The symbolism of unprofessionalism
The author figuratively uses the character Charles Cullen as a symbol of unprofessionalism. The profession of medicine requires people who are dedicated to humanity because their primary role is saving lives. Paradoxically, Cullen is a nurse who does the contrary because his primary objective is intentionally killing his patients. Cullen has killed over four hundred since he became a nurse in the United States of America. The hospitals where Cullen has worked know he is a murderer, but they have done nothing to stop him.
The symbolism of impunity
Impunity is symbolized by the unwillingness of the police to act fast on the claims presented to them by Cullen's co-worker about his criminal activities. Cullen's co-workers used software to track doses administered by Cullen to his patients, and they discovered that he overdosed on his patients purposely to kill them. Later, Cullen's co-workers presented the evidence to the police. Still, the authorities were slow to act, allowing Cullen to run away and get a job in another hospital where he continued to kill incent patients.
Corruption in the hospital systems
Cover-ups of the hospital administrations symbolize corruption in the hospital systems to protect their reputations despite knowing their nurses were doing inhumane acts to patients. There is no single hospital administration where Cullen worked that came forward to press charges against him despite knowing that he murdered patients. Hospitals are only focused on protecting their reputations and generating profits at the expense of the lives of innocent patients.