings as part of a nationwide theatrical release before the Netflix debut.

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The movie tells the story of the killer (Redmayne) finally caught by tenacious detectives and the cooperation of nurse Amy Loughren (Chastain), who had befriended Cullen. But addressed is how the murderer moved between jobs after employers concerned about him harming patients forced Cullen to leave — and then kept quiet about him.

From page to screen

After receiving numerous movie offers, Graeber told the Times, he chose to grant rights to his book to producer Darren Aronofsky’s team because they realized the storytelling needed to be more than “a serial-killer-nurse movie true story.”

“They absolutely got that this is not a movie about the serial killer any more than ‘Titanic’ is a movie about an iceberg,” Graeber said in a phone interview. “This is a story about people and institutions and the banality of evil. And there’s an allegorical element to it, but … the true story is that the evil, those misdeeds were perpetrated by people just doing their jobs — or their jobs as they saw them — in a for-profit health care system. And the heroes here were individuals who worked against their own institutions.”

The detectives (played by Noah Emmerich and Nnamdi Asomugha) who caught Cullen, for example, Graeber said, were discouraged from going after specific administrators, and were prevented for months — while Cullen continued to work with patients — from seeing paperwork a hospital had on file. Loughren had to risk her badly needed job and its health insurance, and her family, to help catch Cullen.

Graeber said it was important for him to trust the filmmakers after feeling a long obligation to the people like Loughren, the detectives and others who had talked to him for his book, as well as to the families of Cullen’s victims.

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He wanted to work with filmmakers, Graeber said, who would take “the ultimate risk” of making “a true story, a whistleblower story where the villains are bureaucrats and administrators in an entire healthcare system. It sounds impossible, and the temptation is to make the serial killer the only villain and make it seem like the system is kicking in as it should. The truth is the opposite: For 16 years, nine hospitals and a nursing home continued to pass this guy forward, giving him positive or neutral references each time, slipping him out the back door where he would become just someone else’s problem. That’s the headline.”

For everyone involved in the movie, Graeber noted, that was “tricky to do,” and he said he feels lucky that the final film accomplishes what it does, with direction by Denmark’s Tobias Lindholm, a screenplay by Krysty Wilson-Cairns (“1917,” “Last Night in Soho”) and performances that Graeber highly praised.

“The best parts of the film are not on the page” of the book, he said. “They're really what comes from an actor conveying whole chapters or sections of the book with just an expression on their face and somehow doing a magnificent job of conveying a whole history of damage just in a flinch.”

Nantucket as his home base

Graeber is an award-winning freelance journalist who has traveled the world covering stories for such publications as National Geographic Adventure, GQ, Vogue, Wired, The New Yorker and many more. His second book, “The Breakthrough: Immunotherapy and the Race to Cure Cancer,” was published in 2018. During and around much of that, Graeber both wrote parts of the book and went through the many stages of getting the movie made while at his Nantucket home.

Graeber grew up in Iowa, but said he spent summer vacations on Cape Cod with his grandparents, including watching Cape Cod Baseball League games at the Harwich Mariners field, where the announcer’s booth is named for Graeber’s grandfather. Family members have lived in various towns, and Graeber worked jobs on the Cape as a teen, including as a dishwasher at Thompson’s Clam Bar in Harwich Port.

He was drawn to Nantucket to find work, and his parents later bought a house on the island. Graeber has lived in Budapest, East Berlin, Cambodia, New York City and other places, but has made the Nantucket house his part-time “spiritual home and actual home” for a few decades, “more winters than summers.” His father now lives on the island, he said, and Graeber had his first journalism job at the Nantucket Beacon.

Talking to a serial killer

It was a journalist’s curiosity that first drew Graeber to the Cullen case.

“I often looked for strange stories that weren't just freak shows, that had substance, an excuse to talk about something more profound without hand-waving,” he said. “When I found that a serial killer nurse in New Jersey was attempting to donate a kidney from behind bars, I said, 'Well, let me see what that’s all about.' And that’s how that started.”

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Seventeen years ago, Graeber became the only person Cullen agreed to talk to, and the killer revealed details about his difficult childhood and family life, and other parts of his past, over years. Much of that was part of Graeber’s book, the author said, though there was little room in the two-hour movie.

He said he had recognized early on that the movie and book would be very different, but was consulted on the film. His involvement extended to sometimes being on the set, talking to the screenwriter, and detailed talks with Redmayne about Graeber’s discussions with Cullen that informed his characterization.

While that gave Graeber a brush with Hollywood, the moments he focuses on most don’t involve him, but Loughren and the detectives he’d become close to. “It was very gratifying to find out how these actors you only know obviously through their roles become gushing fans themselves when the real people show up.”

A vehicle for change?

Both at the Dreamland screening and at the Toronto International Film Festival debut that Graeber attended, the author said, he was gratified and encouraged that viewers ended up being outraged at the hospital system, and how Cullen could have gotten away with killing for so long.

People got it, he said.

It was “really satisfying,” he said “to see a group of people that maybe didn't know anything about this story, or necessarily care, suddenly want to see greater justice done. … I think the film hits a lot more people a lot more viscerally” than happened with the book.

“This is a story where the serial killer is kind of shy and quiet, and there’s no blood and there are no explosions, and the real villain is a bureaucracy,” Graeber said. “It doesn't describe very well, yet it scares the hell out of people.” The idea of monsters is comforting in ways, he said, “because monsters are not us” — but the people he wrote about are just people “who make choices … (and) those choices determine character.”

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Graeber said he hopes that people seeing this story on a wide viewing platform like Netflix – a streaming option that didn’t exist when talk of a movie version first happened, he pointed out – might jumpstart some calls for change. He has already been talking to nursing organizations about possible institutional reforms.

“But I think it really takes a whole bunch of people, informed enough to ask for change in order to get it,” he said. So the movie “is a really shortcut to getting that information.”

Graeber laughed. “It takes less time than to read the book, but hopefully (the ‘Good Nurse’ movie) will lead somebody to read the book on top of it.”

Editor's note: This story was changed on Oct. 27, 2022 to correct a mischaracterization of Charles Graeber's past living situation on Nantucket.

Contact Kathi Scrizzi Driscoll at kdriscoll@capecodonline.com. Follow on Twitter: @KathiSDCCT.

This article originally appeared on Cape Cod Times: Netflix 'Good Nurse' on serial killer based on Nantucket author's book