OLDENBURG, Germany — Bombed out on painkillers, nurse Niels Högel left his little apartment in northwestern Germany to head for work at the hospital, where he injected a 61-year-old woman who had recently awakened from an artificial coma with a fatal overdose of heart medication.
The woman was on her way to recovering and had recently bought a car. She wasn’t ready to die. Later that night he called her daughter to tell her: “Your mother’s circulation is unstable.” The daughter rushed to the hospital, but her mother was dead.
Högel is now suspected of killing more than 200 patients at the hospitals where he worked between 1999 and 2005, when he was first arrested for an attempted murder.
News of that first case raised suspicions about others, but investigations were agonizingly slow. There was a succession of trials over the course of 13 years, and in each one he lied, acknowledging some killings and boasting about more. In the most recent courtroom drama, he is accused of murdering 100 people, and has confessed to all but five.
Part of Högel wanted credit for saving the people he nearly killed. But it didn’t always work, and he didn’t really care.
The heart medication that Högel used most frequently to force his patients into cardiac arrest was ajmaline. People given an overdose might feel dizzy and a fluttering sensation in their neck. Their heart begins to stutter, they struggle to breathe and lose consciousness. “As if you are in the water and drowning,” is how one doctor described it.
But for Högel, now 42 years old, the thrill of grabbing the defibrillator to make a dying patient’s heart beat again was a “kick,” or so he has claimed. And when he succeeded in appearing calmly to save a life, it was like “standing on a pedestal.” In the first hospital he worked, his colleagues even made him a necklace of catheters for being their “reanimation champion.”
A former head nurse testified that when she complained to the intensive care ward’s chief doctor that Högel did not have a good bedside manner, that doctor snapped at her, “You’re just jealous of him.”
Last month here in the northwestern city of Oldenburg, Högel testified in a pop-up courtroom in a concert hall, the only venue big enough to accommodate a crowd of the victims’ relatives. Several came to see this man who had, according to a fellow inmate, referred to their aged or ailing loved ones as “rotten wrappers.”
Högel’s first arrest came when he was discovered next to a switched off infusion pump in 2005. Ever since, Högel has lied to authorities about the scope of his evil deeds. Now on trial for the fourth time, he has been acting polite and speaking calmly about his “work.” At one point on the fifth day, Högel smirked and winked at his lawyer, shaking his head at the complicated wording of the prosecutor’s question, “Man, man, maaan.”
“He is not remorseful, he is angry that he has messed up his life,” Christian Marbach, a spokesperson for relatives, told The Daily Beast. “It’s only about him.”
Marbach began writing letters to Högel around three years ago, to encourage him to come clean. In 2015, Högel was sentenced to life in prison for murdering Marbach’s grandfather, who had been recovering from stomach surgery when Högel crossed his path. During that trial, Högel confessed to having poisoned 30 more of his patients and a new investigation was launched.
This time, Marbach says, there is some satisfaction that he even “engaged” by reading through the medical files of his alleged victims and responding to questions about each case. Still, Marbach says, “We don’t believe him.”
Now for a political twist as cynical as the serial killings are sick.
In Germany’s police crime statistics for 2016 and 2017, there was a substantial increase in the number of murder victims and victims of attempted murders. The increase was overwhelmingly thank to Högel’s late confession and to one other man: Andreas Lubitz, the 28-year-old Germanwings co-pilot with suicidal tendencies and a “not fit to work” doctor’s note, who deliberately crashed a plane with 149 people on board into the French Alps in 2015.
But Högel and Lubitz are not names that Beatrix von Storch—the deputy leader of Germany’s main opposition party, the nativist AfD—mentioned when she tried to defend President Donald Trump’s tweets from July last year which claimed “Crime in Germany is way up” because of Germany’s 2015 open-door policy towards migrants. A few days later, a BBC Newsnight anchor confronted von Storch with Germany’s 2017 police statistics, which showed that crime in Germany was at a 25-year low. “Murders and rapes are still increasing,” von Storch replied.
And even before that, von Storch posted misleading information on social media about how Germany’s police statistics, compared to 2014, show an increase in “murders, homicides.” Never mind that one limitation to these murder stats is that police officers are more likely to charge someone who commits a violent crime with attempted murder (instead of grievous bodily harm) if they are an asylum seeker who doesn’t speak German—because, unlike the courts, the police often won’t have a a translator.
Let’s get back to Högel’s hospitals.
Even doctors with excellent reputations have three minutes per patient and in a badly managed ward the tone can get rough. (A med student in Berlin recently witnessed a cardiologist enter the room of a person he described earlier as having “below room temperature IQ” and joke to that patient’s face: “It’s pretty cold in here, huh?”)
Högel is not the first caregiver in Germany to murder the people he attended. Irene Becker, a nurse in Berlin, murdered seven of her patients. In southern Germany, a nurse called Stephen Letter killed 28. On trial, his lawyer argued that Letter had been motivated by compassion for his patients, many of whom were seriously ill and suffering. The judge disagreed, but considered Letter’s method—he gave them an anesthetic and then suffocated them with muscle relaxant—to be “considerate.”
Högel, it is clear, was not motivated by compassion. Some of his victims were conscious when he made his move. He described one patient as a “whale” and, in this trial, said he thought the hyper-detached attitude of some of his superiors was “cool.”
In the second and last hospital where Högel worked, one woman who survived Högel’s needle told doctors the next day that a man with dark hair and a “cauliflower ear” (Högel’s right ear is permanently swollen) had given her an infusion before her heart stopped working. But no one listened to her. Högel came to her bed again to tell her not to be afraid because she was in a hospital.
That wasn’t the only time that Högel’s workplace failed to stop him. Högel’s first hospital provided a glowing letter of recommendation in order to get rid of him, after a chief doctor refused to let him work on his ward. The staff gossiped about “Niels and his dark shadow,” because so many patients had died on Högel’s watch. But getting the police involved would have been bad publicity. (The state attorney is currently pursuing criminal cases against former staff members of both facilities.)
When the cops questioned Högel for the first time in 2005, they did not even ask him if he was drunk, even though Högel claims that he was, and that “the whole room stank of booze.”
In a 2018 radio show for Deutschlandfunk, a nurse and former colleague emphasized that back in the early aughts, Högel used to be “slim… slender”, and “rated by women.” These days, however, Högel looks like a sick hamster in an Adidas training jacket.
Last month in the Oldenburg concert hall, while Högel mused about his “low self-esteem” and about how his life got “so paradoxical”—when murder left him feeling “indifferent” but he kept killing because he was “longing for the end”—a spectator in the front row jerked and swayed, as if about to fall asleep.
Such is the banality and the boredom of evil.