In 'Good Nurse,' a serial killer exposes health care system

NEW YORK (AP) — Charles Cullen is by some estimates the most prolific serial killer in American history. But when Krysty Wilson-Cairns began writing the script about his capture, she started not with Cullen, who was sentenced to consecutive life sentences in 2006, but outside the home of Amy Loughren, the nurse who first uncovered his crimes.

“I turned up at the real Amy’s house in upstate New York,” Wilson-Cairns, the Scottish screenwriter, recalls. “I think I was 23 or 24. I was like: ‘I’ve never done this before. It’s really important to me. It’s your life story. Can you help me?’”

“The Good Nurse,” which debuts Wednesday on Netflix, takes a deliberately different approach to the true-crime thriller. The story of Cullen, who admitted killing 29 victims but is believed to have killed more than 300 hospital patients while working as a nurse in New Jersey and Pennsylvania, could easily be the kind of sensationalist serial-killer tales that populate streaming services.

But, director Tobias Lindholm and Wilson-Cairns, drawing significantly from Charles Graeber’s forensically researched 2013 book, “The Good Nurse: A True Story of Medicine, Madness and Murder,” wanted to focus their film on Loughren and bigger questions about the U.S. health care system raised by Cullen’s 16 years of undetected murder.

“I saw the potential of doing a serial killer in a way that we had never seen it before, where we wouldn’t be seduced by why is he doing this or how damaged is he as a person, but take a step back and look at why and how would we allow for this to go on,” says Lindholm. “He’s not, in my mind, Hannibal Lecter. It’s not this brilliant mind. It’s a fairly simple guy doing a fairly simple thing, but a system allowing it.”

“The Good Nurse,” which debuted at the Toronto International Film Festival, stars Jessica Chastain as Loughren and Eddie Redmayne as Cullen. In pairing the two Oscar-winners and good friends for the first time, “The Good Nurse” trades on their natural chemistry together. Loughren befriends the recently hired Cullen. Transferring from hospital to hospital, Cullen was easily able to cover up his lethal poisoning of patients in intravenous fluids — thanks, the book and movie suggest, to for-profit hospitals covering up potential liability.

“This case asks us if it’s a good idea that people are making money from other people’s health,” says Lindholm. “Is it a good idea that hospitals are businesses?”

Adapting “The Good Nurse” was Wilson-Cairns first job for hire some 10 years ago. Since then, she's co-authored a pair of high-profile projects: “1917,” with Sam Mendes, and “Last Night in Soho," with Edgar Wright. Her trip to visit Loughren was just her second time in America. To research the film, she spent two weeks shadowing nurses at a Connecticut hospital.

“What I found is that the actual health care providers — the doctors, the nurses, the radiologists, the anesthesiologists — all these people are incredible and are heroic,” says Wilson-Cairns. “They put their lives in a box so they can help save other people. I don’t think any of them are paid enough. I think even at 10 times, those nurses aren't paid enough. I learned that the system they are forced to work within is not the best for patient care.”

Making “The Good Nurse” was temporarily postponed when Lindholm, the Danish writer of the acclaimed films “Another Round” and “The Hunt," went off to make the six-part miniseries “The Investigation,” about the death of Swedish journalist Kim Wall. Chastain and Redmayne remained committed to making the film with Lindholm, drawn to his naturalistic approach.

Chastain, following up her Academy Award-winning performance in “The Eyes of Tammy Faye,” leaned on conversations with Loughren, a single mother. She responded particularly to how Loughren worked as a nurse through her arrhythmia. Before shooting a scene, Chastain would jog around set to get her heart rate up. She also wore an ear piece with a heart beat that could accelerate in the middle of a scene.

“She worked nights so her daughters felt like she was a stay-at-home mom. That’s what she kept saying, that her kids saw her when they were awake,” Chastain says. “The idea that this woman would risk her health in order to provide for her children and also risk her comfort by not getting the sleep she needed, it told me so much about who she was and what she was capable of.”

Redmayne, stepping into darker territory than he's known for, drew on footage of Cullen from his courtroom appearances and from “60 Minutes” to build a performance that eluded usual serial killer stereotypes. In Graeber’s book, Cullen is described as “a sad Mr. Rogers type, both drippy and depressed.”

“There was something in his physicality that was interesting to me,” Redmayne says. “He’s a very still man. But if you actually look close, you’ll see he’s always soothing himself. I don’t know if soothing is the right word, but touching fabrics. There’s always something moving. The guy was a horrendously damaged human being and that idea of looking for comfort was interesting to me.”

Most encouraging to Wilson-Cairns is seeing Loughren, 10 years after she sheepishly knocked on her door, be celebrated for what she did. At the film's premiere in Toronto, Loughren fought back tears during a standing ovation.

“This woman just wasn’t recognized for what she did,” says Wilson-Cairns. “People don’t think of ordinary women as these kind of heroes. They’re not on screens, they’re not in the media, they’re not in books enough. To see the real Amy finally be recognized in a small way for what she did – which is save countless lives – I thought: That’s not a bad way to spend a decade. I’d do that again.”

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Follow AP Film Writer Jake Coyle on Twitter at: http://twitter.com/jakecoyleAP