There are plenty of serial killers whose names are infamous in America: Ted Bundy, Jeffrey Dahmer, John Wayne Gacy … but some serial killers don’t reach a level of notoriety despite staggeringly high body counts and evil methods. Consider New Jersey’s most prolific serial killer, Charles Cullen, who killed at least 22 people and maybe as many as 40. He was only sentenced to prison in 2006, and yet not many people know about him.

That’s likely because Cullen didn’t attack strangers in the night or hide bodies in his home. Instead, Cullen was in many ways scarier: a young nurse who appeared kind and caring, but was instead murdering his patients.

New Jersey’s most prolific serial killer didn’t use guns or knives to kill.

zodebala via Getty Images Instead, he was a critical care nurse who injected drugs like insulin and digoxin.

Charles Cullen ended up killing at least 22 of his patients — although he’s said himself the number might be as high as 40.

John Wheeler / Stringer via Getty Images

Cullen claimed he killed his patients to end their suffering — but in reality he often just made them experience more pain.

John Wheeler / Stringer via Getty Images He also claimed he committed the murders in a fog and couldn’t remember them afterward.

Cullen murdered all these people during his 16 years working as a nurse.

John Wheeler / Stringer via Getty Images 13 of his victims were at Somerset Medical Center, five at Hunterdon Medical Center, one in Essex County and three at Warren Hospital. He also killed seven people in Pennsylvania.

He was eventually given multiple life sentences for his string of horrific murders.

John Wheeler / Stringer via Getty Images He remains behind bars to this day.

The tragic memory of his shocking killing spree remains, though.

AleksandarNakic via Getty Images A Netflix movie about the killer nurse is in the works.

Had you heard of Charles Cullen before?

zodebala via Getty Images

Instead, he was a critical care nurse who injected drugs like insulin and digoxin.

John Wheeler / Stringer via Getty Images

John Wheeler / Stringer via Getty Images

He also claimed he committed the murders in a fog and couldn’t remember them afterward.

13 of his victims were at Somerset Medical Center, five at Hunterdon Medical Center, one in Essex County and three at Warren Hospital. He also killed seven people in Pennsylvania.

He remains behind bars to this day.

AleksandarNakic via Getty Images

A Netflix movie about the killer nurse is in the works.

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