Medicine: The Puzzle of the 17 Patients

In the quiet French wine town of Mâcon on the Saone, the hospital’s doctors and nurses wore worried frowns. Even Madame Anne-Marie Demussy, the usually calm head nurse, seemed upset. Something very odd indeed was going on. In less than three years, 15 women patients had died mysterious deaths under very similar circumstances.

Nearly all the victims had been operated on for disorders of the uterus, ovaries, etc. (two had had stomach operations). In each case the operation had seemed successful. But within 24 hours, every one of the patients had shown the same fatal symptoms: coma, rapid loss of reflexes, and what looked like severe scorching of the tongue. After the 15th death, Head Doctor Raymond Denis uneasily consulted a Paris toxicologist. The expert put Dr. Denis’ vague horror into words: “There is a criminal in your service.”

Then the 16th victim died. The town began to buzz with ugly rumors. The townspeople began to call it “I’HÔpital de la Mort.” Dr. Denis ordered all gynecological patients isolated in private rooms behind locked doors. By mistake, one patient was taken to a ward after her operation. Her death was the 17th.

Inside Job. The Paris press, suddenly waking up to what France-Soir called “the most extraordinary enigma in criminal history,” screamed MURDER. As a horde of reporters and cameramen built the case into a sensational story, a stocky, methodical detective named Edmond Bascou, one of the Sûreté Nationale’s best, took over the investigation.

Clearly, Detective Bascou decided, an inside job. Methodically he narrowed the suspects down to one: the only person present when each of the deaths occurred. His suspect was Head Nurse Demussy. He also dredged up what looked like a macabre motive: the nurse’s divorced husband said that she was physically incapable of bearing children. Had she committed 17 mad murders of vengeance against women undergoing operations to make child-bearing possible? Nurse Demussy, after 22 solid hours of questioning, did not give the detective’s theory much encouragement. Said she: “Do I look like a monster?”

To many of Mâcon’s townspeople, she evidently did. In the public squares, angry crowds cried: “Voilà l’empoison-neuse!” One Paris paper called the case “Atropine and Old Lace” (atropine had been found in the viscera of one victim). But Detective Bascou, finally convinced that Nurse Demussy’s ex-husband had lied about her, changed his tack. The detective decided that the solution must be a medical one, and began to study the hospital’s post-operative treatment of gynecological patients.

Salt Solution? Last week Detective Bascou thought he had found the solution. Nurse Demussy, he said, was no murderess. But someone had been incredibly, perhaps fatally, careless. As standard treatment after an operation, he discovered, patients are given a salt-drip injection—one teaspoon of salt in a liter of boiled water. But the Mâcon Hospital nurses had become woefully unprecise: they had taken to dumping a tablespoonful, or even a fistful, of salt into half a liter of water—and given the solution as a rectal drip. Could such a strong salt dose have killed 17 women? Some of the detective’s medical consultants thought it could (the victims’ symptoms resembled those of shipwrecked sailors who drink sea water).

Some doctors disagreed. Cried a Ministry of Public Health spokesman: “Absurd! . . . The worst that could have resulted was a case of diarrhea and an irritated rectum.” But Detective Bascou was so sure of his ground that he closed his investigation as a police problem and recommended that a medical commission carry on. Solution of the Mâcon “murders” was now up to the doctors.