Genre
Non-fiction
Setting and Context
In the Eastern United States in the late 20th and early 21st centuries
Narrator and Point of View
Third-person omniscient.
Tone and Mood
Violent, dark
Protagonist and Antagonist
The primary antagonist of the book is Charles Cullen. The secondary antagonist is the hospital system.
Major Conflict
The conflict between Cullen's desire to brutally murder his patients and the hospital systems he worked for, all of which were handcuffed by bogus and nonsensical laws.
Climax
When Cullen is finally caught and arrested after years of viciously and cruelly murdering people.
Foreshadowing
Cullen eventually getting caught and arrested is foreshadowed by earlier run-ins with some of his other hospitals.
Understatement
The complicity the hospitals have in the deaths of Cullen's patients is understated in the book.
Allusions
There are allusions to the medical field, history, the popular culture of the time, and geography.
Imagery
Violent, horrific imagery is used to illustrate how evil Cullen was in killing people.
Paradox
Medical professionals are supposed to "first, do no harm." But Cullen, a medical professional, did tremendous harm.
Parallelism
Cullen's times at hospitals - his start and his ultimate departure from each job after being found out - are paralleled with each other.
Metonymy and Synecdoche
N/A
Personification
The drugs Cullen used to murder his patients are personified in the book.
