Waltraud Wagner, a nurse's aide on the graveyard shift at Pavilion 5, was twenty-four years old when she set the ball rolling in 1983. As later reconstructed by authorities, she got the notion of eliminating patients when a 77-year-old woman asked Wagner to "end her misery." Waltraud obliged the lady with a morphine overdose, discovering in the process that she enjoyed playing God, holding the power of life and death in her hands. It was too much fun to quit, too nice to keep from sharing with her special friends.

Over time, Wagner recruited three accomplices, all working the night shift at Pavilion 5. Maria Gruber, born in 1964, was a nursing school dropout and unwed mother. Irene Leidolf, two years older than Gruber, had a husband at home but preferred hanging out with the girls. Stephanija Mayer, a divorced grandmother twenty years Waltraud's senior, emigrated from Yugoslavia in 1987 and wound up at Lainz, soon joining ranks with her murderous cronies.

As described by prosecutors at her trial, Wagner was the sadistic Svengali of the group, instructing her disciples on the proper techniques of lethal injection , teaching them "the water cure"--wherein a patient's nose was pinched, the tongue depressed, and water was poured down the throat. The victim's death, while slow and agonizing, appeared "natural" on a ward where elderly patients frequently die with fluid in their lungs. In the police view, "Wagner awakened their sadistic instincts. Soon they were running a concentration camp, not a hospital ward. At the slightest sign of annoyance or complaint from a patient, they'd plan the patient's murder for the following night."

"Annoyances," in Waltraud's book, included snoring, soiling the sheets, refusing medication, or buzzing the nurse's station for help at inconvenient times. In such cases, Wagner would proclaim, "This one gets a ticket to God," executing the murder herself or with help from one of her accomplices.

Even with four killers working the ward, it took some time for the deadly game to accelerate. Most of the homicides linked to Wagner and company occurred after early 1987, when Mayer rounded out the team, but Waltraud remained the prime mover and head executioner for what was soon nicknamed "the death pavilion." Rumors of a killer at large on Pavilion 5 were widespread by 1988, and Dr. Xavier Pesendorfer, in charge of the ward, was suspended in April 1989 for failure to launch a timely investigation.

Still, it would be negligence among the killers that led to their ultimate downfall. Waltraud and her cohorts liked to have a few drinks after work, reliving special cases that amused them, chuckling over this victim's dying expression or that one's convulsions. In February 1989 they were giggling over the death of elderly Julia Drapal--treated to the "water cure" for refusing medication and calling Wagner a "common slut"--when a doctor seated nearby picked up snatches of the conversation. Horrified, he went to the police, and a six-week investigation led to the arrest of all four suspects on April 7.

In custody, the "death angels" confessed to forty-nine specific murders. Wagner allegedly claiming thirty-nine of her own. "The ones who got on my nerves," she explained, "were dispatched directly to a free bed with the good Lord." It was not always simple, she allowed: "Of course the patients resisted, but we were stronger. We could decide whether these old fogies lived or died. Their ticket to God was long overdue in any case."

There was immediate speculation on a much higher body count, Wagner's accomplices pointing guilty fingers at their mentor in a bid to save themselves. Alois Stacher, head of Vienna's health department, quoted Irene Leidolf as being "convinced that 100 patients were killed by Wagner in the past two years." Stephanija Mayer admitted helping Wagner out on several homicides that Waltraud managed to forget.

Indeed, as the case progressed to trial, Wagner became increasingly reluctant to discuss her role in the murders. By late 1990, she had backed off her original boast of thirty-nine victims, claiming a maximum of ten patients killed "to ease their pain." Chancellor Franz Vranitzky was unimpressed with the turn-about, calling the Lainz murder spree "the most brutal and gruesome crime in Austria's history."

Nor were judge and jury sympathetic when the four defendants went to trial in March of 1991. Prosecutors failed to sell their case on forty-two counts of murder, but they proved enough to do the job. Waltraud Wagner was convicted of fifteen murders, seventeen attempted murders, and two counts of aggravated assault, drawing a sentence of life imprisonment . Irene Leidolf also got life, on conviction of five murders and two bungled attempts. Stephanija Mayer earned fifteen years for a manslaughter conviction and seven counts of attempted murder, while Maria Gruber received an identical term for two murder attempts.