Meet the Doctor Who Botched a Tennessee Execution for 75 Minutes

The Room That Looked Like a Hospital (But Wasn't)

According to The Guardian's investigation, Fowler entered the death chamber at Riverbend maximum security prison in Nashville last year to assist with the execution of Tony Carruthers, a 57-year-old man convicted of a 1985 triple murder he has always maintained he did not commit, and for which there was no forensic evidence. The IV team had already failed to find a usable vein. So they called in Fowler, a physician with 25 years of experience, to insert a central line, a catheter driven into the major vein beneath the collarbone.

Before applying the local anesthetic, Fowler asked the team whether "the patient" had any allergies. Carruthers' lawyer, Maria DeLiberato of the ACLU's capital punishment project, was standing a few feet away inside the chamber. She heard it. "He called Tony 'the patient,'" she told The Guardian. "And he was trying to kill him."

The drugs that would flow through that central line were a lethal dose of pentobarbital. There was no diagnosis being treated here, no prognosis to manage, no recovery room down the hall. The "patient" was strapped to a gurney. The goal of the procedure was his death. The medical framing wasn't incidental. It was the entire point.

Seventy-Five Minutes of Failure

Fowler could not get the central line in. What followed, as The Guardian reports, was an hour and fifteen minutes of the IV team and Fowler repeatedly piercing Carruthers in his arms, his feet, and his shoulder. Eventually, the state called the whole thing off. Tony Carruthers was unstrapped and returned to his cell, alive, making him part of an extraordinarily rare group: people who have survived a legal execution attempt in America.

Fowler, according to The Guardian's reporting, has participated in at least four executions in Tennessee. He was identified not through any investigative breakthrough but through a warden's mistake: the official inadvertently said Fowler's name aloud while announcing the execution of another death row prisoner, Byron Black, last August. Before that slip, Fowler had been shielded by the kind of state secrecy laws that most death penalty states use to keep execution doctors anonymous and therefore insulated from professional or public accountability.

Fowler's response to being subpoenaed by lawyers challenging Tennessee's lethal injection protocol was, let's say, revealing. He scolded his questioners during the deposition. "I certainly hope your office will handle this responsibly," he told them, according to The Guardian, "and that I won't be reading about myself in the Nashville Banner or the Guardian." Reader, he is now reading about himself in the Guardian.

Next Week, He Might Be Back in the Chamber

Tennessee has another execution scheduled. Darrell Hines, 65, convicted of a 1985 murder, is set to die by lethal injection next Thursday. Hines has suffered multiple strokes and is partially paralyzed, which means finding usable veins will be, at minimum, as difficult as it was with Carruthers. His lawyers have argued in court filings that allowing Fowler back into the death chamber would create, in their words, "an intolerable risk that [Hines] will experience severe suffering due to the use of insufficiently qualified medical personnel."

The Tennessee Supreme Court denied a motion that would have required the state to disclose whether Fowler will be on duty for the Hines execution. So the public, and apparently Hines himself, will likely not know until it's happening. The Guardian reports that Fowler is now expected to disappear back into the anonymity that the warden's loose tongue temporarily stripped away.

The Hippocratic Problem at the Center of Lethal Injection

This is the part where you have to step back and look at the whole architecture of what's happening here. Lethal injection was sold to the American public in the late 1970s as the civilized alternative to the electric chair. No more burning flesh. No more spectacle of the body convulsing against leather straps. Just a quiet, clinical, pharmaceutical death, administered in something that looked reassuringly like a hospital setting.

The problem, as The Guardian lays out, is that making lethal injection look like medicine requires actual medicine, which requires actual doctors, who are not supposed to kill people. The American Medical Association has prohibited physician participation in executions since 1980, two years before Charles Brooks became the first person executed by lethal injection in Texas. The Hippocratic Oath has explicitly warned against prescribing deadly drugs for roughly 2,500 years. As author Corinna Lain chronicles in her book Secrets of the Killing State, what this prohibition produces is a very small pool of what Lain calls "dissenters": doctors who are either ethically flexible enough or ideologically committed enough to bring their medical training into the death chamber anyway.

Fowler is one of those doctors. He is not a rogue actor operating outside the system. He is the system. He is what Tennessee's lethal injection protocol requires to function.

The Man Who Wants His Privacy Back

When The Guardian's reporter called Fowler on his cell phone, Fowler did not engage with the substantive questions. He described the situation as "private" and complained that "the lawyers are churning up a lot of nonsense." He is 68 years old, based in Union City, Tennessee, and has apparently been doing this work for years while remaining almost entirely unknown to the public.

His desire for privacy is understandable on a human level. It is also completely irrelevant. The state of Tennessee is conducting executions in the name of its citizens. The doctor carrying out those executions is a public actor performing a public function at public expense. The reason execution physicians get shielded by secrecy laws isn't to protect some noble principle. It's because states know that if the public could see clearly who was doing this work and what it actually looked like, the support would be harder to sustain. Fowler's unmasking didn't create the ethical problem at the center of lethal injection. It just made it impossible to look away from.