Angel of Death

A year ago, bucolic Port Angeles was rocked by the death of 3-day-old Conor McInnerney. Now one emergency-room doctor is on trial for his murder, and the supervising ER doctor is in a mental hospital.

By all accounts, January 12, 1998 was a hectic night in the emergency room at Olympic Memorial Hospital in Port Angeles. A pregnant woman was in with a ruptured fallopian tube; another patient had a heart attack; and at 8pm paramedics were en route with 3-day-old Conor McInnerney, who had stopped breathing while nursing. Normally, the ER is staffed by only one doctor, two nurses, and an emergency-room technician. Critically ill infants are usually flown immediately by helicopter to Children's Hospital in Seattle, but a snowstorm that night kept the evacuation team grounded, so ER chief Dr. Bruce Rowan called the town pediatrician for help with the baby.

Eugene Turner has been Port Angeles' pediatrician for almost 30 years. He arrived at the hospital at about 8:50 that night, but according to notes taken by an ER nurse, Conor already appeared "dead, blue, poor color." As the night wore on, however, Conor would mysteriously—some later said "miraculously"—gasp for air, "pink up," and show improved vital signs. Near midnight, three hours after the baby arrived at the hospital, ER nurse Raedell Warren brought some juice to Dr. Turner, who had initially given up on the doomed newborn only to later attempt a series of experimental life-saving procedures.

According to her notes, Turner was standing over his patient, covering the infant's nose and mouth, when nurse Warren entered the room. Startled, he dropped his hand.

"Don't let me stop you," Warren said.

So one more time, Turner pinched Conor's nose shut and put his hand over the baby's gasping mouth, until all life signs subsided for good.

ALTHOUGH DR. TURNER maintains that Conor was brain-dead from the moment he arrived at the hospital and that by blocking the baby's breathing passages he was only extinguishing postmortem spasms, the beloved pediatrician was charged with second-degree murder in October. His trial is scheduled to begin next week.

Port Angeles has been dealing with this controversy for nearly a year, since the story first broke in the local news. During that time Dr. Rowan, the ER chief, was arrested for murdering his wife—an act he said was caused by distress over this incident—then was found not guilty by reason of insanity and put in a mental institution. To further complicate an already bizarre story, Rowan sits at the center of the case against Turner. Notes from Rowan's confidential diary question the pediatrician at almost every turn during Conor's hospital stay. Though Rowan is unlikely to testify at Turner's trial (nor can he talk to reporters), his notes, written the night after Conor died, are the most detailed account of the night the baby was brought to the ER. Save for the crucial diagnosis of death, the facts laid out in the notes are largely undisputed—even by Turner.

Seventeen thousand PEOPLE LIVE in Port Angeles, which is nestled in the foothills between the Olympic Mountains' Hurricane Ridge and the Strait of Juan De Fuca. Two and a half hours by ferry and car from Seattle, it is the biggest town on the Olympic Peninsula. Home to fading resource-based industries—timber and fishing—and to Peninsula Community College, it is in many ways a two-tiered town, with a college-educated professional class residing uneasily among the town's traditional, hardscrabble, blue-collar families.

Gene Turner, who may be the most respected and admired man in town, has been treating Port Angeles' children for 27 years. He founded the Peninsula Children's Clinic. He has donated his time, money, and land to charity. He served in the Peace Corps in Ecuador. When one of his patients, a beautiful 18-month-old girl named Madeline Bradley, lost her hearing to meningitis, Turner offered to learn sign language in order to communicate with her.

A series of news stories, including a report by NBC's Dateline, have characterized Port Angeles as bitterly divided over Turner's impending trial. But visiting the old mill town, it is hard to find many who would not still trust him with their lives. "I think it's a misconception that the town is split on this issue," says Madeline's mother, Tami Bradley, one of Turner's most outspoken supporters. (Her four children are all Turner's patients.) "I believe the vast majority of the town supports Dr. Turner." Two weeks ago, an overflow crowd of 400 people showed up at Holy Trinity Lutheran Church for a $5-per-plate "spaghetti feed" fund raiser hosted by Youth for Gene Turner. Parents, young children, teens in letterman jackets, hospital colleagues, and clergy were all there in support of the pediatrician. Over his objections, the town—mindful that criminal proceedings are not covered by malpractice insurance—has raised more than $40,000 for Turner's legal defense. Decent people seem to trust him unconditionally. "I refuse to believe he did anything to hurt that child," says Bradley. "Conor was dead."

Of course, that's difficult to determine—especially in newborns. According to Washington state law, death is defined as the "irreversible cessation of breathing and circulation or irreversible cessation of all brain function," but even the most sophisticated medical equipment cannot measure brain activity in children less than 1 week old. Most medical experts agree that Conor must have been severely brain-damaged, but the actual moment of death in newborns can be very difficult to determine. "I probably would not do that again," Dr. Turner said in one of his few public statements, "not because I don't think that's the thing to do, but because of the unbelievable amount of anxiety, angst, and emotional turmoil and financial embarrassment that has come as a result of the situation." He maintains that his act was not a mercy killing.

But the question remains: Even if a baby is brain-dead, where in medicine or law does it say to then put your hand over its nose and mouth? "I don't know," says Bradley. "I think he wishes he just walked away. I wish he would have walked away."

ACCORDING TO DR. ROWAN'S notes, he officially signed Conor's case over to Turner at 8:45 on the evening of January 12. "Sometime later and it is not clear how long later, I saw Turner as well as [a] Pediatric Resident standing at the desk with very saddened sullen faces. I asked what had happened. They essentially said that the child had died." It was roughly 9:45 at this point. Turner wrapped the baby in a blanket and pronounced him dead in his mother's arms. The grieving parents and Turner all went home.

"I subsequently continued to work in the busy department," Rowan wrote, "and noticed that the lights were turned off in Room 2A where the child had been." Almost an hour after Turner had gone home, Rowan saw two nurses standing in the dark, leaning over the child, who was still in the baby warmer. "The child was making somewhat hiccupy gasping respirations, approximately every 10 seconds," Rowan wrote. "The child did have a pulse. . . . The pulse oximetry reading [a measure of oxygen levels in the blood] was in the 96 percent to 98 percent range. At that point, I recommended that they immediately call Turner for further direction."

At 10:45, an ER nurse called Turner at home. A full hour after being pronounced dead, "the child appeared quite stable," according to Rowan, and Conor was "pinking up," according to one nurse.

In a statement released to the press, Turner's attorney, Jeffery Robinson, explained that at this point, Conor was brain-dead, which does not necessarily mean that his organs had completely shut down. "Conor's sporadic heart beat and agonal respiration after he died are natural indicators of death," the lawyer wrote. "[These type of] reflexive actions can be caused by a number of factors, including strong cardiorespiratory drugs used in resuscitation efforts." Conor had indeed been pumped full of such drugs.

In any case, Turner returned to the emergency room and began to work on the baby once more. From then on, notes were taken in pencil, according to a statement by one of the nurses, "so if there was a good outcome she would fill in the blanks. If there was not a good outcome then the notes would not go on the chart. This didn't feel right either."

Although Turner still maintains that the baby was technically dead at this point, he attempted to re-intubate the child, guiding a tube down his mouth and past his vocal cords in order to force oxygen into his lungs. Intubating an infant is tricky business, and according to Rowan's notes, Turner said that he rarely had the opportunity to intubate such a small child and had needed practice. "It was not clear whether this comment was truly one that denoted that he was simply practicing intubation on a presumed deceased child or that the comment was made regarding the repeated attempts that were required," Rowan wrote.

This point is critical to Turner's case. If Turner believed the child was in fact brain-dead and his irregular gasps were what's called "agonal breathing," a sort of postmortem reflex, then why did he try to re-intubate and resuscitate the baby? Could it really have been for practice? The child had originally been intubated in the field by paramedics, and the tube pulled out when Turner pronounced the baby dead earlier in the evening. In his few pretrial public comments, Turner has not addressed this level of detail, and neither he nor his attorney would comment on it to this reporter.

According to Rowan's notes, Turner's behavior grew stranger from then on. After his repeated and unsuccessful attempts at re-intubating the child, one of the nurses suggested calling an anesthesiologist (an expert intubator), but Turner refused. Instead—now clearly trying to revive the infant—he tried an experimental procedure unfamiliar to everyone present: He put the baby in a bath of ice water. Concerned and confused, Rowan asked Turner what was going on, as infants are almost always warmed, not cooled, in emergent situations. Turner explained that he had read somewhere that a child can sometimes be revived by cooling it rapidly in order to produce a dive reflex. (A well-known procedure, it also is known not to work on neonates.) "This was a measure that I was completely unfamiliar with," Rowan wrote. "At that point, I elected to call Dr. [Craig] Jackson, the Neonatologist at Children's Hospital Medical Center in Seattle."

Rowan had mixed feelings about calling the Seattle expert and confided to a nurse that he had never before questioned a colleague's orders by calling another physician at a separate hospital. During that telephone conversation, Rowan explained how uncomfortable he was with the situation. "I was quite concerned regarding the care the patient was receiving," he wrote.

Meanwhile, the scene in the treatment room was grim. "It felt awful," one of the nurses explained in a note later recovered by police, "like it was a done deal. I felt [Turner] was hurrying this along, I felt like it was taking a life."

Neither Jackson nor any other doctor at Children's Hospital would discuss particulars of baby Conor's case or even provide background information regarding neonatal care, for fear, according to a hospital spokesperson, of being called to testify at Turner's trial. Still, Rowan's notes from his midnight conversation with Jackson suggest the expert was equally baffled by Turner's actions.

Jackson explained to Rowan that under these circumstances it was unusual to pronounce an infant dead, as Turner had done two hours earlier. "Jackson described to me that the determination of brain death in a neonate under 1 week of age is extremely difficult and that a determination [of death] at the bedside would essentially not be possible." Rowan then asked about Turner's cooling procedure and the dive reflex he was trying to induce. Jackson told Rowan that he was also unfamiliar with this technique and that it "clearly was not within normal management of practice." Jackson then volunteered to talk to Turner.

It was too late. During Rowan's conversation with Jackson, Turner finally plugged the baby's nose and mouth. In his lawyer's words, "Dr. Turner stopped [Conor's] reflexive actions." No more pulse, no gasps. When Rowan went to inspect Conor for the last time, he wrote, "the child was very catatonic, ashen, and appeared dead."

THREE DAYS LATER, Olympic Memorial's executive committee met to discuss Conor's death and figure out what, if anything, to do. In addition to the normal attendees, including the hospital's chief of surgery, chief of staff, and medical director, the executive committee invited University of Washington medical ethicist Dr. Thomas McCormick and hospital attorney Donna Moniz for guidance.

According to minutes of that meeting that are now part of the court record in Turner's case, Dr. McCormick facilitated the discussion. Among the issues raised were the foggy details of neonatal diagnosis, the baby's initial respiration problem, the educational background of the parents, and Washington state's child-abuse and euthanasia laws.

In Washington state, so-called "passive euthanasia"—such as withdrawing life support—is permitted and not uncommon, while Kevorkian-style "active euthanasia" is illegal. (Turner maintains that since the baby was technically dead when he stopped its agonal gasps, neither term applies.) The hospital's attorney also explained that the 48-hour deadline to report child abuse, or suspicion of abuse, to law enforcement authorities had already passed, and that to report Turner's possible abuse of the baby too late might open the hospital to the risk of criminal charges. The executive committee finally decided not to call the police because "the local community may not be able to cope with such a report."

The committee was right.

A week passed before the story broke. On January 20, 1998, eight days after Conor died, Daniel Heassler, an emergency-room technician who was not on duty the night Conor died but had heard the stories circulating among nurses, called his neighbor, Clallam County Deputy Sheriff Dan Dalton, to tell him what happened. Heassler was a veteran paramedic and one-time cop. His children and wife were patients of Dr. Turner. Even so, he says now, "I had no other choice but to do what I expect of my 10-year-old."

Within hours, the police contacted Olympic Memorial Hospital, Heassler was suspended for spreading "rumors and gossip," and the story hit the front page of the local Peninsula Daily News.

The town's immediate reaction was outrage—at the newspaper. "I have known Dr. Eugene Turner my entire life," began one letter to the editor. "Like many people who know Doctor Turner, I was appalled by [your] allegation of facilitating the death of an infant. . . . I am confident the truth will come out but the damage has been done and I feel the Peninsula Daily News is partly responsible." Another letter read: "I have watched this town's growth. Now I am watching its downfall. Have we become so bored with the unemployment issues in the town that we are actually beginning to tear down the people who have made this community a place worth living in?" The paper was picketed, advertisers threatened to pull their ads.

Those in Port Angeles who remain suspicious of Dr. Turner's treatment of baby Conor have not received the same level of public support. A month after filing second-degree murder charges against Turner, Clallam County Prosecutor David Bruneau was voted out of office after 17 years of service. "We have no choice," Bruneau told the Los Angeles Times about his decision to file charges. "If not the law, then who? Do you leave it to the elites? Personally, I don't like God-playing. When someone starts making decisions about another person's life, that's the worst sort of overblown arrogance." Turner's supporters charged that the prosecutor was retaliating against the pediatrician because his wife, Norma Turner, had organized the campaign of Bruneau's 1994 opponent. (The case has since been assigned to Snohomish County Prosecutor Jim Krider.)

Heassler, the whistle-blower, lost his job at the hospital, and says he is not suing to get it back because he cannot find a lawyer to represent him. He also says that he has had coffee thrown at him, that his car has been vandalized twice, and that he had to shut down the video store he ran on the side after an unofficial boycott by Turner supporters.

All but forgotten are Conor's parents, Michelle and Martin McInnerney. Hospital executive committee minutes that had been made public include this note, which was to help lead to the widespread impression that the McInnerneys were uneducated, fundamentalist Christian welfare recipients: "It was noted that the age of the parents, education, etc. could be important. Were they capable of making the appropriate decisions?" (Others were to cite the notation as proof of the hospital's bias against the poor.) The McInnerneys' image was further damaged by the baby's grandmother, who told a reporter, "Michelle and Marty will come out of this with $20 million. Marty says he's going to own that hospital."

DR. ROWAN, MEANWHILE, began saying he was terribly disturbed by Conor's death, and claiming that he was hearing voices in his head that said he was a horrible person. On March 1, 1998, six weeks after Conor died, the Rowans went to the movies and saw Titanic. Rowan later said that a brief scene of a crew member shooting himself after shooting a passenger in the sinking ship's chaos showed him the "tremendous relief of being dead before you hit the ground."

When he and his wife got home, Rowan says he couldn't sleep. His wife, Deborah, was asleep in bed when he went outside to get an ax. "I just took it and swung it. I just hit her," he testified at his trial last October. "There was no reaction, no reaction at all."

Rowan proceeded to clean the blood from his bedroom walls, carpet, and ceiling. He put his wife's body in their late-model Subaru, propped a rock against the accelerator, and sent the car hurtling into a tree to fake an accident. Police weren't fooled: Mrs. Rowan's wounds appeared unrelated to the accident, and a $500,000 life insurance policy on her took effect the day she died. On the night of the murder, Dr. Rowan left the room in his house where he was being questioned by police and stabbed himself nearly to death. Ultimately, he confessed.

"One would have to be crazy, stupid, or insane to kill your wife on the day the insurance policy took effect," Rowan's lawyer, noted Seattle defense attorney David Allen, said during closing arguments at the murder trial. "And we know Bruce Rowan is not stupid." Amazingly, the jury agreed. Rowan was found not guilty by reason of insanity and ordered to the psychiatric ward at Western State Hospital in Steilacoom. He could be released as early as this June, after only six months of treatment. He has already reapplied for his medical license.

Underlying the bizarre series of events that began unfolding a little more than a year ago is the classic "how could it happen here?" reaction. The notion that two pillars of the Port Angeles community—trusted doctors, no less—could be charged with the murders, respectively, of a baby and a spouse, seems utterly antithetical to this classic small-town-America setting surrounded by some of the world's most picturesque natural wilderness. Even Dr. Jackson, the neonatal expert at Children's Hospital, is at a loss to explain the deaths and the questions surrounding them. He notes, wonderingly, at what seemed at the time a trivial twist of fate: that it happened to be snowing the night Conor McInnerney stopped breathing. Had it not been for that apparent accident of timing, it is possible that Conor and Mrs. Rowan would still be living, and Drs. Rowan and Turner would both still be practicing medicine. "My own personal view," says Jackson, "is that it was extremely unfortunate that it was snowing that night, that because of the weather we were unable to bring the baby here. Dr. Turner's life would have never been turned upside down, not to mention Dr. Rowan and his wife."

It has not snowed since in Port Angeles.

 
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