Listener discretion is advised, this episode features discussions of violence and murder that may be upsetting. We advise extreme caution for listeners under 13.

We are all products of our pasts of the people and the moments that shaped us. Some are driven forward by the hope that positive experiences bring, while others push themselves to overcome their mistakes. But then there are those who are haunted by their early memories, so paralyzed by fear that they become frozen in time, unable to grow and change. Sometimes a single bad day can change the course of our lives alone. Image can twist and pull at our psyches until they're warped by obsession.

It can even tarnish the lens we use to view others casting a dingy light on the world that makes monsters out of shadows. For h. H Holmes, one terrifying memory set him on a course that eventually claimed the lives of nine people. He became an arbiter of death, and it might have all started in a doctor's office.

This is Medical Murders, a podcast original. Every year, thousands of medical students take the Hippocratic Oath. It boils down to do no harm. But a closer look reveals a phrase much more interesting. I must not play at God.

However, some doctors break that oath. They choose to play God with their patients, deciding who lives and who dies each week on medical murders. We'll investigate these doctors, nurses and medical professionals. We'll explore the specifics of how medical killers operate not just on their patients but within their own minds, examining the psychology and neurology behind heartless medical killers. I'm Alastair Murden and I'm joined by Dr. David Kipa, M.D..

Hi, everyone. It's a pleasure to be here to assist Alister by providing medical information and insight into the killer's modus operandi. I've been in private practice for over three decades specializing in internal and addiction medicine. I'm thrilled to be part of this episode because I'm a huge fan of crime stories and I'm very interested to see what happens with Dr. Holmes.

You can find episodes of medical murders and all other podcast originals for free on Spotify or wherever you listen to podcasts to stream medical murders for free on Spotify, just open the app and type medical murders in the search bar. This is our first episode on Dr. H.H. Holmes. Often cited as America's first serial killer, Holmes eventually claimed to have killed over 200 people, though only nine murders have ever been confirmed. Many suspect him of slaughtering dozens, if not hundreds of unsuspecting victims between 1891 and 1894.

Today, we'll examine Holmes's early murders and the way he used his medical knowledge to conceal his crimes. Next time, we'll examine the heights of Holmes's murder spree and the sensational rumors that immortalized him as one of the world's most notorious killer doctors. All this and more coming up. Stay with us.

According to author Adam Selzer, H.H. Holmes was quiet and easily startled. The perfect target for schoolyard bullies. Older boys regularly tormented him, teasing out his fears and insecurities with a knack that only meanspirited children seem to have. It didn't take them long to figure out that Holmes was especially terrified of the local doctor's office. He'd heard stories about evil potions and jars of human remains festering in the back of the building and couldn't stand to even go near the place.

His bullies played on his terror one evening by dragging young homes to the darkened office and shoving him through the door. Inside, they'd rigged an anatomical skeleton to lunge at him. As Holmes stumbled forward, he was greeted by a staggering pile of bones suspended on metal wires, though he eventually shook the nightmares that came with it. Holmes never forgot the feeling of being so helpless in the face of death the anxiety.

Nor did Holmes, even as he became an adult to compensate for his insecurities, Holmes convinced himself that he was smarter than everyone else in his provincial town of Gillman's in New Hampshire. Despite the facade of towering self-confidence. Deep down, Holmes worried he was worthless after he married his childhood sweetheart, Clara Lovering, at the age of 17, he struggled to make ends meet. His money troubles became worse a year later, in 1879, when Clara gave birth to their first child.

But above all, Holmes was committed to making a fortune, and so he decided to pursue a career in medicine. In 1880, at the age of 19, he began an apprenticeship under Dr. Nayim White, the physician who practiced at the office that so terrified Holmes as a boy.

Holmes quickly found that though he didn't have much natural talent for taking care of others, he was willing to go to any lengths to get the status symbols he wanted money and respect. On top of this, he was fascinated by human anatomy, which made him the perfect pupil for Dr. White. White was an outspoken proponent of dissection. So it was a. Morally controversial subjects in the late 19th century, though, it wasn't outright illegal, getting a hold of cadavers was extremely difficult.

In fact, nearly every medical school and medical student then resorted to shady means to further their studies. It's likely that Holmes went with Dr. White to the cemetery himself, or else paid someone else to rob a grave to get the subjects they needed.

Qadi body snatching does have a lengthy history. Human cadavers were actually first introduced into medical schools and 1745 for dissection and anatomy classes. And for the next 200 years, cadavers were in very high demand as more and more medical schools sprang up. And there's high demand certainly led to some underhanded methods of getting bodies. As time went on, medical schools started increasing their enrollment, so supplying these cadavers became a bigger problem. Since the early 2000s, medical students are no longer required to dissect human bodies.

Instead, medical schools now receive pre dissected bodies through donation programs. This saves students time and frees up space for new curricula. And some medical schools now even offer virtual anatomy courses. But from my personal experience, there's no substitute for the real thing. By being able to see the anatomy of a medical student can not only understand how nerves, blood vessels, muscles, tendons, bones all relate to each other, but as students go through their training and learn the physiology of disease, they can now use that anatomic information to understand best how the body works.

All medical students, when they first encounter a body for dissection, have some reservation. It's natural. Once we're in the laboratory, however, for several days, weeks, months, it becomes second nature. In the beginning of the dissection courses, people are very squeamish. After about two months, people are bringing in a sack lunch. People are moving around the room. It's a very different atmosphere once medical students become used to this home.

Certainly wasn't uncomfortable. When he began attending the University of Vermont Medical School in 1880, his classmates remembered his fixation with dead bodies. John Madden, a fellow student, later recalled that Holmes once asked a professor to let him take the cadaver of a baby home with him to experiment on during vacation.

Homes took the body of the infant back to his boarding house and inexplicably stuffed it under his bed before going out for the night. His landlady popped into Holmes's room to sweep while he was gone, only to find the dead eyes of the baby staring at her from the floor. The discovery terrified the old woman, and she refused to go into his room for weeks afterward. Luckily, the landlady didn't have to deal with Holmes for long. He ran out of money and was forced to drop out of school after a single year.

The setback was frustrating, as was his mediocre performance on his final exams. But Holmes was determined to finish medical school. And so for the next few months, he worked hard to earn enough money for tuition. By 1882, Holmes had the money for another year of school, but he was too ashamed of his financial hardship and unimpressive grades to return to the University of Vermont. So he enrolled at the University of Michigan, instead resolving to prove his worth once and for all.

In Ann Arbor, Holmes continued to struggle with school, but this time he found a scapegoat in his wife, Clara, who had made the move to Michigan with him along with their two year old child. By day, Clara worked as a dressmaker. While Holmes studied at night, Holmes blamed her for his frustrating performance in class, and neighbors reported disturbing incidents of what was most likely domestic abuse. Clara gave everything she had to support her husband, but after years of mistreatment, she left homes.

In early 1884, they remained separated, though never legally divorced for the rest of their lives.

After Clara left, Homes threw himself into his studies, he became close with the professor of anatomy, Dr. Herdman, and got a job preparing bodies for dissection to compensate for the income he lost when Clara left. One student claimed that Holmes frequently accompanied Dr. Herdman on his night trips, implying that they went to graveyards together to procure fresh corpses for the school. His creepy behavior didn't make homes any friends at school. None of them knew him well, but nearly everyone felt there was something off about H.H. Holmes.

He seemed secretive and restrained and had an air of smugness about him, coupled with his obsession over dead bodies. It was no wonder that few people considered themselves his friends. Despite the struggles Holmes pushed through and graduated from medical school in 1884 at the age of 23, he felt like he could finally make his fortune and get the respect he deserved. But to take full advantage of his new credentials, he needed to go somewhere far away.

He wanted to be a big fish in a small pond. So after graduation, Holmes moved to the small town of Mor's Fork's, New York.

He worked part time there as a teacher and a doctor. But Holmes didn't care about healing anyone. He only wanted to feed his ego.

And with such selfish ambitions as his guiding force, it didn't take long for his dark side to emerge.

Coming up, H.H. Holmes embarks on a life of crime.

Now back to the story.

In 1884, 23 year old Dr. H.H. Holmes graduated medical school, ready to use the power of his credentials to scam everyone around him, tricking those he saw as beneath him was the surest way for Holmes to prove to himself that he was unique and clever. It seems Holmes never intended to make his money. Honestly, only a few months after Holmes moved to the small town of Moore's folks, New York. He abused his power for the first time. After a minor smallpox outbreak in town, Holmes ordered a large quantity of smallpox vaccines.

He traveled from house to house, selling them for 25 cents each, about the equivalent of six dollars and 50 cents today. He didn't get many bites at first. It's possible. That's because Holmes was a newcomer in town. The average resident didn't trust him to give them an unsolicited shot. Holmes apparently found that deception worked a lot faster than trust after initially struggling to sell the medicine, he decided to con his neighbors. Instead, he went door to door a second time, now posing as an official from the Board of Health.

He now claims that the vaccine's still priced at 25 cents were mandated by the government. The townspeople believe they were forced to pay and were threatened with legal consequences if they refused.

People inherently trust their doctors and health care officials. It's similar to how we view airplane pilots.

We blindly trust them because our lives depend on their skill and know how we want to believe in their competence because the alternative is far too scary. A thought at the time of Dr. Holmes malpractice was not a significant issue.

However, in the mid 70s, we saw a peak in concern over this issue, and this is when malpractice suits began blossoming.

And over the past four decades, we've seen the medical boards become more and more watchful of doctors. And thanks to this, patients rights are now taken very seriously.

The biggest advantage for patients with protecting their health outcomes are malpractice lawyers. We don't need to search them out. Patients are sometimes motivated to file malpractice suits because of potential lucrative settlements.

The doctors that are less likely to be sued are those that have developed long standing relationships with their patients, like a time trusted family physician. These changes ensure that doctors are doing what's best for their patients and not what's best for their own pockets.

Unfortunately, homes only cared about himself, the scam netted him the seed money he needed to rent a small office, which he turned into a laboratory. His next goal was to create a patent medicine and over the counter treatments commonly sold in pharmacies as a kind of cure all for a variety of symptoms. At the time, patent medicines were seldom subject to any kind of legitimate medical trials. Today, things are very different.

To enter the pipeline, a new medication must go through five FDA phases. First, its discovery and development, which is when the patent is filed. The second stage is preclinical research and then comes to clinical research where the drug is now tested on people. This is followed by an FDA review and if approved, the drugs go through a final phase of additional safety studies. The average time for these drugs to gain approval in the United States is approximately seven years.

This is different in other countries. But today the United States has probably the most strict regulations for approving a drug. Back in the eighteen hundreds, approving a patent medication was not a lengthy procedure because there was no oversight. So they didn't test people in these medications. They had no controls over what went into these medications.

So you could buy a patented medicine at that time, one month and the next month by the same product without this having any reference to the product you bought the month before.

This lack of regulation made the eighteen hundreds of very lucrative time for patent medications. There was virtually no oversight. And home certainly wasn't the only one participating in this unethical game. The fact that there was so much competition eventually became a problem for Holmes. He tried for months to perfect a unique concoction, but eventually abandoned the project. By that point, his money problems were so bad that he was having trouble paying rent. A slight saving grace came when his landlord offered to pay him to perform an autopsy.

But as usual, Holmes treated a simple favor as an opportunity to run a con. The landlord's friend, an ex soldier, had recently passed away. Holmes examined the body and found that an old war wound had led to the soldier's death, which entitled his wife to a cushy pension. But instead of turning the evidence over to the grieving family, Holmes held the bones of the dead man hostage. He tried to extort the widow, demanding she pay an extra fee for the bones to be returned.

Unfortunately for Holmes, the autopsy report was enough evidence for the widow to claim her pension without paying him. Needless to say, the stunt didn't win him any goodwill with his landlord. He began pressing homes even harder for the back rent he was owed. Holmes could feel the walls closing in. So in the dead of night, he fled to New York to escape his debts and made for Pennsylvania. We don't know a lot about this period in Holmes's life, but it's clear that he badly needed money.

He later claimed that starvation was staring him in the face, willing to do anything he could to earn some cash and never able to resist a get rich quick scheme. Holmes began discussing insurance fraud with an old college friend.

Their grand idea was to fake the death of a third individual, a friend of Holmes who had a wife and child. They would fabricate a crime scene and make it look as if the third friend had killed himself and his family. Then Holmes would collect the life insurance and split the take evenly between them. In practice, the plan was convoluted, and unsurprisingly, the schemers soon ran into problems.

In the course of researching the scam, Holmes read a book on the insurance industry. To his surprise, he learned that the companies had sophisticated methods for detecting fraud and investigating bodies unless he found cadavers, which matched the physical description of his friend. Exactly.

The companies would refuse to pay out by the mid eighteen, hundreds of autopsies were becoming more sophisticated with the addition of toxicology investigations. As autopsies were becoming more sophisticated, it would have been harder to lie on a death certificate.

Today, there are four major steps involved in an autopsy.

First, the bodies photographed, then it's examined externally fingernails, hair, skin lesions, followed by an internal examination of the chest and abdominal organs.

And lastly, the brain. After the autopsy, the organs are weighed and biopsied and then taken away for further study. The point in an autopsy where we were more likely to find that there was fraud would be in the examination of the heart and the brain, because these are the areas where we would generally see an acute cause of death from an exclusion of one of the blood vessels in one of these two organs. Life insurance carriers also began scrutinizing death certificates around the late eighteen hundreds challenging dishonest reporting to deny fraudulent claims.

As such, it became harder to forge a cause of death. Fooling a medical examiner became increasingly tougher.

In May of 1886, Holmes realized his original plan was impossible to pull off, though he never forgot the core idea. In the meantime, he had more immediate concerns with creditors hounding him, 25 year old homes started bouncing from city to city. He would look for work for a while, then leaves the state whenever his debts piled up. During this period of hectic travel, homes underwent a market change. For years, he had been devious and unscrupulous, but rarely subtle.

After years of struggling to make friends, he finally learned the value of superficial charm. He started putting more effort into his appearance and perfected his ability to lie off the cuff. The man that emerged was almost unrecognizable. H. Holmes gradually became an extroverted gentleman thanks to his new persona. At some point around 1885, Holmes charmed a woman named Merta Belke Knap. She was quick witted, independent and eager to travel, which suited Holmes perfectly. She and Holmes were soon engaged, likely marrying in mid 1886 after they settled down in Chicago, of course, because he was still legally married to Clara.

This marriage was by all means off the books.

Homes found that he could remain anonymous in such a big city, allowing him to easily stay ahead of potential creditors and carve out a place for his new family. With that in mind, Holmes came up with a new scam almost as soon as he moved to Chicago by turning on the charm.

Holmes discovered that the couple running a local drugstore were in over their heads and struggling to make a profit, pretending to be an experienced businessman. Holmes offered to help manage the store for them. The naive couple took him up on his offer. Almost immediately, he began helping himself to the store's stock, stealing bits and pieces of equipment nearly every day. It was all a part of a master plan to tank the store's value even further within just a few months.

Holmes was able to buy the pharmacy for a fraction of what it had been worth.

Holmes was elated by his success now that he'd given up any pretense of being himself. He leaned even further into his role as a charming business mogul and committed a slew of petty crimes. He settled into a routine of creating phony businesses to attract investors, making grand promises and then making off with their capital and never paying it back to homes. It was all a game and rules were irrelevant. After all, if someone was stupid enough to believe that a 25 year old doctor was also an ingenious inventor, then they deserved to have their money taken.

In early 1887, he used his ill gotten gains to purchase a plot of land right across from the drugstore and construct a new two storey building there. The first floor was earmarked for retail establishments, including a new drugstore. While the second floor was to be filled with apartments. Holmes told the contractors he intended on becoming a landlord and real estate mogul. But even the first blueprints included some eyebrow raising features.

For instance, in the back of the new drug store, Holmes placed a small secret room between the first and second floors. He also installed a hidden staircase. The entrance to this staircase was found behind a trapdoor in the bathroom on the second floor. Eventually, the building would grow to be one of the most notorious in all of Chicago. But at the time, most people who knew Holmes only found him to be odd and a little untrustworthy rather than downright evil.

It was yet another testament to Holmes's growing charm. He was already adept at using his authority as a doctor to earn people's trust once he added the title of respectable landowner to his resume. People were more inclined to write off his disturbing qualities as simple eccentricities. In fact, they played into the persona of ambitious genius he sought to cultivate.

As construction wrapped up and homes began staffing his new drug store, he hired a dozen or so employees. It didn't take long for them to realize their boss was not everything he seemed. For instance, Holmes's housekeeper claimed he often told her he was going out of town for the weekend, only to show up skulking around the building at night. Whenever she caught him, he always made an excuse about his plans being canceled, but they never seemed particularly believable.

What Holmes was up to at night is impossible to know. He was constantly dodging debtors' and dreaming up new schemes to defraud investors. The custodian at his drug store once said Holmes owned a collection of false mustaches and disguises. High genes like these were odd, but they were nothing compared to what Holmes was truly capable of. As far as we know, his schemes from 1886 to 1889 were mostly nonviolent, a convoluted series of shell companies and phony business dealings.

But Holmes still nurtured a secret obsession with the dead and fantasized about dissecting bodies. It wasn't long before he crossed the line and began treating the people closest to him like test subjects. Soon he would cut into a person who had died by his hand. Up next, Dr. H.H. Holmes commits his first known murder now back to the story. By 1889, 28 year old Dr. H.H. Holmes was losing his ability to distinguish fact from fantasy, using an intricate web of fake contracts, shell companies and shady business practices, Holmes had purchased a small retail and apartment complex in Chicago.

His wife, Merta, had no idea her husband was a criminal or that his eyes were wandering to her. Holmes appeared to be the perfect family man. He expertly shielded her from his criminal ventures. And in mid 1889, the couple welcomed a daughter, Lucy, into the world. But at the same time, Holmes was cheating on Merta with one of his employees, a cashier named Julia Connor. Holmes saw Julia for two years, but by the end of 1891, he got bored of her.

Afraid for his reputation.

Holmes didn't want to simply break up with his mistress. Instead, he settled on more drastic means of cutting her out of his life.

On Christmas Eve, Julia and her six year old daughter Pearl, had dinner with another family who boarded at Holmes's building, The Crows, they said that Julia spoke to them about travelling to Davenport, Iowa, to attend her sister's wedding. She was looking forward to the trip and told her friends that she wasn't planning to leave until after Christmas.

Yet after she left the crow's apartment, no one ever saw Julia or Pearl again. It seems that Julia was keeping more than one secret from her friends. Homes later claimed that he had gotten her pregnant. When Julia told him, he panicked. He insisted that they would have to terminate the pregnancy. It wouldn't be good for either of them if news of their affair got out.

Holmes convince Julia to meet him in his office on the night before Christmas to undergo the operation, he promised Julia that with his medical knowledge, he could perform an abortion safely and covertly. But Holmes had never even attempted surgery like this before.

When we look at Dr. Holmes practices, we see several areas where there was room for improvement going into somebody's abdomen. To do a procedure that you've never done without. A full understanding of the anatomy is a very dangerous undertaking. With any operation, there's always some risk of infection and your odds go up by 30 percent during abdominal surgeries. The abdomen is a highly vascular part of the body. So operating in this area is very risky since blood vessels can easily be damaged.

This increases the risk of complication and death regardless of surgical intentions.

He was putting his own needs before those of his patient knowingly putting Julia's life at risk. In the dead of night, Julia arrived at Holmes's makeshift operating room, lightly lit by lamps without much more than a wooden table to lie on in later years. Holmes insisted that he had genuinely attempted to perform the abortion but had failed. If that's true, it wouldn't be surprising considering his lack of experience. On the other hand, it's possible he never intended to operate on Julia in the first place.

He may have just wanted to get rid of her to hide the evidence of his affair.

Her upcoming trip to Illinois provided the perfect cover. No matter what led to Julia's death, Holmes was once again excited to have a dead body on his hands, he took his time dismembering Julia and burning her corpse in a large furnace he'd installed in the cellar. But what happened next was even more tragic, a display of cruelty that was remarkable even for H.H. Holmes. Holmes didn't stop after disposing of Julia's body. Her six year old daughter Pearl was still alive, snoozing in their apartment.

Holmes wanted her gone in the earliest hours of Christmas morning. Holmes snuck up to Julia's apartment and murdered her child.

While he never provided details, it's likely Holmes either poisoned or drugged the girl, considering he would have had anesthetic at hand anyway. It's possible he used that to kill. It wouldn't have taken much for such a small child.

Holmes knew that even a small dose of anesthetic could stop someone's heart or breathing and knew that children were especially vulnerable to sedatives. Children are much more sensitive to anesthesia than adults, primarily due to their size, which increases their risk for complications that can lead to a respiratory arrest.

Despite these scary complications, the odds of dying under anesthesia are only about one in 100000. These odds can increase depending on the type of surgery, the skill set of the doctor and the personal reactions to specific anesthetics. There's also no obvious external signs of a death from anesthesia.

A resulting death would only be made apparent through a toxicology report once Julia and Powell were out of the picture, Homes hurried to give himself an alibi. By the end of Christmas Day, he'd already boarded up their apartment. He told the neighbors that Julia had gone off to Davenport early and did his best to lie low, putting a temporary stop to his many scams to cover his tracks. Holmes pretended to be just as confused as everyone else. He claimed he was worried for Julia's safety and even wrote letters to her friends and family asking if they knew where she was two months after he killed them.

Holmes contacted Julia's parents to ask if she was in Davenport. It was nothing but a ruse. Holmes knew he was torturing Julia's loved ones by asking after her whereabouts to deflect suspicion from himself. Even further, he started spreading wild rumors that Julia had run off with a mystery man to another state.

None of it caused him any remorse the minute Holmes felt sure he wasn't suspected in Julia and Pearl's disappearances. He went back to his life of petty crime. He sold Julia's apartment to another renter, leaving most of the furniture and decor exactly where it had been before they died. Then he embarked on another scam, a more complicated adventure than usual. He recruited a young typist, Emmeline Sergant, to help him set up yet another fake company. But as usual, Holmes had more than one iron on the fire and plenty of ulterior motives.

He didn't just plan to have Emmeline do some work for him. He wanted her to replace Julia in time. Just like Julia, the young woman would fall into the same traps, be caught in the same intricate web of lies and eventually share the same fate. Next time on medical murders, H.H. Holmes is killing spree kicks into high gear using his medical knowledge. Holmes commits what he believes to be the perfect crimes, and he was determined there wouldn't be any loose ends.

Thanks for listening to medical murders. And thanks again to Dr. Kipa for joining me today. Thanks, Alistar.

This was very enjoyable and I look forward to seeing what ultimately happens with Dr. Holmes.

For more information on H.H. Holmes, among the many sources we used, we found the book H.H. Holmes The True History of the White City Devil by Adam Sulzer. Extremely helpful to our research.

You can find all episodes of medical murders and all other podcast originals for free on Spotify. Not only does Spotify already have all of your favorite music, but now Spotify is making it easy for you to enjoy all of your favorite podcast originals like medical murders for free from your phone, desktop or smart speaker to stream medical murders on Spotify. Just open the app and type medical murders in the search bar. We'll see you next time. Medical murders was created by Max Cutler and his Apakan Studios original.

It is executive produced by Max Cutler, Sound Design by Ron Shapiro with production assistance by Carly Madden, Kristen Acevedo, Jonathan Cohen and Jonathan Ratliff. This episode of Medical Murders was written by Terrell Wells with writing assistants by Maggie Admire and stars David Kipa and Alistair Murden.