Health Care and Domestic Workers Could Have Hidden Pasts

We found this article in New York Times Magazine.

We have excerpted the article here. for the full article, click on the hyperlink above.

Knowing Noreen

The public seating in Room 25 of the Circuit Criminal Court complex in Dublin is not designed for comfort. The half-dozen rows of benches are wooden and narrow, with barely enough room for your knees. I spent the better part of October trying not to fidget in those pews, sitting, as I was, just a few paces away from the defendant, who was under strict orders from her lawyer not to fidget at all.

In this court the defendant sat apart and alone, on a separate bench, directly opposite the jury, while the lawyers for both sides shared a large wooden table. For nearly a month this defendant followed her orders well; while I squirmed, she stared purposefully ahead, rarely looking directly at anyone, though once in a while I accidentally caught her eye.

Her name was Noreen Mulholland. She was a nurse. She was in this courtroom charged with assaulting two patients in her care. In the Irish tabloid headlines she was “the Naas Nurse,” after the town where the supposed crimes were to have occurred.

She had also been my children’s baby sitter.

I met Noreen in 1994 when she answered an ad I placed in our suburban New York newspaper seeking help on Saturday nights. My son Alex was a newborn then, and Evan had just turned 3. The occasional weekend night became every week — and also whenever our au pair was sick, or I had to travel for work, or we needed an extra pair of hands. At one point, when Noreen was between apartments, she lived in our spare room. At another point, so she could make extra money, I hired her to clean the house. My friends grabbed the rest of her time, and after school every day she cared for a little boy who was Alex’s best preschool friend. My world and Noreen’s were loosely, but definitely, entwined.

One day, when Alex was about 5, he said he didn’t want Noreen to come anymore. “Noreen scares me,” he said, but could not, or would not, explain further. By then I’d known her long enough and — I thought — well enough that I owed her the benefit of the doubt. I told her what Alex had said. I hoped she would answer as I like to think I would if I learned that a child was afraid of me — with concern, or at least an explanation, maybe an apology, an offer to help make things right. Instead she said, “You know, Lisa, kids lie.”

James Joyce, whose spirit is everywhere in Dublin, once said, “In the particular is contained the universal.” This is about child care only in its particulars. It is not a tale of evil nannies lurking around every corner, or a declaration that children are not safe with anyone other than their mothers. More universally, it is about trust, and the harsh reality that as well as you ever know anyone, you can know only what he or she allows you to see.

We know this, and yet we trust. We trust strangers not to poison our food in their restaurants, not to drive drunk when we board their buses. We trust loved ones, even though each year brings news stories of husbands leading double lives, wives whose hidden demons cause them to kill. We hire office workers after a few hours of interviews, at best, and trust them not to steal or destroy all that we have built. We go to a doctor based only on the fact that our neighbor seems to like him. We hand employers our Social Security numbers, and valets our car keys, and bank tellers our balances, and nannies our children.

When I learned that Noreen was in trouble, in May 2004, my first question was “What has she done?” I knew she had gotten her nursing degree and moved to Ireland after we’d parted ways, but I had no idea how to reach her. The news reports I could find online were sketchy, alluding to possible exhumations, a planned review of the cases of any patients she might have cared for and a hot line relatives could call if they thought their loved one had been harmed by the Naas Nurse. “Did She Poison Them?” screamed a headline in The Irish Daily Mirror, next to a prominent photo of the woman who used to give baths to my boys. But what none of these stories told me was what exactly she was accused of. Was she a serial killer? An “angel of mercy”? A screw-up? An innocent victim of a false accusation? Or some combination of the above?

My second wave of questions, following milliseconds behind the first, began with, “What had I done?” As a reporter, it is part of my job to size people up quickly — to know (or at least wonder) if they are lying or sublimating or telling a story that isn’t linear and complete. I had sized up Noreen and welcomed her into my family. Along the way there were hints that everything was not perfect. But no human being is perfect, and to have a relationship, any relationship, means to decide which imperfections we choose to accept. I accepted, even embraced, Noreen’s. Until Alex said that she scared him.

I became all but obsessed with getting answers to these questions, which is how I found myself two years later in a Dublin courtroom, trying not to stare too blatantly at Noreen while she tried not to glance my way. By then I had learned that she was not a serial killer, in fact she was not a killer at all, and despite the flurry of headlines and hysteria, she would, in the end, be charged in just two cases, and in both instances she was accused of assault and giving an unprescribed drug. But that was about all I could learn from afar. I needed to hear the evidence from the mouths of those who accused and defended her and decide the facts of the case firsthand. I needed to know if I was right to have trusted this woman long ago. Even more, I needed to know if I could continue to trust myself.

Many details of my years with Noreen Mulholland are fuzzy, but others are crisp, and among the clearest are those of the first time we met. I was a sleep-deprived mother of an infant and a toddler 12 years ago, looking for a way to go to dinner and a movie on Saturday nights. I couldn’t believe my luck when this Irish burst of energy all but blew into my house for an interview.

She was 23, curvy in a comforting way, with auburn hair, a warm smile and the habit of calling everyone “Love.” Until that moment I didn’t know that I carried an image of the nurturing Irish nanny, but she filled it completely. Then, as always, her hair was perfectly cut, her makeup smoothly applied. She took pride in looking good and, I would later see, in doing things right. “It’s O.K., Love,” she might have said to Alex as she offered to take him from me and then rocked him on her knees while we talked. She had the sure moves of someone who had done this before.

One of the first things she told me was that she was determined to become a nurse. Her mother had been a nurse, and it was all Noreen ever wanted. She was a teenager when her mother died, from a brain aneurysm, at 41. I’m not sure if she mentioned her mother during that first interview, but I am positive she talked about her own nursing goals, because it was a large part of the reason I hired her. Nursing is shorthand for caring and competence. It says, “I don’t shirk from the messy” and “I have smarts and ambition beyond being just your baby sitter.” What more could a mother want?

Well, glowing references from a former employer, for starters. And Noreen didn’t have those. She described her depth of baby-sitting experience — much of it back home, then several years with a family here in the States. As I recall, she then said she preferred that I not contact that family. Things ended badly, she told me. She loved the kids but felt friction with the mother, who, by Noreen’s description, was jealous that the nanny was better with the children.

I didn’t hire her entirely without references, though. As it happened, she was dating the son of a woman who worked in the local school district, and that woman described Noreen as kind and hardworking and lovely. I also went ahead and called the family Noreen had asked me not to speak to. The mother wasn’t home, so I spoke to the father, who basically said that his wife felt it was time for a change. Anyone who has ever checked references knows that is code for volumes more.

And yet I hired her. I remember wondering whether this young woman might be the type who always insisted she was right, and if one day I would be the one she complained about to the next prospective employer. On the other hand, she would be coming only on Saturday nights, which the children spent mostly asleep. I gambled because I trusted the warmth she showed while holding Alex. I was relieved to have found someone who spoke fluent English and was more mature than a neighborhood teenager. The delightful brogue, I confess, didn’t hurt.

As it turned out, she was wonderful with the boys. Alex loved when she baby-sat, and even more when she came to clean, because she would wave the vacuum wand over his Dutch-boy haircut and make his hair stand out straight from his head. She seemed to love him back. One afternoon when she wasn’t working, she was at a neighborhood pool with a friend and an announcement came over the loudspeakers that a child named Alex was missing. The next day she told me how frantic she felt for the moment when she wondered if it might be “our Alex.”

We would chat in my kitchen while she took a break from cleaning and I took a break from writing. I have two sons, and while she was too old to be like a daughter, she certainly added some welcome girl talk to my life. I don’t remember much of what I told her, mostly stories about the boys, I think. She, in turn, told me stories of her family back home — of her father, whom she didn’t speak to; of land her mother had left her that some relatives tried to steal; of an argument over her mother’s headstone.

I heard a lot about her love life too — a series of relationships that seemed particularly tumultuous. In the last, and most serious, of these, she lived for more than three years with a man who, to her dismay, would not propose.

I wondered along the way, as I had the day we’d met — what was it about this woman that she was always being wronged? I kept those thoughts to myself, though, and instead I tried to help, offering advice, lending an ear. She had no health insurance, so I sent her to my doctor for flu shots and chicken pox vaccines and paid the bill. I proofread her application for nursing school and wrote a letter of recommendation. When she was wait-listed, I called the dean and told her they would never have an applicant who was more determined to become a nurse. She was accepted.

Going to school full time while still working nearly full time took its toll over the coming months. She became tired and snappish. Which is why when Alex said, “Noreen scares me,” I was not as alarmed as I might have been. She was burned out, and she screamed at him. That’s what I believed then. I still believe that now. Lord knows, I had been known to do the same. I knew she had a temper — although I had never heard her raise her voice to a child, I had witnessed her displays of anger at those she felt had wronged her over the years, and I’d heard her describe it herself when telling me how she’d thrown her boyfriend’s clothes out of the apartment during an argument and screamed at his mother over the phone that he didn’t appreciate her. I could imagine that she’d snapped and turned that temper on my boys. Not acceptable, but not a crime.

Unacceptable, though, was her answer when I’d asked about it. “You know, Lisa, kids lie.” Once again she was the victim. Once again she was in the right and the other guy (my kindergartner) was in the wrong. This time it was too close to home, and it was the last conversation we would have for several years. I simply stopped calling her with work.

I heard through friends that she finished nursing school, with honors, and returned home. She would have preferred to have stayed in the States, but her arguments with that boyfriend over marriage had reached the point at which she’d threatened to go back home if there was no wedding, and in the end he called her bluff. “I would have married the girl,” he told me one recent morning, when he appeared at my door after learning I had been at the trial. “But not because she was telling me to. If only I’d have married her, none of this would have happened.”

When I next saw Noreen, it was in a jam-packed Irish courtroom, nearly five years after her work for me ended. She all but collapsed in my arms. We had talked on the phone a few times, but she hadn’t received the e-mail message that said I’d be coming. When she saw me, her knees buckled and I had to grab her arms to keep her from hitting the ground. It took but a few moments for her to compose herself, though. “I’m not allowed to cry, no emotion, I can’t let them see me cry,” she kept saying, as she put her game face back on. By “they” she meant the cameramen outside and the print reporters inside.

This courtroom, in November 2004, was in Naas, about an hour outside Dublin. Noreen was there for a hearing to ask for a change of venue, which was granted. As we left the courthouse, it became clear why her lawyers did not want her to be tried in Naas. Cameramen yelled her name as they followed her down the block and around the corner toward her car.

She was out on bail and was required to check in with her local police station every Monday and Friday. She had been planning to drive directly back home after the hearing, but I talked her into letting me buy her lunch. She chose a restaurant that didn’t have a TV in the bar so that she wouldn’t have to see herself on the midday news while she ate. The dining room of the restaurant was decorated like a living room, and we sat side by side on a cozy couch with a low table in front of us.

She asked me why I had come. I told her, honestly, that I wasn’t sure. Part of me, I think, wanted to save her. She was in over her head, and I wanted to help. Part of me, though, wanted to shake her and demand to know what she had done. Had she lost her temper? Had she lost her mind? And then there was the part of me that knew I might be writing this article. I wasn’t certain I would, but I told her that day that I might, and I took notes while we talked. My pad on the table was my way of reminding us both that while our roles and emotions were muddled, I was very much a reporter.

I asked how she was doing. “My life’s on hold,” she said. She’d had to sell her house near Naas and move to Northern Ireland, where she qualified for welfare. Once there she spent her days reading the growing file on her case, calling it “my homework,” and exercising like a demon at a nearby gym. She’d lost weight and viewed herself as training for a fight.

Gradually we inched toward the subject of the case itself. What, exactly, had she done? She had been charged with harming John Gethings and Seamus Doherty, both elderly men in very poor health, when they were admitted to Naas General Hospital in 2003. Noreen was accused of giving each man an injection with the drug haloperidol, known by the brand name Serenace in Ireland (and as Haldol in the U.S.). An antipsychotic, it is also used as a sedative for agitated patients. Gethings died. Doherty was, at the time, still living but in a nursing home. (He would die, of unrelated causes, in March 2006. An autopsy later showed that Gethings’s death was not caused by Serenace.)

Noreen told me in an earlier phone conversation that she had learned of the charges one afternoon when a supervisor called “out of the blue” and said that all her shifts were canceled. She had been working at Naas General for about six months when she got that call in July 2003 and thought she had formed good friendships with other nurses there. When she went down to meet with the administrator, she described being stunned to see “my best friend’s handwriting” on a complaint report.

From these sketchy descriptions, I gathered that she was accused of giving each man an injection with an unnecessarily large needle in a way that caused pain. She also told me she was accused of throwing a glass of water at one patient and saying, “If you don’t shut up, you’ll get another” injection. But she had done none of those things, she said. Whatever other facts were out there would be kept sealed under the Irish system until the actual trial, so for now all I had was Noreen’s assurance that this was all a mistake, a vendetta by co-workers who turned out not to be her friends.

She suspected that they were jealous, she said, since she had trained in the States and was better at nursing than they were. “My colleagues just hadn’t a clue,” she said. “Their technology was decades behind.” Periodically, she said, she would ask herself: “ ‘Where the hell am I?’ They’re doing backward nursing here. I’d tell myself, ‘Just blend in, do the best you can.’ ” And yet, she said, she made sure everyone knew she graduated with honors from nursing school, and she often wore her gold honors’ society pin on her white nursing blouse and was proud that the others had nicknamed her the Professor.

As the hours passed at lunch that day, Noreen talked more about her past. She described a childhood spent watching her father regularly beat her mother. Noreen wanted to be a nurse not for the reason I’d thought — to follow in the footsteps of a beloved mother — but because she was determined to avoid her mother’s fate. “I wasn’t going that route,” she said. “I wasn’t going to be pregnant and dependent, with a bruised face.”

In a way her ambition was a different kind of homage to her mother. “I knew I could nurse because I had been my mother’s nurse,” she said. “I knew really young to get the wet cold cloths. I knew which were the old towels and to use those to clean up the blood.”

Sometime during her childhood her father was sent to prison for bludgeoning a man in a bar fight. She was glad when he went away, she said, because he couldn’t hit her mother when he was in jail. Her mother made plans to go back to school and continue the work that had been interrupted when she’d had children, but before she could finish, she died. With nothing left for her back home, Noreen left for the U.S. and did not return until the fight with her boyfriend in 2001. Her father died in February 2004, a few months after Noreen saw him for the first time in more than 16 years.

My mind was reeling. I was scanning through mental snapshots of what I had known of her life and seeing them through this new lens. Her choice of problematic men — a re-creation of her relationship with her father? Her inability to see herself as in the wrong — a response to a lifetime of being told that she was? Her determination not to ask for help — a belief that she was completely on her own?

I might well have hugged her then and told her everything would be O.K., when she went one thought too far. In the dimming late afternoon light, she turned to me and said, “One Christmas you wrote me a note saying that I must have come from a loving family to show such love.”

She took a deep breath and looked me straight in the eye. “Wow, did I put one over on you.”

Her voice was steel. Icy. Scary. She seemed pleased with the pain her words could cause.

I know we stayed longer and talked more, but I have no record of what was said because I all but stopped writing after those words exploded between us. I felt blindsided, deceived, ill. Somehow the conversation came around to the question I had gone all that way to ask, a question that seemed trivial against the enormity of what I now knew.

What had happened to frighten Alex?

Her answer is the last thing written on my pad from lunch that day: “I was burned out. I was a cleaner. I was taking care of four walls, not the people within them. If your kids got me before a certain time, they got singing and playing and fun. After a certain time, I held back. I wanted my own children someday, and when they would do certain things I knew I would say, ‘That’s just like Alex, or Evan, or Eli.’ I didn’t want that. I needed to save something for my own children.”

The relationship between a mother and the woman she hires to care for her children is filled with unspoken truths. The mother does not say out loud that she expects the nanny to have more patience, more time, more energy than she has for herself. The nanny does not say, in turn, that this is just a job, and that you cannot love a stranger’s children as your own. The mother wants the nanny to give love, and the children to return that love — but not too much. The nanny has opinions, based on experience, but she knows enough to keep most of them to herself.

I know mothers who do all they can to make it a business relationship, with charts and lists and performance evaluations — the better to be able to end things if the situation starts to sour. I know others who embrace their nanny as a friend — as if knowing her every thought, the wheres and whos of every Saturday night, will keep the children safe. The first group always seems to feel that their relationship is cold, and the second that things are too fraught.

I spent a lot of time in the months after I returned from Ireland replaying Noreen’s words — “Wow, did I put one over on you”— and trying to decide why they hit me with such force. I couldn’t get over the feeling that she had lied — if not by commission then by omission. Why had she not told me about her tortured childhood?

I fully understood why she didn’t walk in the door and tell so deep and personal a secret at our first interview. It’s not something you would share with a stranger. Besides, had I somehow known everything from the start, she would have been right to fear that I might not have hired her. I know the scientific literature. Abusers have often been abused themselves or witnessed abuse. Of course I also know that the reverse is not true — a history of abuse does not make you an abuser. But while I would have been — and still am — impressed by Noreen’s determination to escape her mother’s fate, I might not have taken a chance when the job was caring for my children.

Corra has for a while now been cautioning our clients to “make sure they are who they say they are.” If you are hiring employees for your business or domestic help for your home, check them out before you hire. And for those of you who are dating and therefore meeting strangers, check them out as well. For a few bucks you learn if someone is a threat to you or your children, if he or she has good intentions or wants to steal your money.

No background search can guarantee against any wrong doing, but they it can sure go a long way into helping you prevent myriad disasters.

This tale above is but one more story of deception and disappointment, of learning about someone in the aftermath rather than up front where it can do you the most good. It is a fine story and while we only excerpted here, we urge you to click the hyperlink and read the entire article.

We suggest you run at least a criminal check and credit check on most prospective business employees. We suggest as well the Social Security Trace and perhaps employment and education verification. Most people, when they lie, will lie about their educaition.

For domestic help, you may run a criminal report and either a license or certification verification, often along with the Social Security Trace. If you are planning on dating someone, you may want to run a comprehensive background report. Otherwise you may not only be risking the well being of yourself by that of your entire family.

As Corra says, check them out before you hire. And check them out before you date them, or at least get seriously involved.